What It’s Like To Have a Compulsive Skin Picking Disorder
Understanding
dermatillomania and managing anxiety impulses …
“The first time I realised I had a problem, I was at the cinema with my boyfriend. I can't remember what we had been to see, but what I do know was that it must have been something intense and possibly scary since I spent the entire film a bundle of nerves. As the credits rolled and we stepped out into the brightly lit lobby, he stopped in his tracks.
"What's happened to your mouth?" he asked, "It's bleeding!"
Catching a glimpse of my reflection in my phone screen, I immediately understood what had happened. Totally engrossed in the film, I had absentmindedly managed to pick away an entire layer of skin from my bottom lip, leaving it a pulpy, bleeding mess.
I often picked my lips, in fact, by that point, picking at my skin had become a daily occurrence. While reading or watching TV, I would find myself routinely plucking at my lips until they bled. As I sat in lectures, I would gnaw at the skin around my nails to the point that I found it too painful to type out my notes. Often at home, alone in the privacy of my bathroom, I would lose hours scanning my body for red spots and ingrown hairs that I could poke and prod at to my heart's content.
“Like any bad habit, picking at my skin when I was bored or anxious was surely something I could and should learn to manage on my own, I thought.”
But this was bad - I don't know if it was the darkness that meant I couldn't see the blood pooling around my fingernails or I had been too pre-occupied with the drama unfolding on screen to realise what was happening. I just had no idea how I had managed to do so much damage without realising.
I flashed my boyfriend a reassuring, albeit painful smile, and explained there was nothing to worry about, but the morning after I found myself tearing away at my still-raw lips before I even realised what I was doing. I snapped my hands to my side and tried to keep them there but the urge to pick was overwhelming. I didn't understand why I simply couldn't stop. I grabbed for my phone and frantically tapped into Google without thinking, 'can't stop picking at my skin what to do'.
That day I discovered two things: one, that I was not alone (there were others like me out there, flooding online forums and social media with posts about their skin-picking) and two, my problem had a name: dermatillomania.
According to the Anxiety UK, dermatillomania is characterised by the repetitive picking of the skin. It's both a physical and mental issue – causing scarring, discolouration and even tissue damage to the skin, but also significant emotional distress. As I read that sufferers often say they entire a trance-like state when picking and describe a feeling of relief once their compulsions have been met, I found myself repeatedly nodding to myself, mentally ticking off everything I had experienced. Finally, I understood what had been happening to me.
According to the Trichotillomania Learning Foundation, a US-based charity entirely dedicated to supporting individuals with body-focused repetitive behaviours, 75% of people affected by compulsive skin-picking are female. However, this may not be entirely accurate for several reasons; the condition is often misdiagnosed as a symptom of stress or anxiety, and men are also much less likely to seek treatment than women are. Likewise, research indicates that skin-picking affects just 1.4% of the global population, but again, in reality, this number may be much higher.
“ I signed up to meet with a therapist once a week for 6 weeks and noticed straight away in the days following each session a significant reduction in anxious picking. ”
"There's a massive disparity between those who don't know that they're suffering from dermatillomania and those who do, which explains the underreporting," Leslie Lee, Communications Director at the Trichotillomania Learning Foundation explains. "For people who have skin-picking or hair-pulling tendencies, there's a lot of shame attached to the behaviour, which could stop someone from seeking help."
For me, it was something else entirely that caused me to wait almost a year to set up an appointment with my GP about my skin picking problem. It just didn't seem as important as other things people go to their doctor for. Like any bad habit, picking at my skin when I was bored or anxious was surely something I could and should learn to manage on my own, I thought. So instead, I trawled internet forums and found advice on how to control my urges, such as ramping up my skincare routine and rewarding myself when I managed to resist picking for a day.
When I finally did go to the doctor I was told the primary treatment for dermatillomania is Cognitive Behavioural Therapy (CBT), something many of my friends have sought out for anxiety and depression and have only good things to say about. Eager to try, I signed up to meet with a therapist once a week for 6 weeks and noticed straight away in the days following each session a significant reduction in anxious picking.
Unlearning unhealthy behaviours is never easy. These days my skin-picking compulsion rather annoyingly rears its ugly head the most when I'm trying to get words down on a page so even as I write this, the temptation to pick at my skin is almost overwhelming. But through getting the help I needed, I've learnt how to resist my impulses and recognise what triggers them. Most importantly, unlike that night at the cinema, I know that even if I do start picking, I can stop myself before it gets out of control.”
For advice and support you can reach out to Anxiety UK on 03444 775 774 or the TLC Foundation for Body-Focused Repetitive Behaviours at bfrb.org.
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Thank you so much to the wonderful Eve Crosbie for contributing such an honest and invaluable piece to TIGC- we hope you loved reading it as much as we did! To see more from Eve you can find her on Instagram at @eve_crosbie, or head to her portfolio at www.evecrosbie.co.uk.