Cuticle Picking and What to Do About It

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As far as body-focused repetitive behaviors (BFRBs) go, cuticle picking often gets neglected, but it’s every bit a BFRB as picking your pores until they get infected or pulling your hair until it starts showing. In fact, it very well may be more common. About 75% of people who pick their cuticles are women, but we know that these statistics tend to be skewed because, to put it simply, women tend to be more honest about their mental health struggles than men. I could employ a more complex, academic way of explaining it, but it just boils down to that.

Just like other BFRBs, cuticle picking provides self-soothing and comfort. And just like other BFRBs, it’s away to cope with certain internal experience without having to acknowledge them. We may have thoughts, memories, or feelings we can’t tolerate and we “channel their energy” as it were into the act of picking and that allows us to get rid of the effects without acknowledging, accepting and properly processing the emotional causes. When this avoidant mechanism is at its best, clients come in with complaints like “oh, I am perfectly calm and I have no thoughts or feelings, I just do it.”

We can say that cuticle picking has two components. One is that it’s a habit. Only, habits aren’t random. To form a habit, it takes a lot of repetition, and we don’t repeat meaningless actions. The second component, therefore, is its avoidant component, and in order to treat cuticle picking both need addressing.

Body-focused repetitive behavior is a scary mouthful of a phrase. Is it necessarily a disorder? Perhaps some of my colleagues wouldn’t agree, but I would treat this as a problem only if my client treats it that way. Strictly physically speaking, picking your cuticles can cause skin infections, some of which can be rather serious. Another potential physical complication is that it can alter the shape of your nail because picking the skin just around your nail and, especially with an infection, can deform the nailbed, therefore causing irreversible damage.

I won’t go into all the details of how the treatment starts, how self-monitoring works, how identifying triggers work, etc. We’ve discussed this in the BFRB Club more than once. Instead, I want to offer a broad self-help framework that can help your skin heal relatively quickly and give you a fresh start – as well as a chance to really dive in and learn how to soothe yourself in healthier ways.

Skin hygiene

Cuticle picking is not something you’ll resolve in a day with no lapses or relapses. Unfortunately, even seemingly simple problems like this one don’t go away quickly. Habits take time to establish and take even more time to change. So while you still pick, you have to take proper care of your hands and nails.

After every picking episode, wash your skin with warm (but not hot) water for about 30 seconds and use a gentle, neutral soap. If there was any bleeding or any redness remains, apply a topical antibiotic.

Skin healing

Scabs and rough skin that picking leaves behind is usually a cause for even more picking so taking care of your skin and helping it heal properly is imperative. Applying hydrocolloid patches everywhere where you pull will help your skin heal faster. Supplements like vitamin C can be helpful as they can help your skin heal slightly faster.

However, the real work of healing is something that you might resist – but do give it your best shot. Purchase a box of latex gloves and whenever you’re home, use them. They will physically prevent you from picking and that alone will allow your skin to heal faster. In addition, before putting on the gloves, you can apply a hydrating cream in a thick layer or Vaseline. Those two will properly hydrate your skin and further help it regenerate. Instead of gloves, you may consider finger covers. They are affordable and readily available. It might take a week or two for your skin to heal.

It's especially helpful if you wear gloves with a hydrating cream/Vaseline over night – every night.

Stimulus control

Gloves and finger covers act as a kind of stimulus control, creating a mechanical boundary that prevents you from picking your cuticles. So even though your skin may have healed, there is a lot of value in wearing them. When you can’t wear them, you can put band aids on your fingers or small hydrocolloid patches to prevent yourself from unconsciously continuing to pick at your cuticles.

Alternative behaviors

Until you get some healthier coping skills and learn how to process emotions - and if you’re thinking about resolving this issue permanently, this is definitely something you can’t do without – it is useful to have something else to fidget with. Worry stones are typically small and easy to carry around and spinner rings are actual jewelry that can look cool and always be available. Have them with you or on you all the time. Don’t make excuses for yourself.

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The procedure outlined above will be useful if you apply it diligently and with discipline, but it won’t resolve the problem forever. Because cuticle picking, just like other BFRBs is a form of avoidant behavior and because emotional states like boredom, stress, anxiety, anger, discontent, etc. are going to be present in your life just like they are in my life or everyone else’s, it’s imperative to work on developing these skills.

Take this as anecdotal evidence, but in the past, I’ve had clients who would stop one BFRB using these behavioral methods and would then give up on diving deeper or even developing better coping skills. Some of them would develop other BFRBs like onychophagia (nail biting), trichotillomania (hair pulling), etc. Some have even developed more intense symptoms of anxiety such as panic attacks!

The “simple” model I suggested above does work, only it has its limitations, so approach it with that in mind.