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Eric S.

Help! Just popped a huge cyst, need coping techniques

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Hello, everyone. I'm Eric, new to these forums. Without giving too much away about myself, I am a PhD student in political science at a major American university.

For about five years I have struggled with body dysmorphic disorder. I went on Accutane in fall 2006 despite my mild acne because I was paralyzed with fear about having acne. 18 months after Accutane, I started getting a few pimples again, but this time I started picking them really badly -- to the point of needing antibiotics to stop infection. I've worn more bandages out in public than any reasonable person should.

I thought I had this problem under control when my acne seemed to go away again, over the past six months or so, but now I just realize that was because the antidepressant I was on was suppressing my hormonal equilibrium and decreasing the acne I got. Weird, huh? Anyways, the other day I got a HUGE cyst on my left cheek. At first I tried very hard not to touch it -- very hard, was able to stop the impulse for about a day and a half while I made a few dermatological appointments.

Needless to say, at some point temptation gave in and I squeezed for about 30 minutes, getting as much out as I could. The result was that my cheek on the left side looked completely, totally inflamed and blood-red. Later that evening when I saw that the pimple really hadn't gone away, I literally gouged it out of my skin. Very painful but somehow stress-relieving at the time.

Now, about 36 hours later, the redness on my cheeks has gone down to the point where it isn't really an issue, but I'm left with a large black/brown/red crusty scab about the size of a nickel. It's flat, which is good, and I know I'm not going to fiddle with this, but herein lies my dilemma: This is my first major skin-picking episode after moving to a new city, among new colleagues, and I have a vested interest in making sure those people do not know that I pick my skin obsessively. I have a feeling -- just a hunch -- that this episode was bad enough that I won't be picking for a while. But at the same time, I feel compelled to stay inside until this damn scab falls off -- which, based on past experience, should be in about six days.

During those six days, I'm trying to cope as best as possible with the isolation. I've set a six-day countdown on my computer and told myself that I only get to look at the scabby area once a day. And I've also told myself that when those six days are up, I'm going to go face the world again no matter how I look. One option that I could use is to wear a bandage over the area, but I suspect the people around me would guess what had happened, based on my generally neurotic disposition. So for now, I've told my colleagues I'll be working from home this week (not a terrible idea in academia) and have brought all my work home with me. I'm really poised to just "camp out" until this is gone.

I just sent away for Dan's Regimen for the first time, but of course I know not to use it on any area that is inflamed and has been picked recently.

How do I avoid picking in the future? What are some of your tips? I am on medication for OCD and anxiety, which clearly didn't help stop this recent very serious skin-picking episode. I just want my skin to heal so badly but at the same time I know that the next blemish that comes up will be just as tempting. Worse still, perhaps, I have a dermatologist in the area to whom I was recently referred who would be willing to put me back on Accutane because of the psychological stress I'm having about acne -- but that's a nuclear option I don't want to use unless I absolutely need it, since Accutane would for a few months just give me more bad skin to worry about...

Interested in any advice anyone here has, both about coping with this recent skin-picking episode and healing emotionally after my skin has healed physically.

Edited by Eric S.

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I had a really bad episode a few months back, one that required antibiotics, both oral and topical.

I am now currently on accutane.

While I don't have a severe problem, I traumatized the hell out of myself.

I swore I would never pick like that again, and I haven't. Now, I do extract when appropriate, and believe me, there are appropriate times. However, to ensure I never feel that bad for so long again, I took pics to reference just how bad it was. For me, in the heat of the moment, I tend to tell myelf I'd rather have a scab now than an infection. It doesn't always turn out so well.

The other thing I did, which may or may not work for you, was to put a note on the bathroom mirror. I have a very young daughter, and my revelation was, would I do that to her? No. Not at all. So the note on my bathroom mirror reminded me to treat my skin the same as I would my daughter's.

Hope this helps :)

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A note on the mirror! Now there's a very cool, practical idea-- especially since I live alone.

I had a really bad episode a few months back, one that required antibiotics, both oral and topical.

I am now currently on accutane.

While I don't have a severe problem, I traumatized the hell out of myself.

I swore I would never pick like that again, and I haven't. Now, I do extract when appropriate, and believe me, there are appropriate times. However, to ensure I never feel that bad for so long again, I took pics to reference just how bad it was. For me, in the heat of the moment, I tend to tell myelf I'd rather have a scab now than an infection. It doesn't always turn out so well.

The other thing I did, which may or may not work for you, was to put a note on the bathroom mirror. I have a very young daughter, and my revelation was, would I do that to her? No. Not at all. So the note on my bathroom mirror reminded me to treat my skin the same as I would my daughter's.

Hope this helps :)

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Very simple update. I just picked off some loose kind-of scabby material around the main nickel-sized scab on my cheek, which I have not picked -- it's still red and fleshy under the spots I picked (couldn't help myself :( ), but not broken skin, which is a good thing. So I need to just tell myself that I won't look at my face for the next 24 hours. Just set a timer. 23:59:30 to go...

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how abut wearing a bandage or surgical tape over it when you're at home, so you can't see it? i've done that when i've been home alone and had the urge to pick. it works for me, because i always run my fingers around the affected areas to "check" the healing, which is really counterproductive, because it almost always makes me want to pick the scab. if i have tape over it i can't feel it, and the unusual feeling of the tape reminds me to move my hand away.

and another thing, which i mean in the most non-aggressive and nice way: your medication will never stop you from picking. don't think it'll do it for you. you still have to fight the fight. the medicine might be very helpful in dealing witht the emotional stuff, but it's still about you saying "fuck you ocd" and stepping back from the mirror when you feel that urge to pick.

breathe, do yoga. yes, super-hippie, but it works. laugh at silly movies, make really good food. talk to someone on the phone. do good things for yourself and forget about that stupid scab for a little while.

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I think I had that happen a month ago where I picked at my skin, and I felt like I needed to hide for a few days. It really is the worst. I'm so OCD about my skin too. It's horrible. I will obsess about a pimple if it's an obvious bump, yet I think picking and squeezing the heck out of it will make it look any better.

If this ever happens again, you should try putting polysporin on the spot 24/7 for a couple days. If I do that, the spot will usually be a lot better by 2-3 days later. Or at least to a point where the skin's not raw or broken. Plus it prevents infection and helps prevent scarring.

Next time, try waiting until you get to a derm to extract it. That's what I try to do now.

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