Zit Picking: Sign of ADHD

Last week, sitting in the dermatologist’s office with my teenage daughter, I had to face my childhood demons.  I had acne as a child, and now, so does my beautiful daughter.  I twinge when I consider my genetics  gave her this battle with acne, that is more painful psychologically than physically.  Unlike my parents (it was different time, 30 years ago), I am determined she will not live my teenage experiences, and so we were in the dermatologist’s office, again.  The Epiduo he prescribed had not stopped the pimples.

Dr. Dermatologist bounced into his examine room, took one look at my daughter and said simply, “Here is an awkward question: has she been evaluated for ADHD and anxiety?”  My mouth feel open.  Acne excoriee is also known as picker’s acne. The condition starts with an acne outbreak usually during the adolescent years, when the body is undergoing major hormonal changes and at a time in life when even the little things seem big. It’s almost impossible not to “poke, prod, and squeeze a bit.”

The problem with picking acne blemishes is that it can cause infection to set in, causing a bigger blemish. Another problem is that it’s unsightly, more so to the victim facing it every morning in the mirror, than to family and friends. When the acne blemishes occur on the face of someone experiencing episodes of self-doubt, emotional turmoil, or low self-esteem, common problems for girls coping with ADHD, picking the blemishes can lead to a disturbing self-perpetuating obsession, a vicious cycle of eruptions, picking, and open sores.

I was a notorious picker, an insecure anxious teenager.  I always blamed my parents for not aggressively pursuing treatment for my skin.  I am learning now- my acne was, a complicated issue, more about treating my anxiety and ADHD, than just my acne.

There is very little research out there about this connection between acne excoriee and ADHD.  One study, suggests substitution behavior training to redirect picking behaviors to manipulatives has been effective.  Other treatment suggestions include the use of anti-anxiety medications, selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, sertraline and fluvoxamine.  I find it disappointing that no one to date has looked at the process of raising self-esteem and self-confidence as a method of breaking this acne picking cycle.

To date, we are uncertain if  we will pursue prescription medication.  We have and continue to address her ADHD. She is working on substituting her picking habit for another more-acceptable fidget behavior, in hopes of sparing her complexion.  Our bigger challenge will be addressing her self-esteem, and self-confidence, now I understand that we need a psychological treatment more than a topical one.

One Response to “Zit Picking: Sign of ADHD”

1. Karrie Muston says:

   August 24, 2011 at 12:00 pm

   Acne nodules are definitely probably the most terrible skin illnesses that can crush one´s social life