My husband picks at his skin constantly. How can I get him to stop or how can I learn to live with it?

oaoos, time to take hubby to see a dermatologist, to see if this is a skin issue or if it is a nervous habit.

Hope it is something as simple as dry skin which can itch like crazy until lotion is placed on the skin. See if you can trim his nails as short as possible.

This is a common dementia symptom. There are mitts that you can purchase for this purpose. Also, there are fidgit 'toys' that are available for dementia patients that allow them to fidgit without hurting themselves. 

Excoriation (skin picking disorder) is not limited to people with dementia. Dementia may make the treatment more complicated. For example, if your husband hated the habit and wanted to stop and decided to wear gloves that might be helpful. But if he doesn't remember that he is trying to stop, gloves you've given him might not work as well.

I agree with ff that a visit to a dermatologist is a good start, to make sure there isn't a physical cause for the picking. Excoriation is classified as an OCD disorder. Seeing a mental health practitioner would be my next step. Definitely shop around until you find one with experience in treating OCD behaviors -- experience in excoriation would be great but may not be easy to find.

Antidepressants of the selective serotonin reuptake inhibitor (SSRI) type are sometimes tried. That includes Zoloft, but there are several other SSRIs available. Since Zoloft didn't work, I'd ask to try a different one. (This kind of try-and-try-again approach is not at all unusual.)

I sincerely hope you can avoid isolation, for both of your sakes. I'd try a few more things before I'd give up!

If you'd like some background information on the Skin Picking Disorder, try WebMD.com.

Neurologist, dermatologist,PCP offer no help. And I really don't think he would see a psychologist or psychiatrist. When I call the behavior to his attention, he waggled his fingers at me as if it is funny or cute.

One treatment that does work is the use of a steroid cream, like Betamethazone or Chlobesterol. Both prescription and quite expensive. You apply the cream and cover with plastic securely taped down to exclude the air and leave on overnight. it seems to kind of dissolve the lesions and they eventually clear up.
There seem to be many reasons why people pick like this and you have tried to help but ran into a brick wall. Is there a wound care clinic where you can take him? maybe there is something you can access through the diabetic clinic.
Is his diabetes well controlled?
I hate the idea of the two of you with cardboard between you. Can you arrange your chairs in front of the TV at an angle so you are turned away from him.
Did the Zoloft actually control the behavior? Maye try a much smaller dose or something else as Jeanne suggested. Remember all these drugs take about two weeks to become effective
If the lessions itch you can buy a 4% lidocaine gell OTC which is very effective and reasonable. There is also a 5% ointment which is prescription and horrendously expensive and only slightly better.
Not an easy situation to deal with but don't be embarrassed you are not doing the picking

My FIL was a picker and also a squeezer. Both his daughters have scars on their faces from his constant picking. He passed this nasty habit to his son, my hubby. Hubby already has compromised skin from being bedridden. He knows he’s doing it and continues and when he picks until the area bleeds, he denies he did it, half-kidding. I’ve gotten some games for us to play. “Uno” is one, that keep him entertained. It’s brought us closer and made him less annoying.

I totally agree with the dermatologist visit though. It may not be skin-related but the doctor may give you ideas on where to go from there.

Just a suggestion is trying an ointment called calmoseptine. I get it on amazon. It’s for any type of itch to calm the area. It has zinc in it and is good for bites hemorrhoids diaper rash...I can’t travel without it. If his arms are actually itchy it might help. At the NH they also have long white sleeves to keep arms safe from pickers or skin tears.

My aunt does this to her ear. She started with the top of her nose and then her scalp. It’s been only the top of one ear for the last several months. At one time we put creams etc. bandaids. But now for the most part we ignore it. She will get angry if we mention it. I tried showing it to her in the mirror and it upset her. She told me that she didn’t want to do it to herself. So an acknowledgement that she knew she was doing it and felt helpless to stop.

You don't ask him if he wants to see a psychiatrist. You take him to one for an effective treatment plan.

There are so many SSRIs available; get with a psychiatrist who will work to find a med and a dosage that works.

If an initial dosage causes him to appear over-medicated, CALL the doctor and ask what to do. Don't just stop the drug.

So many suggestions! Many I have already tried, e.g., "NH sleeves." I called it compression bandages. Dermatologist? She says she can't do anything until the sores heal.Mitts? I called them gloves. Fidget toy? Lasted five minutes. Games? Did I tell you he is legally blind? Don't ask, just take him to a psychiatrist. Ever try taking someone bigger than you to a place he doesn't want to go?

Try several psychiatrists? We are already paying for sailboats for several MDs. How many more would be reasonable? Ignore the scratching? Sure. Just tell me how. Don't be embarrassed? Just tell me how.
Betamethazone? Chlobisterol? Sure. Maybe lidocaine. OTC 4%. Did I tell you the PCP ordered Nystatin cream (anti Fungal) AND triamcinolone acetonecream 0.1% (antibiotic)?

How would he know if the doctor he was going to was a psychiatrist if you didn't tell him?

I'm not suggesting you try several psychiatrists. I'm suggesting that, as SSRI therapy is the recommended treatment for excoriation, it might be that a couple of different meds might need to be tried before you find the correct med and correct dosage. If the medication isn't working or causes too many side effects, you tell the doc who prescribed it and get advice. You don't switch doctors.

A Vitamin E oil or Vaseline applied thick daily on the affected areas might help. It'll be too 'slippery' for him to get to it. rub his hands too. I's easier to pull or pick when dry.

You don't say how old he is. I guess I'm a picker too. I have small scabs on my shoulders and other body parts from tremendous itching. I have diabetes type 2, fibromyalgia, and thyroid deficiency. If he has any of these symptoms/diseases they can all make him itch. I have tried creams, lotions, and antihistamines, but, the only drug that helps with it is Xanax. I have heard these nerves may be trying to transmit pain, but what the body feels is an itch. Since it may be a central nervous problem making him itch, the Xanax helps with that feeling. He might not need the Xanax, maybe klonopin can help with the itching. If his condition is like mine, had a heart attack, and with the above conditions, if his health is failing, his Dr. might not want to give him a benzodiazepine. My Dr won't prescribe for me either. I have to get it from a friend. Makes me damn angry about it to. He needs to stay away from hot showers, or hot room temperatures, and overly warm clothes. I've also heard that tepid colloidal oatmeal baths can help. I feel for him because not too many doctors are understanding about this itch. It can be unrelenting, and debilitating. Any visitors that he gets just need to be understanding, and non-judgemental. I'm sure he can't help it. Good luck to you both.

Have you tried buspirone? This helps with the underlying anxiety.

My wife is a picker. She is Bipolar and I believe that this is just one of the behaviors from this terrible mental health disease. She is type II diabetic. She has been treated by psychs for 33 years and on medication the whole time. If she finds a scab or a crusty area of skin, it's coming off.
I believe this is the cause of 2 rounds of MRSA and at least 2 of her 5 times of endocarditis, each of which has caused strokes that have been minor to the one she had in Nov.2017 that she is still in the NH recovering from.
I have tried every suggestion before this post and nothing works long term. you would think that not knowing who you are, where you are, what you are, who you spouse and children are even for short terms (up to 3 weeks) would be enough to get someone to stop. Nope. I catch her and she will swear that she wasn't picking, scratching, pulling, you name it, she was "only rubbing it". I have found her sitting on the toilet with tweezers pulling the final minute pieces of dry skin from a seeping wound.
She always claims: "I did not know I was doing that"
I do not give up because I believe this behavior will end up causing her death.

My grandmother did this in response to a tranquilizer she was taking--when they took her off of it, the picking stopped. My mother also took something during her last days before she died that made her pick at the sheets--she said she saw bugs but knew they weren't really there. If this is a new habit for your father, it may be some drug he is taking.

Older men tend to get a 'fungus' of sorts. You can try a lot of antifungal products (Ting spray works, but not for long) - but what finally worked for my DH is a mixture of Triamcinalone and Ketoconzaole - both are prescription and both are supplied by the VA. Also, both were advised by a dermatologist for a situation on his feet. Just by luck I remembered and tried on his hands and arms and the relief is almost immediate. Now I only have to use it intermittently when the itching comes back.

This is a serious medical condition and you need to address it. Scratching the skin the way they do, opens them up to all manner of infections, including the dreaded Staph.

My Mom had a picking disorder, started before we noticed her dementia but was probably related. It was an obsessive complusive disorder, she could not control it. People , including heath care workers( nurses, CNAs etc.) would also try to get her to stop by verbally telling her, but that doesnt work at all with this issue. We tried gloves, distractions , everything you could think of. We went to several Psychiatrists, some meds would work for awhile and then it would start up again. She went under hospice care and they put her on methadone , for severe back pain. Well she stopped picking, we didnt make the connection until she went into a nursing home after a broken hip and the doctor took her off the methadone. She went back under hospice care and we were able to get her on the methadone again and the picking stopped and it helped her pain issues. Unfortunately she passed within a month on going back on the methadone. I dont know if this would work for your husband, but it was like a miracle for us. I know first hand how frustrating being around a picker can be and how much we worried about infections, etc. good luck. She was on palliative care after the first time she was on Hospice (she got better because of the methadone helping her pain) and they gave her the methadone.

I'm sorry my answer was confusing.

By "shop around" for mental health care I didn't mean to take Dad to multiple offices. Let your fingers do the walking. "Does your clinic have someone who specializes in OCD behavior in adults?" Ask his PCP. Ask your dentist. Check websites.

You are making an appointment with someone who can help him feel better or help him stop itching or whatever seems appropriate. If he is legally blind he is not apt to notice the discreet sign that says "Mental Health Department."

Some medications will make an elder get into this incessant habit of picking at the skin. Of course, the more one picks, the more one is inclined to continue. There is an RX ointment which can be obtained from a dermatologist. Make sure to get ointment and not cream since cream tends to rub off. Tics, pulling out of hair and picking of skin oftentimes needs to be addressed by a clinical psychologist.

My Dad does this also but picks his head, nose and face. Makes me seriously grossed out. Especially because he won't shower and has dandruff which leaves skin all over his shirt. He completely fights anyone who tells him to shower and change clothes, also wont stop picking. He's always done this but it is much worse now that he's got Dementia/ Alz and wont shower. 😒 The partition thing is such a good idea! Save your sanity for sure. ❤

To 0aoos1492, I have the same problem. My husband was diagnosed with Alzheimers in 2014 long after I suspected it. The skin picking began before also and has gotten progressively worse. I read all the answers and suggestions and have tried most of them. As you say it is much easier said than done to make a grown man much stronger than you are do anything he does not want to do. Added to that is the problems that having Alzheimers brings such as they don't know they are doing harm to themselves and cannot remember from one minute to the next what you tell them. My husband also denies doing the picking even when I'm looking straight at him. We have seen two different Dermatologist for around 5 years or more. They suggested waterproof bandaids and if he leaves them on it will get better but meanwhile he makes new ones in other places. He has had them anywhere he can get to including his chest, stomach, arms hands. neck and face. Like you, I'm not doing the picking but it embarrasses me also. Not only is it an embarrassment but a possible health problem for me as well as him. The Dermatologist use to do swabs to test on several places and they came back showing MRSA and Staph. He was given antibiotics for 10 days a few times and I wondered if that got rid of it. Lately the Dermatologist freezes a few spots which would help but it only gives him a scab to pick off which is all in the bed, floor and any place he can put them. There is blood all over the sheets, the comforter, his clothes, and anywhere he sits. I clean up bloody tissues etc constantly. My husband is taking Lexapro, Arcept, Seroquel and Namenda for Alzheimers and behavioral problems. We also have tried creams, gels etc that were mentioned. We also see our medical doctor as well as a Neurologist. I don't think a Psychologist could add anything because we already know this sometimes happens when Dementia/Alzheimers occur. The doctors don't seem to be concerned, one doctor told me I should tape his fingers or tie his hands. I told him that was not possible and left trying to fight back the tears. In fact I've never had a doctor say an actual name of this skin picking which I read is Excoriation. If this disorder could be cleared up, it would be wonderful and one less thing to worry about. I fully understand your problem and wish I had an answer that would work for both of us. While others say you should not be separated from him I must say I do not presently sleep in the same bed and I wash his clothes and other things separately from mine. Most everyone tells me I should be wearing rubber gloves to clean after him. My suggestion is to do what you feel you have to do because I don't see any other answer. My husband is physically able to do his own baths, dressing and simple things like make a sandwich or feed himself. The bathing is a problem also and again I can't make him do it. I can only ask and he says he just took a bath when I know he hasn't. I suspect he is at least in the sixth stage of Alzheimers. At times he doesnt know who I am. No one knows how long a person has with this disease in any stage or how fast it will progress. Meanwhile I try to do what I possibly can do for him while trying to keep my own sanity. I hope you will do the same. If anything works, I'd love to know.

If your husband has seborrheic keratoses, which is very common among the elderly, he might be doing the right thing by scratching them off when they are small. Some people get dozens or hundreds of these lesions, which look like warts, and which start off tiny and itch a little, and when you scrape one off when it's tiny, it's gone. Unlike warts they are not contagious and don't spread when you scratch them off. If you let them grow they become large wart-like growths which need to be removed surgically. Some people get them daily and usually several new ones pop up every day, when they are tiny they itch and can be removed by one or two scratches.

Sharonheart! Finally someone who really understands! Things are getting better here. The anti fungal/antibacterial ointment combination healed the open sores. With PCP support, I used BagBalm overnight, covered with bandages and a compression sleeve to soften the "callouses" ...dead skin.. And then lightly rubbed the spots with a pumice stone. Did this only twice so far, to avoid opening new sore spots. His skin looks much better.

oaoos1492, I'm so glad you are getting the sores healed! Has hubby's picking been reduced?

My heart goes out to you and Sharonheart. What a sad challenge to deal with.

Does the type of clothing he is wearing make any difference? Long sleeves vs short sleeves, for example?

You’ve probably experimented with your laundry detergent/ dryer sheets already and I dont know if this may help or not but we have always used fragrance & dye free items, but we were never 100% consistent with the brands. We used to use Wegmans brand but for some reason switched. DH began getting little itchy bumps on his back, so just for kicks we switched from Arm and Hammer Sensitive Skin back to Wegmans Advance and the itchy bumps went away. So evidently not all fragrance free soaps have the same ingredients, and you may want to experiment. Just a thought.

Many people pick at their skin once in a while, but sometimes it crosses the line into a condition called skin picking disorder (excoriation).

When this happens, picking at the skin -- for example, picking a scab or the skin around your nails -- can become so frequent and intense that it causes bleeding, sores, and scars.

Some people with this disorder repeatedly scratch to try to remove what they see as some kind of imperfection in their skin.

Long sleeves didn't help. Sores are much better now after meds and BagBalm with pumice. He occasionally touches his arms to see how they are, but no picking. Skin is much smoother. Progress! I appreciate all the input and support I got here.