Skin Picking Treatment: Options and What Actually Helps

Skin Picking Treatment: What Actually Helps

If you have reached the point of searching for skin picking treatment, you have probably already tried the obvious things: covering the skin, hiding tools, "just stop when you notice." When those have not been enough, it helps to understand what treatment actually targets.

This guide walks through the main options available in Australia, where clinical hypnotherapy fits, and what a course with Paul or Rebecca Smith at Norwest Wellbeing typically involves.

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What treatment actually targets

Effective habit-level work is not only about covering marks. The pattern usually includes one or more of:

• A cue that starts the pick (stress, boredom, a visible bump, concentration)
• A hand or tool that arrives before a decision feels available
• Shame afterwards, then the same cue next time
• Rules that last days, then fail

If the main behaviour is pulling hair, start on the trichotillomania page. If the main behaviour is biting nails, use nail biting. If the main picture is obsessions and rituals, use OCD.

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Map of approaches in Australia

These are not mutually exclusive.

GP and dermatology. First stop if there is infection, spreading wounds, or a skin condition that needs medical treatment. Hypnotherapy does not replace that care.

Habit reversal training (HRT) and CBT. The best-studied behavioural approaches. Teng, Woods and Twohig (2006) compared habit reversal with a wait-list in 25 adults with chronic skin picking. Habit reversal produced a greater decrease in picking at post-treatment and three-month follow-up. It depends on catching the urge early, which is hard precisely because the habit is often unconscious.

Clinical hypnotherapy. Aimed at the automatic loop. Complementary to HRT and medical care, not a substitute. See the skin picking hypnotherapy page.

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How hypnotherapy helps

A session with Paul or Rebecca Smith starts with a non-judgemental conversation about your actual cues, then guided relaxation and suggestion aimed at those situations. You stay aware throughout.

The practical aim is a quieter automatic pull and a more available alternative when the cue arrives. It is not a claim that hypnosis rewires the brain on a scan, and it is not a promise of complete cessation after one session.

Lochner and Stein (2017) reviewed treatment options for excoriation (skin-picking) disorder. They noted that hypnosis has been proposed, and that no randomised trials of hypnosis for this condition had been undertaken. That remains the honest research position.

Norwest Wellbeing's own reported outcomes sit in a 75-85% range for many people within 2-5 sessions. That figure is clinic-reported, not a research finding. Results vary.

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What a course at Norwest involves

Paul or Rebecca Smith. Clinic at Baulkham Hills, or Zoom Australia-wide.

1. Assessment. Cues, what you have already tried, and whether hair pulling, nail biting, or OCD is the better page.
2. Sessions. Most people need 2-5. Later sessions review real situations and adjust the work.
3. Between sessions. Notice the cue. Use the response you practised. A personalised audio is available at /hypnosis/skin-picking.

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Who it suits

It suits adults whose picking is automatic, has lasted months, and has not held with covering the skin or hiding tools.

It does not suit someone who needs medical care for infection first, or whose main job is hair pulling, nail biting, or OCD rituals.

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Frequently asked questions

How many sessions will I need? Most people need 2-5. You will get a realistic view after the first conversation.

Can I do this on Zoom? Yes. The clinical process is the same. Book in clinic if home is not private.

Will the scars go? Many people pick less once the cue quiets, which gives skin a chance to heal. Scarring already present may still need dermatology. That is not the promise of this page.

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Next step

Read what skin picking is, try the screening quiz, or book from the skin picking hypnotherapy page.