What does having dermatillomania entail?

I pick at my skin compulsively and obsessively. Personally, I squeeze spots and blackheads. People can pick at scabs, scratch away skin, pick at their scalp, etc.

It is not a one-time thing. I do it daily and sometimes it’s all I can think about, especially when I try to resist.

With dermatillomania, there’s also intense shame or guilt involved after the act.

Do you have other related conditions?

Not that I know of, but I’ve suspected that I have OCPD, for unrelated reasons, but which could correlate.

I have a serious case of scoliosis, which has also affected my body image.

Do you know what may have caused it?

I can’t be so sure, but when I was under very high stress when moving house that could’ve been it. Without telling the whole story, moving was a mess and I had to live with my grandparents for 8-10 months. I was 10 and I missed my old friends a lot but had no way to contact them.

I received very little to no support from my parents and broke down in school a few times. I was looking for an outlet. At first I would hit myself, but the bruises were too obvious, but when I started picking it just felt right. It gave me an escape, to not think for however long the trance lasted.

When did you first start picking?

It’s hard to say, but my guess is about 10 or 11.

How did you feel knowing that there was a word for what you had? How did your diagnosis help?

I don’t think words could describe the feeling. I felt so seen and not alone because it described me to a T. I think my first exposure to the term “dermatillomania” came from a Rachel Oates video where I related so much. I looked more into it after that and found out it was much more common than I initially thought.

What symptoms do you experience? What areas do you usually pick?

I pick at spots (I think Americans would call them pimples but not totally sure of the difference) on my face, lower neck, shoulders, chest, back, and sometimes my upper legs.

How often do you pick?

Every day, when I’m at my worst. It’s hard to know how long every day because it’s quite spread out, but a half hour at the very least.

What are your triggers?

Any mirror I see. It’s also turned into a habit as I pick my shoulders and chest when I’m about to go to sleep at night, no mirror involved. I can’t escape it, even when I’m not triggered.

How would you describe how you feel when you pick at your skin?

I feel so powerful and at peace. It’s cathartic. The physical pain doesn’t matter. I don’t think about anything else because I’m just in the moment.

Afterwards is a whole other story though. I feel so ashamed when I see my patchy skin. Guilt consumes me when I relapse.

Have you ever been caught picking?

Not actively, but it’s very hard to hide how red and patchy my face is after the act. My mam has seen and she has made comments about it.

How does dermatillomania affect your day-to-day life?

I waste time by picking. Picking can also be constantly in my head until I give in and feel the release by picking again, especially when I try to stop and resist.

Are there any potentially dangerous aspects to having dermatillomania? Have you experienced any?

Permanent scarring a big fear of mine. If you aren’t careful you can experience mild to severe infections and even hospitalisation if it gets really bad. I’m lucky I haven’t experienced that.

Do you tell people you have dermatillomania or is that something that you hope would remain more of a secret?

Only my three closest friends know I have it.

I have tried to explain the compulsive part of it to my mam before but she doesn’t believe me. That’s left it very difficult to open up, so I don’t tell people I have it.

Have you developed mechanisms to manage it?

I try to listen to music as a way to ground myself. It helps to not completely space out and also gives me an idea of how long I’ve been picking. It’s not foolproof, but it’s the best I have so far as nothing else has helped me.

Have you experienced any sort of stigma for having dermatillomania? Did that take a toll on you? How did/do you deal with it?

My mam doesn’t believe me when I say I can’t control it. “Just stop” is something I’ve heard over and over. It’s definitely taken a toll on me by making it harder to open up to people or to even trust myself. I’ve caught myself thinking “maybe she is right, maybe I am making it all up” which is so harmful to recovery.

The only way I can deal with it is by trusting myself because it’s my experience and not hers. It is hard, but you have to.

What is your general outlook on your condition?

I hope I can recover but I know it’s a long, long road ahead. I recently relapsed so I’ve been pessimistic, but the best thing I can do is to keep going and trying to recover.

Does dermatillomania have an affect on what you wear or things you do? Is there anything that having dermatillomania has prevented you from doing that you really wish you could do?

It’s on and off for me. Sometimes I don’t care and will happily wear a tank top and shorts in public. Other times, I try to completely cover any evidence of my condition (harder for my face though, I don’t wear makeup).

How does dermatillomania affect your love life?

I haven’t been in a relationship yet but sometimes it leaves me feeling ugly and undesirable. I’ve often thought “no wonder nobody’s interested, look at the state of me.”

What did your parents do right and wrong, in raising a child with dermatillomania?

They didn’t have enough support for me when I was going through the roughest part of my life so far, which resulted in me becoming addicted to this harmful coping mechanism. Parents need to be more open and less judgemental with their children. Children need someone they can open up to and trust.

What are misconceptions about dermatillomania?

That it’s just a bad habit, or that we can stop when we want to. If it was that easy to stop, I wouldn’t be here writing this. If I could stop today, I would. But it’s not the simple.

What do you find is the biggest challenge of living with dermatillomania?

Feeling good in my appearance. It’s hard enough when you’re a teenager in general, but having dermatillomania has definitely made it harder for me. I also have scoliosis, so I can be very insecure about how my back appears.

What are your fears that stem from having dermatillomania?

I fear people noticing that I have this. There have been many nights where I sneak back to bed after spending ages picking in front of the bathroom mirror. I also fear having permanent scarring, especially on my face.

What are things to NOT say or do to people who have dermatillomania?

To just stop. It’s the most unhelpful thing you can say. If anyone with dermatillomania could just stop, there wouldn’t be anyone with dermatillomania.

If you do know someone who picks and you see them doing it, the best thing to do is to distract them by talking about something unrelated. Bringing attention to a person’s picking only makes them feel more guilty, ashamed and insecure.

What would you like to say to people who have dermatillomania?

Relapsing does not make you a failure. You have not lost progress. You got through that time without picking and that’s so tough, but you can do it again.

What would you like to say to parents of people who have dermatillomania?

Be a reliable outlet for your children. If your child does pick, don’t make it a big deal. Acknowledge and support them, but don’t bring great attention and fuss to it because it will make it worse.

How do you wish our society would perceive and treat people with dermatillomania?

I wish we would talk more about this. It happens to so many people but is barely ever acknowledged, especially in media.

What would you like people to know about dermatillomania?

It is not just a bad habit. It goes beyond what you see on the surface. There is deep emotion attached to this. We feel so much guilt and shame as part of dermatillomania.