Treating scarring caused by skin picking: guest post by dermatologist Dr. Sasi Attili

I know scarring is a concern for many skin pickers. Even when you are successful in stopping or continually reducing your picking, it can be disheartening when scars remain. Today I bring you a guest post from dermatologist Dr. Sasi Attili. Here, Dr. Attili outlines several medical options that are available to treat scarring:

Treatment For Skin Picking scars

Compulsive skin picking (CSP), also called excoriation disorder, dermatillomania, and a variety of other names, is a condition which usually leads to skin damage. The skin damage often results in scarring.As you know, scarring can be bad for your self esteem. Human beings are visual creatures and we often judge and treat people based on how they look. So, what scar treatment options are available for CSP sufferers?

1) Local steroids

Intralesional steroid injections are effective in treating hypertrophic & keloidal scars. These injections are given every two to six weeks and are quite effective.

2) Pressure (occlusive) dressings

Pressure dressings not only prevent sufferers from getting to their skin, but pressure has also been shown to help reduce the prominence of thick scars. The dressing is done for twelve to twenty four hours daily over a number of weeks.

3) Steroid creams

If the scar is swollen or red, a potent steroid like clobetasol propionate has the effect of calming the skin through absorption by skin cells where it reduces inflammation.

4) Skin Lightening creams

2-4% Hydroquinone in combination with isotretinoin and steroid creams (eg. Triluma cream), is very effective in treating hyperpigmented scars and hyperpigmentation caused by skin picking. This should be used only under a Dermatologist’s supervision as hydroquinone itself might induce pigmentation if used excessively.

5) Laser

If steroid and lightening creams do not work, consider going for laser skin resurfacing. Today’s fractionated laser technology is able to even out skin surface and to improve the formation of collagen. It only takes between one and three sessions to get the desired results. You could go for non-ablative lasers or ablative laser. The non-ablative laser works by stimulating collagen production without damaging the surface of the skin while ablative laser (made up of erbium and carbon dioxide) works by vaporizing the scar so that smoother skin can replace it. You could also go for pulsed dye laser which involves the use of a laser that is absorbed by the blood vessels around the scar and which destroys them so that they do not feed the scar. This is particularly effective in treating red scars.

6) Filler treatments

Skin picking sometimes leads to deep scars. You could go for filler injections to fill the indentations left. You should, however, note that you will need to go for filler injections twice or thrice a year since the filler is re-absorbed into the skin with the passage of time.

7) Polyurethane patches

The use of adhesive hydroactive polyurethane at least twelve hours every day can help reduce scarring in around ten weeks. The patch is effective in reducing redness, roughness, elevation, and the feeling of itchiness and tension.

8) Silicone gel

You could apply silicone gel as a gel-impregnated sheet or as a topical gel to reduce scarring. However, despite a number of studies suggesting benefit, the author has not found this mode of therapy particularly useful.

9) Cryotherapy

Cryotherapy is often used in combination with other techniques to prevent the growth of early-stage keloids.

10) Surgical Excision

Particularly useful for deep/ ice-pick scars, where the above modalities usually fail to work.

11) Microneedling/ Dermaroller

Usually only works for superficial acne scars, but can be combined with any of the above treatments.

Regardless of the treatment you opt for, remember that scar tissue is sensitive, and it is very important to use a SPF>30 sunscreen at all times and keep away from direct sunlight!

About the Author:

Dr. Sasi Attili is a Consultant Dermatologist, Dermatosurgeon & Dermatopathologist based in the UK. He runs an Online Dermatology Consultation service, helping millions of sufferers worldwide. Follow him on twitter: @online_skin

P.S. While this article is about medical treatments, here's a post about effective inexpensive home treatments.

Scars won’t fade if you keep making them! If you’re picking your skin and can’t stop, learn how to stop picking first.