About Dermatillomania (Compulsive Skin Picking). null.
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I started compulsively skin picking as a child. The earliest record is my early childhood when I started picking at my belly button, scratching it so much I was making the skin red and bleeding. My parents could not get me to stop, neither could the doctors. I’m not sure if it was my grandad or my parents who came up with the solution but I was told that there was a magical spec of black dirt in my belly button and if got it out something really bad would happen. I suspect my grandad because he was the person who used to tell me that there was cauliflowers in my ears and things like that. The rouse worked, it put the fear of god into me and I stopped.

It was many many years later, as an adult, that I suddenly remembered what I had been told and went… wait a minute…. 😛 I don’t begrudge them the little white lie; it stopped me from destroying my body.

I picked again when I like all children inevitably caught chickenpox. I couldn’t stop scratching. Even now as an adult if I get an insect bite I will scratch it raw so chickenpox was a nightmare for me especially as I didn’t have a clue about skin picking. I was just told not to scratch, it makes it worse. It was bad, a naughty habit. At that age, I spent time at my aunt’s house which was one door down from my own, and her son and our playmate had contracted it at the same time. My parents had given me a compromise; scratch your head, they told me. It didn’t matter if I scratched there because if it scarred no one would ever see it. 

My aunt wouldn’t let me. I remember her being furious with me every time I scratched my head. It didn’t matter that my parents had given me permission, when I was in her house I had to do what she said.

As I got older and hit adolescence I started to pick spots, and I was met with the same attitudes everywhere I looked. If it wasn’t people noticing and commenting on “my bad habit” then it was teen magazines constantly saying not to pick. The shame kept on building, I kept on picking and just got better at hiding it. I moved on to picking at my pores, shaving my eyebrows, and gradually as I moved into adulthood the picking began to include skin elsewhere on my body. Fingers were a natural step, all those bits of skin that catch around the nails and fingertips. I’d even started using scissors to cut deeper. Acne on my back, my chest, eczema on my elbows. Any imperfections I found and dug them out, scratched them from the surface of my body.

In reality, I was just making wounds in my skin. I knew something wasn’t right, I knew it wasn’t healthy. Every time someone said to me about stopping I’d say “I know!” with frustration and change the subject. Eventually, I decided to just Google it. I couldn’t stop picking, surely someone else somewhere had come across this, right? I had heard of Trichotillomania, compulsive hair picking, so my logic was that if that existed it was that far fetched to believe that other compulsive conditions did too.

It was a huge relief when I found that I was right and that I was not alone.

About Dermatillomania

The act of compulsively picking one’s skin is known as dermatillomania or excoriation disorder. Both of those are quite a bit mouthful to say so you’ll find that it is quite often referred to simply as (compulsive) skin picking. Those are the medical terms for the condition though so it is important to be aware of them especially if you need to seek medical assistance. I mentioned trichotillomania, and both it and dermatillomania are known as body-focused repetitive behaviours (BFRBs).

The keyword when talking about dermatillomania is “compulsive” it’s something that you cannot stop doing no matter how hard you try. I can say to myself “I’m not going to pick, I am just going to wash my face and that’s it” and then I look in the bathroom mirror, see something and I start picking. I lose time picking. I’m not just standing in front of a mirror for a few minutes, we’re talking 20 to 30 minutes minimum. Sometimes it can even be an hour or more. Everyone picks their skin a little bit, scratches that itch or tugs at that annoying hangnail. Most people don’t stand there picking for 30+ minutes and they most certainly don’t use tools like tweezers and scissors to dig deeper into their flesh. As soon as they see blood they stop; compulsive skin pickers don’t stop at blood. They only stop when the compulsive has been satisfied or someone interrupts them (I’ll talk more about how to do this safely later).

About Compulsive Skin Picking - A photo of me showing evidence of skin picking on my face, chest and arms. The photo is of Heather a young white woman wearing glasses with brown hair pulled back into a loose bun. The skin on her face, chest and arms is marred with blemishes and wounds caused by compulsive skin picking.
A photo of me showing evidence of skin picking on my face, chest and arms.

What causes compulsive skin picking?

For me, it’s stress and anxiety but it is different for everyone. Most people who compulsively skin pick have co-existing mental health related issues whether it’s anxiety, depression, low self-esteem, OCD or something else. I listed OCD there because compulsive skin picking is not linked directly to OCD. It’s referred to as being OCD-adjacent. I recognise OCD tendencies in myself as part of my anxiety but I do not have full OCD.

I skin pick every day, it’s a compulsion I can’t stop. However, it’s become a manageable part of my daily routine now rather than something I lose time to. When I get stressed or anxious the need to pick grows stronger. I’ll start doing it straight away if the situation is bad enough, fiddling, scratching and picking. Otherwise, it bottles up and comes out when I get home or to the bathroom.

“Scratching at your skin puts sufferers into a numb, trance-like state, that helps them escape their overwhelming feelings. Often they don’t realise they are causing damage until they exit the ‘trance.’ “

Dr. Sheri Jacobson, founder and CEO of the -based Harley Therapy, (Quote source)

That is what it feels like to me. When I’m picking the only thing that matters is getting rid of the impurities in my skin, whether it’s a whitehead spot or dirt in my blackheads. I know logically that doing so is the worst thing to do, but while I’m doing it I have control over one thing in my life. I can’t remove all the other bad things from my life, I can’t stop people from saying things or being ignorant. The yucky stuff in my skin? I can do something about that.

For me, skin picking is a form of self-harm. I take out my pain on my skin through the skin picking. I want to emphasise that this is a realisation that I came to for myself and it may not be the case for everyone who skin picks. If you skin pick and this is something you wish to explore then please make sure that you talk about it with a licensed counsellor/therapist in an environment where you feel safe.

Things that have helped me

I was in my early twenties when I finally found the courage to believe that my skin picking was more than just a bad habit and recognise that it was something I could not stop. Since then I have tried many different things, including just trying to force myself not to do it. I am now at a point where, yes, I do still pick but it is a lot more manageable and once upon a time even admitting I skin picked would have been abhorrent let alone write this entire page about it. So here is what has helped me.

Talking to my Family

The first step for me was learning that my skin picking was linked to my mental health and beginning to understand my triggers. I then spoke to my family and told them what I needed from them, namely to stop calling it a bad habit. The shame I had felt all my life every time someone told me not to pick, not to scratch had just made me feel more anxious and led to more skin picking. It was a difficult transition but it helped immensely.

Working on my Mental Health

I have been working on my mental health for over half my life now and every bit of treatment, every step of progress helped me make progress with my skin picking as well. I am on anti-depressants and I currently attend a weekly therapy group. My skin picking has gotten a lot better since attending the therapy group even though it’s been over Zoom due to the pandemic. The way group therapy has been portrayed in TV shows and movies tends to put us off it, however, good group therapy should be more like a chat with good friends than a circle of chairs where no one talks.

Compulsive Skin Picking - Before my skincare routineCompulsive Skin Picking - After my skincare routine
On the left; my skin before I started my skincare routine in January 2021. On the right; my skin in April 2021.

Finding the right Skincare Products for Me

Finding the right skincare routine for my skin has been key to helping me manage skin picking on my face. As I said, I still do it, but because there are a lot fewer imperfections to pick I don’t do it nearly as much and when I do I’m not causing huge damage. It has taken me years of searching for the right products to get to the point where I have clear skin so if you still haven’t found the right ones please don’t think you won’t. I’ll be writing up a post about my current skincare routine soon, but for now please find some advice below.

Get a Routine that Works with you

While my skin picking is more manageable I do still sometimes fall down the “rabbit hole”, so to speak, and lose myself in the trance of picking when I’m feeling rough or emotional. If I have an event or an appointment coming up that is making me really anxious, for example, this will trigger me. My fiance and I never talk about it because he knows it makes me feel extremely uncomfortable for which I’m very grateful. Instead, he’ll just call to me in the bathroom and ask if I’m ok, or as is our long-standing joke, “Have you gotten lost again/fallen down the toilet?”.

It’s a little thing, that humour, but every time it snaps me out of it. It took me years to realise he was even doing it. So he just calls, “wakes me up” out of my trance and I slip back to reality. That’s our routine and it works for me, knowing that he’s watching and is giving me space but also ready to stop me when I go too far.

Distractions

I realised that I pick most when I have nothing to do to distract myself from how I’m feeling, whether it’s or anxiety. In particular, being stuck in a situation where I can’t DO anything is a major trigger for me; waiting for a bus, waiting rooms for appointments or (sorry for the TMI) being in the bathroom when I have an IBS flare-up. To avoid picking in these situations I started to ensure I always carried a range of things to distract me because with seven chronic health conditions I’m not always feeling up to doing one thing. When I leave the house I have in my bag; my tablet, my phone, a notebook and whatever I’m reading at the time. That means I have a book to read, access to the internet, games to play and a notebook and pen to take notes for work if I want to do that. When I’m stuck at home I take a digital device with me or have a selection of books in the bathroom in case I forget to pick one up. I basically make sure there is something else to do other than picking at my own skin.

Advice

Over the years I’ve picked up a lot of knowledge of how to manage skin picking from my own experiences and also from medical professionals. Please keep in mind that I am NOT a medical professional myself and any advice here is simply from my own experiences. I know I keep saying it, but every single person is different and some of these techniques I don’t use, however, may work really well for someone else.

This is also not an exhaustive list and I’ve included a list of useful websites for more information, advice and other people’s stories. This is just my story and I’m one of many, if you feel mine does not resonate with you then please visit those links.


Find your triggers – When do you pick the most? Next time you skin pick think back to what happened before it, how your day was. Picking Me.org has a really good skin picking log to help you with this.

Get help for your mental health – Not everyone has a full mental health condition. Some people suffer from stress or low self-esteem, but we all have mental health just like we all have physical health. As the saying goes, if you broke a bone you would go to a doctor, right? There is a wide range of ways to help your mental health nowadays not just therapy and drugs. I highly recommend mindfulness, which isn’t just about meditation, and a book that really helped me is Mindfulness: A practical guide to finding peace in a frantic world.

Find skincare products that work for you – Whether it’s your face, hands or another area of your body there are great and affordable ranges of skincare products available. I’ve heard accounts of people spending a fortune on facial skincare products that have not helped them at all, and the problem is that they have failed to do two things; 1) identify their type of skin correctly and 2) understood what type of product works for their skin type. I incorrectly identified my skin as combination skin for the longest time and it was only when I realised I actually had oily skin that I made the massive breakthrough you see in the photos above.

If you don’t know what type of skin you have Nivea have a great page and some quick tests that you can take to find out. The next step is to read up on which active ingredients in skin care products work for your skin type. There is a whole load of information out there and the simplest I found is this article by Real Simple; “How to Choose the Skincare Products Best Suited for Your Skin, According to Dermatologists“. It’s what I used to pick mine and well, you can see the results!

For body skincare products I’ll admit now that I have not tried any yet. I focused on my face first because that is my outwards presentation to the world and was the one causing me the most anxiety personally. I’m hoping to try Revolution’s Body Blemish products as I’ve had a lot of luck with their face products. For hands, I’ve found that cuticle creams like Burt’s Bees Lemon Butter Cuticle Cream have really helped me with my dry and damaged cuticles, thus helping me stop picking at them as much.

Paint your nails – A similar tactic to taking care of your skin, this was suggested to me by a counsellor. Maintaining your nails can help prevent you from picking at the skin around your nails and fingertips. Alternatively, it gives you something else to pick. I’ve had both methods work for me.

Wear an elastic band or bracelets on your wrist – Another tip from the same counsellor was to wear an elastic band or bracelets on your wrist to keep your hands busy. Stimming is now more well known than it was when I was given this advice, so I’m going to call it what it is; stimming. As Good Therapy explains stimming is most commonly associated with people on the Autistic spectrum, however, everyone stims. Ever seen someone tap their foot when they’re getting impatient? That’s stimming. For those of us who skin pick we reach for something to pick, so wearing something around your wrist or using something else to stim such as a fidget spinner gives you something else to do. It’s very similar to me ensuring I have things to keep me occupied when I know I’m going to be waiting somewhere.

Distract yourself – If you notice yourself picking at certain times, such as when you’re bored or anxious, get into a routine where you always have something with you to distract yourself. By keeping your mind off of whatever emotion you are feeling you can help suppress the urge to pick. Speak with the people you live and work with if you need to change your surroundings to help you do this. Admitting it is for skin picking is embarrassing so if you can’t do that then try to ask for your own area or space, especially in a shared location, where you can put whatever you need. Or find an easy way to carry something with you.

Some of the Products I mentioned

I also recommend checking out these pages for more information too:

 

Advice for Family and Friends

If you think you know someone who may be skin-picking the first thing I’m going to say is this; talking to them is going to be extremely difficult. As I explained above shame is a core emotion linked to compulsive skin picking so by talking to them you will be making them face up to something that is incredibly embarrassing to them. So before you do you need to be prepared to talk to them with love, understanding and a lot of patience. You are more than welcome to show them this page (and if someone who cares for you has done just that, please know they have done so because they care and want to help) and recommend showing them the pages I listed above.

My biggest advice is to not lecture the person you care about. Do not tell them to stop, do not call it a bad habit or try to take away the things they use to help them pick (unless it is getting to a stage where they are going to hospitalise themselves) because you will just cause the shame they already feel to keep building. You need to be patient. You will probably never understand what/why they are doing or going through – I know my fiance doesn’t – and you need to learn to be ok with that.

If the person in question is young, a child or a teenager, I suggest watching to see if their picking correlates with any particular event or emotion. It most likely will. Working out what triggers the picking is one step, but you can also help take away the urge to pick by trying some of the other things I’ve listed above. Teenagers especially are going to be difficult to talk to, but helping them find the right skincare routine and also giving them the financial support to do so will hopefully act as an olive branch to get them to open up to you.

If you have any questions

If you have any questions about anything written here please feel free to leave a comment or contact me on Twitter. I’m happy to answer any questions and help if I am able to.

Please Note – I will, however, not indulge anyone who sees fit to argue, debate or lecture me on anything related to my disabilities or health. This page is here to provide my audience with information so they can better understand how my disabilities affect my life, and offer help to others suffering from compulsive skin picking. It is NOT a cry for help or a request for assistance. I do not care what worked for your sister’s cousin’s mother. You have been warned. 

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