Dermatillomania: The Skin Picking Disorder You've Probably Never Heard Of


At some point, we’ve all been there: Standing in front of our bathroom mirror, examining a pimple on our face, with the urge to pop it. There is something so satisfying in the act of popping; blemishes are reduced, infection and pus are expelled, the bump goes down and we can move on with our lives.

But what if that urge never goes away? What if we can’t move on? What if we end up in front of the bathroom mirror for hours on end, trying to rid ourselves of any imperfections?

The obsessive urge to pick one’s skin is called dermatillomania. Also referred to as the “skin picking disorder” or “excoriation disorder,” dermatillomania is a form of OCD that can significantly impair the life of the person suffering from it. Someone with dermatillomania will pick their skin to the point of causing wounds, which can result in scarring, discoloration, tissue damage, and infection, not to mention the mental effects of guilt, shame, anxiety, and obsession.

I know these effects firsthand, as I have suffered on and off from dermatillomania for years. For me, skin picking is triggered by stress, and I tend to focus on four key areas: my belly button, scalp, ears, and face. When I get to picking, I enter an almost trance-like state, where I pick, scratch, pinch, and tear at imperfections. The imperfections I am referring to are blemishes or old scar tissue, inflamed moles, scabs, or dry and peeling skin. The more I pick, the more it scabs and the more scar tissue builds up, resulting in a vicious cycle of picking and healing, picking and healing.

As I pick, I tell myself to stop. I tell myself that I know the consequences. But I can’t stop. I physically and mentally cannot stop because I’m so close, I’m almost there, just one more pinch and it will be gone. This past summer, during a particularly stressful time at work, I picked a spot in my ear so badly that it hurt and bled. When I left work and looked in the mirror, my ear was caked in blood, and I cried and hated myself.

I’ve picked entire moles off of my skin. When my grandmother was dying, I gouged out an entire freckle; I still have a huge, round scar from that.

My dermatillomania is mild compared to more severe cases. But this disorder is little understood, even by doctors. During periods of particular anxiety for me, when my picking was at its worst, I’d mention it to my doctor, psychologist, and psychiatrist, but it was never addressed head-on. It was never treated as a serious concern. I shared that entire moles were gone from my body by my own hands, but no professional asked me why I picked, which only made the shame and the desire to pick even worse. Why could no one understand this urge or recognize it as something I needed help to deal with? These gouges had infections; why was no one alarmed or concerned? Because no one took a serious look at the obsession to pick, there were no treatment plans to effectively help me to stop.

Doctors need to not only be aware of this condition, but they need to treat it seriously, because it is not just a teenager popping pimples in the mirror before prom. It can be debilitating, shameful, and painful, which it has always been for me. So how have I coped with it?

First, just having a name for it was immensely helpful. To know I was not alone, that it is a disorder, that other people feel these same urges. Second, reading message boards about it or talking to support groups online about it provided even more comfort. Third, reducing my stress level as much as possible, and redirecting my urges elsewhere: fidget spinners, stress balls, or other items that provide tactile and sensory stimulation. And finally, just educating myself as much as I could about the condition. When you begin to understand something, you begin to destigmatize it for yourself and others.

If you suffer from skin picking disorder, know that you are not alone, and that help is out there. Visit http://www.mentalhealthamerica.net/conditions/excoriation-disorder-skin-picking-or-dermatillomania for more information and treatment resources.



By Kaitlin Konecke

1 comment

  1. Thank you so much for writing this. I've suffered from this since I was in 5th grade. At least one other person in my family suffers from this as well. I, too, had no words for it and couldn't figure out why I couldn't stop--and I couldn't understand why no one cared, which made it feel extremely shameful. I thought I just had terrible acne.

    It wasn't until after college when I lived abroad in a sooty coal mining town, where I could literally feel that my fingers were too dirty to touch anything, let alone my face, that my "acne" cleared up. When I connected the dots and discovered dermatillomania was a thing, I was floored. Others were like me--and they were figuring out ways to stop the cycle.

    When I returned to the US, the cycle returned. I've worked with professionals, who've taught me tricks like mapping out the "Danger Spaces" where the subconscious picking happens (the car, the shower, in front of the computer, watching TV). The idea is to be aware when you enter those spaces, that you choose not to pick. You can prep those spaces notes, put out barriers (I have a pair of lightweight manicure gloves I sometimes wear) or fidget items (rubber bands, bracelets, or my favorite, Thinking Putty).

    To stop the conscious picking in the bathroom, the doctor suggested covering the mirror or replacing bathroom lightbulbs with dimmer ones, plus putting a note on the mirror with an inspirational quote or photo or something that reminds you why you care to stop.

    But let's be honest: sometimes, all of this doesn't help. There are times when my mind tells me that I don't care the outcome. That this is me and I'm going to do it, and it doesn't matter. I hate when I can't make myself care.

    Which brings me to why I'm commenting. I did all these things for a while and was improved for a long time. However, I'm now 36 and this has come creeping back into my life. I wanted to share that this isn't something that is easily just walked away from. It's hard. It can be an every day struggle to break the cycle--or even an every moment struggle. Don't give up if you pick. Don't say, "well, I'll start over tomorrow." You can start over the moment you stop picking. Every minute is a new chance to take control.

    Anyway, this is what I'm telling myself. I'm trying to go after this with new zeal--I just ordered a HabitAware bracelet (haven't received it yet). Today, I'm going to remap my danger areas. I'm gonna get back to good.

    Much love to you and everyone suffering out there.

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