Skin Picking

My 4-year-old daughter is constantly picking on an almost 2-month-old scar on her face. She does it when she is in the car, watches TV (limited to 1 hr spread during the day), when she is bored, when I’m reading to her, in other words, when she is not actively playing. When she turned 2.5, she suddenly started sucking her thumb and picking on my skin (arm). This seems to bring relieve. But I can’t figure out where the stress or anxiety to pick her skin or my skin come from. I stay at home with her and my 2-yr-old son. She doesn’t go to preschool, she enjoys her brother and she is a very social and happy bilingual kid. She breastfed until I forced weaned her at 18 months, we co-slept (she still comes to our bed whenever she wakes up), she eats healthy foods, and exercises a lot. Recently, about 6 months ago, I changed some of my parenting ways for a better Aldort-style. How can I stop the compulsive skin picking? Thanks.

Dear Laura,

You are right to sense that your daughter may be experiencing some anxiety. I hear you clearly when you observe that she has a happy life that does not justify compulsions. However, your daughter is telling you that she does experience stress and I am delighted that you are listening to her and looking for ways to understand and help her.

Of course I cannot know what she is anxious about, but I can give you some direction based on the information you have provided. There may be other causes of course, and I cannot know what they are. If you wish to get my full assistance, you may want to book yourself a phone session with me. 

In your question you mention a few very likely reasons for your daughter’s compulsive behaviors. Please read with an open heart but without guilt. You always do the best you can. Children are born to humans. When loved and free to express themselves, they are well equipped to grow with our imperfections.

1) Your daughter started thumb sucking and picking her skin when her baby brother was about six months old. This is the typical time when an older sibling so close in age start doubting herself. The baby starts crawling and instead of being like a doll in her life, he becomes another one like her. Adoring him and playing well with him does not preclude this possible anxiety.

2) She was weaned against her wishes at 18 months. Thumb sucking is one good solution to missing the breast even if it is found a year later. She was not done and her need for oral stimulation may be incomplete. In addition her brother was/is breastfeeding and observing him may have stimulated her recognition of this need. 

3) Your daughter is not sleeping with you while your son is, or has been. This can create a lot of anxiety. Just sleeping by herself, even without having a sibling who sleeps with you, is difficult enough. Young children are not meant to sleep alone. Her coming to your bed as soon as she wakes tells you that she would rather sleep with you. Not having that closeness at night is likely a source of fears and self-doubt, and having a brother who was/is with you makes it rather bitter. She is the only one by herself, missing the slumber party. In-spite of your love and being at home with your child, she may be confused about her worth and her place in your and your partner’s life.

4) Changing your parenting ways to more of my philosophy can only help and bring relief. Yet, your older ways may have left a longer lasting impact which will take some time to clear. Is your child anxious to please you? Meeting your emotional expectations by being a happy child? Is she feeling controlled? Is she feeling left out or secondary to her brother? Is she not feeling comfortable to express her negative feelings? Is she being a “good girl” and inauthentic? These and other emotions can cause anxiety and fears that are relieved by compulsive activities.

You are obviously a well connected and loving mother. I suggest you find the causes of stress in your daughter’s life and remove them when you can. Consider a return to a full co-sleeping for the whole night. During the day, become aware of the times that your son is in your arms and your daughter is not, or times that you protect him from her (if you do.) You may need to spend more one on one time with her without her brother. If she is upset about something, avoid stopping her emotional expression; instead, make sure she feels loved when crying so she can let it all out and not be stuck with unexpressed feelings.

On the technical side: Cut her fingernails as short and as frequently as possible. At night, cover her scratched skin with a bandage with lots of oily natural ointment (vitamin E, olive oil, or honey etc.) Keep her hands busy with play, art, dance and other activities.

Even when content, it is hard to stop a habit. Spend more of the day outdoors with mittens on her hands and busy with her whole body. Let her thumb sucking be. Ideally she could still be breastfeeding, and she is taking care of herself nicely. Your goal is not to stop your child’s compulsions but to alleviate the source of anxiety in her daily life. 

In this response I have done a lot of guessing so it may or may not fit. If you wish to speak with me, you can sign up for a session here:


Naomi Alodrt