Q. Dr. Markovitz, I'm not sure if I have a problem or not. I'm trying to find more info on skin picking. Since I was 5 yrs. old I have picked the skin on my fingers. I'm now 38 yrs. old. I will pick them until they are bleeding and sore. I will pick them down past the first joint. My parents sent me to dermatologists as a child, but nothing seemed to work. I seem to pick them more since I have been taking Meridia for weight lost. I go through periods when I pick more than usual, and periods when I won't pick at all. Since I have become an adult I started picking the skin on my lips with my teeth. I was picking the skin on my heels of my feet, but I stopped doing that by putting lotion on them and making the skin smooth. I always though that it was just a habit, but I get in a trance like state while I am picking and will put the skin in my mouth and bite it with my front teeth.

  A. There are a number of reports on this and similar conditions in the literature. Instead of using Meridia, I would talk to my doctor about using Effexor XR. Both have an identical mode of action. Get the Effexor up to 450 mg per day or so, and the picking should go away or at least down a great deal in the ensuing 6-8 weeks. You will need to stay on the Meridia at the dosage that works.