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Nose Picking: why do we do it?

Dear friends, TGIF!


Welcome back for Dr Euan's Blog Post; this week we look at something almost all of us indulge in ....Nose Picking!



Why do people pick their noses?

Nose picking is truly a curious habit.


According to a study, Trusted Source published in 1995, 91 percent of people who responded to the questionnaire reported that they do it, while just 75 percent thought that “everyone does it.” In short, we are all stuffing our fingers up our schnozzes from time to time.


Why people pick their nose likely differs from person to person. Noses that are dry or overly moist may be irritating. A quick pick can relieve some discomfort. It may even relieve boredom, for example when waiting in a car for someone else.

Some people pick their nose out of boredom or as a nervous habit. Allergy, inflammation and sinusitis can also increase the amount of mucus in the nose.


In rare situations, nose picking is a compulsive, repetitive behaviour. This condition, called rhinotillexomania, often accompanies stress or anxiety and is seen with other habits like nail-biting or scratching. For people with this condition, nose picking can briefly ease anxiety. Excessive nose digging can traumatise the nasal lining and lead to nose bleeds (epistaxis).


But most people who pick their nose, do so out of habit, not compulsion.

Nose picking may not be socially acceptable, but it’s rarely dangerous.

Can nose picking cause damage?

Nose picking is a bit like pimple popping, scab scratching, or ear cleaning with cotton swabs. You know you should not do it, but sometimes you just cannot help yourself!


Picking your nose is unlikely to cause you any serious problems. Still, these potential issues are especially problematic for people who are ill or have a weaker immune system:

  • Infection. Fingernails can leave tiny cuts in your nasal tissue. Potentially dangerous bacteria can permeate these openings and cause nasal infections. A study published in 2006 found that people who pick their nose are more likely to carry Staphylococcus aureus, a bacterium that is responsible for potentially serious infections.

  • Spreading illnesses. Mucus catches dust, bacteria, viruses, and dust that you breathe in every day. You could share those germs if you pick your nose. One study found that nose pickers may spread the bacteria that is responsible for pneumonia.

  • Nasal cavity damage. Frequent or repetitive picking can damage your nasal cavity. One study found that people with compulsive nose picking (rhinotillexomania) may experience inflammation and swelling of the nasal tissue. Over time, this may cause scarring and narrow the nostril passages.

  • Nosebleeds. Scratching and digging in your nose may break or rupture delicate blood vessels. This can lead to nose bleeds.

  • Sores. Nasal vestibulitis is inflammation at the opening and front part of your nasal cavity where there are fine nasal hairs located. It is commonly caused by minor infection with Staphylococcus Aureus. This condition can cause sores that can develop painful scabs. Likewise, when you pick your nose, you may pluck nose hairs out of their follicles. Small pimples or boils can form in those follicles (folliculitis).

  • Septum damage. The septum is a portion of bone and cartilage that divides the left and right nostrils. Regular nose picking may damage the septum and even cause a hole in the long term.

How to stop picking your nose

Picking your nose may be a habit you may wish to stop, or at least get a handle on so your finger does not mindlessly wander to your snout in public, and cause any social distress or embarrassment.


The key to learning to stop is finding alternatives to the reasons you are picking your nose. Here are some techniques that might help break the habit:


1. Saline spray

If dry air leads to dry nasal passages, a quick spritz with saline spray may help restore moisture and prevent dry snot and boogers. A humidifier can increase the natural moisture in a room, too.


2. Saline rinse

A saline nasal wash is a sanitary way to clean your nasal passages and sinus cavities. Your GP or ENT specialist may provide you with a nasal douche to irrigate your nose hygenically. They are readily available at any pharmacy with no prescription. This is the recommended way to clear out mucus or dirt from your nose.

Image from the YouTube video: "How to use Sinus Rinse" by NeilMed


Insturctions on how to perform the nasal douche:

  1. Stand in front of a sink, bend forward and tilt your head down.

  2. Keeping your mouth open without holding your breath, place the cap snugly against your nasal passage.

  3. Squeeze bottle gently until the solution starts draining from the opposite nasal passage.

  4. Do not swallow the soluition

  5. Blow your nose gently and keep your head tilted forward to the opposite side of the nasal passage you just rinsed.

  6. Repeat steps 3 and 4 for the other nasal passage.

  7. Clean the bottle and cap and air dry.

A rinse may be especially effective during times when seasonal allergies are most problematic. The rinse will wash out any pollen or allergens that might irritate your nasal passages and cause them to create excess mucus.


3. Treat the underlying cause of nose mucus

If you think you have more boogers to pick than normal, you may need to first diagnose the problem that’s causing your crusty nose.


Dusty environments or bothersome allergies can increase mucus production. Low humidity causes dry sinuses. Smoke may do that, too, and household allergens like dust and dander can irritate your nose.


Once you identify the underlying issue, work to reduce or eliminate it so you can better control your nose’s mucus production. In turn, that may cut down on the irritation or sensitivity — and the booger production — that leads you to dig more frequently.


4. Use a memory device to stop nose picking

Jog your memory and stop your picking before it starts. An adhesive bandage is an inexpensive, easy option.


Wrap the end of your dominant picking finger in a bandage. Then, when your finger is drawn to your nose, the awkward shape of the bandage will remind you to not pick. Keep the bandage in place as long as you need to retrain your behaviour.


5. Find an alternative stress reliever


People with chronic stress or anxiety may find that nose picking provides a temporary moment of relief. It’s safer for you, your nose, and your anxiety if you find a more productive stress reliever, however.


Consider listening to soothing music when your anxiety level starts to climb. Practice deep breathing by inhaling slowly and counting to 10, then exhaling slowly and counting down to zero.


If you need to keep your hands busy, look for a stress ball or handheld game that requires you to occupy your hands.


If none of these activities work, talk with a mental health care provider about ways to manage the anxiety that causes the picking in the first place.

Takeaway Message:

Despite possible risks, the majority of people do pick their nose from time to time. While it’s often OK, it’s not entirely without risk. If your picking habit is not causing your nose damage or has not become a compulsive, repetitive behaviour, you might be able to pick safely (preferably in private!)


If, however, you find that you pick your nose a lot and cannot make yourself stop, do see your GP or ENT Specialist. They can help you find ways to manage the behaviour, treat any underlying medical conditions and prevent possible complications, including infections and tissue damage.


Meanwhile, have a restful and relaxing weekend ahead!


References:


1. Rhinotillexomania: psychiatric disorder or habit? Jefferson JW, Thompson TD. http://psycnet.apa.org/record/1995-36836-001 J Clin Psychiatry. 1995;56:56–59. [PubMed] [Google Scholar]

2. A preliminary survey of rhinotillexomania in an adolescent sample. Andrade C, Srihari BS. http://www.psychiatrist.com/jcp/article/Pages/2001/v62n06/v62n0605.aspx. J Clin Psychiatry. 2001;62:426–431. [PubMed] [Google Scholar]

3. Nose picking and nasal carriage of Staphylococcus aureus. Wertheim HF, van Kleef M, Vos MC, Ott A, Verbrugh HA, Fokkens W. Infect Control Hosp Epidemiol. 2006;27:863–867. [PubMed] [Google Scholar]

4. Body-focused repetitive behavior disorders in ICD-11. Grant JE, Stein DJ. Rev Bras Psiquiatr. 2014;36:59–64. [PubMed] [Google Scholar]

5. ADHD presenting as recurrent epistaxis: a case report. Rather YH, Sheikh AA, Sufi AR, Qureshi AA, Wani ZA, Shaukat TS. Child Adolesc Psychiatry Ment Health. 2011;5:13. [PMC free article] [PubMed] [Google Scholar]

6. Demolition site: rhinotillexomania. Giger R, Nisa L. Am J Med. 2016;129:48–49. [PubMed] [Google Scholar]

7. Rhinotillexomania: a rare cause of medial orbital wall erosion. Rathore D, Ahmed SK, Ahluwalia HS, Mehta P. Ophthalmic Plast Reconstr Surg. 2013;29:0–135. [PubMed] [Google Scholar]

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