Despite growing numbers of people sharing their experiences of dermatillomania, it’s still shrouded in taboo and shame. It’s time to shine a light on the misunderstood condition
I didn’t realise that my secret habit of skin picking had spiralled out of control until one cold, dark night in November, about three years ago. I’d finished my shift at work and had, as I’d been doing every Thursday for several weeks, walked the five minutes it took to get from my office to the run-down community centre where I met my counsellor.
Her room was a haven of soft hues and curved lines, the orange light slightly dimmed and the air was warm, inviting. The air smelled of play-dough, which sat on the table like an offering. She mainly saw children, but I was one of a handful of adults on her roster. I sank into the soft chair nestled in the corner and when asked how I’d been, started talking about the things we usually talked about: my anxieties, my mood. The usual. It felt good, restorative.
It was only when there were two or three minutes left on the clock that I started unexpectedly shaking. My heart was pounding, and, panicked, I blurted out: “I can’t leave yet.”
“OK,” she said, her kind voice calming me instantly. “We can stay a little longer. Is everything OK?”
At that moment, what I’d pushed down and down for weeks rose to the surface with frightening clarity. There was a single toilet cubicle in that building, with a small square mirror above the cistern. After every one of my sessions, I’d locked myself in there and picked my skin, completely zoned out and numb, before leaving and getting the train home. The hellish pull that dingy room exerted over me was torment.
“I can’t stop picking my skin,” I said. I’d already Googled those words in the safety of home, but now I’d said it aloud it was real.
Since then, I’ve had high-intensity cognitive behaviour therapy and am to this day working on strategies I hope will one day help me to stop completely. Along the way, though, I’ve felt ashamed, brought low by common misconceptions of the disorder and how hard it really is. There are some myths I wish I, and others, had known were just myths when I embarked on my path to recovery. Here, I’m debunking them.
1. It’s just a bad habit
The act of picking one’s skin can, for some people, be chalked up to bad habits, in the same way some people bite their nails. It’s a question of scale, intensity, and personal experience. What makes certain skin picking behaviours reach ‘disorder’ status, is when they start to detrimentally impact the person’s life and become compulsive.
It’s when these body-focused repetitive behaviours (BFRBs) are taken to the extreme when they spiral out of control and start to serve some kind of emotional purpose (which can be complicated, entwined for some in anxiety and the self-soothing they feel while doing it; for others, it’s an attempt to perfect perceived imperfections) that they move beyond just habit. Many people who pick experience a sort of ‘high’ or release while doing it – myself included – such that it becomes addictive, an urge that feels impossible not to act on.
Related to obsessive-compulsive disorder (OCD), for some people skin picking goes way beyond being a habit and needs to be treated as such.
Most people are open to understanding, even if it’s something they’ve never heard of before
2. If you tell anyone, they’ll think you’re disgusting or unhygienic
It took me so long to admit I had a problem because I was so scared that whoever I told, whether a medical professional or not, would be repulsed by my ‘dirty secret’ and think I was weird. These are things I told myself every day – and if I thought them about myself, surely someone else would, too?
But the truth is, most people are open to understanding, even if it’s something they’ve never heard of before because the person you’ve likely chosen to tell (if they’re not a medical professional) will probably be a friend or loved one.
And if it is a medical professional you’ve disclosed your problem to, they’ll definitely have seen it before and won’t react in the way you’re worried about. Around one in 20 people are thought to be affected by skin picking disorder (SPD), so you’re not alone.
3. It’s not that big of a deal and will go away on its own
This ties in closely with the ‘It’s just a habit’ myth but, for me, it goes deeper because for a long time I put off asking for help because I didn’t think SPD was a legitimate mental health complaint, and that it would just go away on its own. I’d constantly brush it under the carpet, telling myself to pull it together because it wasn’t that big of a deal, and that I could stop whenever I wanted.
Alas, as with all mental health issues, it thrived in the shadows and spawned bigger and bigger until I just couldn’t lie to myself anymore. Dermatillomania is a legitimate reason to seek out the medical help and support you deserve, try not to waste time talking yourself out of it!
4. It only happens to people with pre-existing skin conditions
Some people think the disorder is related to other skin conditions such as eczema, but that’s not necessarily the case. Of course, people with skin conditions may develop dermatillomania, just as people without it might, and it’s true that triggers for some can include rough patches of skin or blemishes, so this can certainly play a part. But lots of sufferers in the grip of SPD find themselves picking areas which, to anyone else, would look like smooth, even, bumpless skin.
The reality is that all skin has texture – it’s an organ characterised by pores and is always changing – and those seeking out somewhere to pick won’t ever be short of surfaces.
5. You’ll never feel happy in your own skin
Part of the shame spiral I feel after a particularly nasty picking session is the hopeless, seemingly unshakeable, un-get-round-able idea that my skin will never be the same again: that I’ve caused irreparable damage I can never undo.
Sure, it would be a lie to say that the ensuing scars will fully go away. But it would also be a lie to say that even a person without dermatillomania’s skin will be the same day-to-day, week-to-week, month-to-month anyway.
The best thing my counsellor, the one I was telling you about, ever said to me was this, and I repeat it to myself often when I’m feeling that familiar shame: “Let yourself off the hook.”
‘Hands’, Lauren Browns’s memoir about anxiety and skin picking, has been published by Harper North and is now available from all good bookstores.