Yahoo Finance Dermatillomania: The OCD That Affects 1 in 20 of Us
Dermatillomania, also known as skin picking disorder, is a condition in which a person repetitively and compulsively pick at their own skin, to such a degree that they cause bleeding, bruising or other types of damage.
This is understood to be an attempt to relieve anxiety. It is a pretty common problem: An estimated one in 20 people are thought to be affected by dermatillomania, and, though there is no precise data, women are believed to over-index.
Here, writer Lauren Brown explains what living with this is like – and speaks to the experts about what drives the phenomenon.
I hadn’t realised I’d been holding my breath. As I snapped out of my trance, a hot line of pain suddenly throbbed across my belly. Standing on my tiptoes hadn’t brought me quite close enough to the mirror, so, without thinking, I had lumped myself over the sink’s edge and its porcelain lip had been sitting beneath my ribs. My eyes were dilated and the tips of my fingers hurt.
What is it like to have Dermatillomania?
Moving away, working to steady my now rapid breathing, the realisation of what I’d done – again – sunk into shame.
The skin of my face was angry. In some places it was bleeding, in others flaming red. When I looked at my phone I saw thirty minutes had passed since I had started picking. After applying some expensive skincare products I absolutely could not afford, I went to bed. This was – is – my nightly routine.
It didn’t occur to me at first that this procedure was out of the ordinary. Ever since I was a teenager I’d picked my spots – so what? – but as I found myself at 23 struggling to resist the overwhelming urge to have just one more 'session' in front of my bathroom mirror, I knew something was wrong.
If you think that you may be dealing with Dermatillomania, speak to your GP, call 0845 390 6232 to speak to someone from OCD Action or head here to access support from Mind.
Simultaneously desperate for perfect skin and the high my picking brought, I caught myself on the Tube or at work running an anxious finger over my face and neck, like an expert Mars rover scanning for any surface irregularities. Now, there were occasions when I was left so scarred and scabbed I’d cancel plans with friends.
One day, I Googled 'Can’t stop picking skin' and the word dermatillomania appeared. Unexpectedly, I was confronted by an actual disorder.
What triggers Dermatillomania?
The charity OCD Action defines the condition as 'repetitive picking at one’s own skin to the extent of causing bleeding or damage to the skin to relieve anxiety or urges,' and recognises that it may be described as being on the spectrum of Obsessive Compulsive Disorder, in a similar fashion to anorexia or Tourette’s Syndrome.
Is Dermatilliomana a type of OCD?
Dermatillomania is further grouped into a cluster of issues known as body-focused repetitive behaviours (BFRBs). These are habits in which people pick at, scrape or pull their skin, to an extent which results in damage to the body. They are generally understood to be OCD-adjacent.
For some, the action may be focused on the face. For others, around the fingers, in places like the cuticles and around the nails, or elsewhere on the body. In terms of treatment, cognitive behavioural therapy (CBT) and medication, such as Selective Serotonin Re-uptake Inhibitors (a type of antidepressant) are commonly prescribed.
OCD Action notes that skin picking 'is often preceded by an 'itch' or urge, which the person in question believes can only be relieved by picking. A feeling of depression or hopelessness follows when the damage caused is realised.
'Paradoxically, a kind of 'compulsive perfectionism' may convince the person that picking is a necessary means to achieving a clear complexion. In this way, a vicious circle arises that is hard to break. Thus it may be seen to have obsessive-compulsive aspects that are similar to OCD.'
For me, it was the part about relieving anxiety which struck a nerve. I deal with anxiety and depression and had come to see my picking as a an escape – a way of putting my constant whirlwind of thoughts on pause.
Why do some people pick their skin?
Dr. Sheri Jacobson, founder and CEO of the London-based Harley Therapy, explains: 'Skin picking is more often than not related to emotional suffering. This might be low self-esteem, emotional pain you don't know how to process, or a hidden core belief the world is a dangerous place and you need to try to take some control.'
'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.' '
OCD Action referenced 'compulsive perfectionism' – the illogical belief that skin picking would perfect the skin. A trigger which had developed for me was the sudden influx of clear and dewy complexions I had started to notice on my social feeds.
When I found (to my joy) a Facebook support group filled with other people with dermotillomania (mainly women), I heard similar stories.
Katryna, 29, who picks her face and calves, said that the process makes her feel calmed and in control. Like me, she has found herself uncontrollably spending on pricey products in a quest for the complexion she wants.
'I feel like I owe myself these expensive products as punishment for my picking,' she said. 'Literally, I see it as the price I have to pay to have this calming habit.'
Ashley, 32, says she frequently woke up in the morning 'to bloody sheets from picking my skin during my sleep.'
She continues: 'I now only pick areas that people can’t see, but I used to pick my face. I began getting facials, laser treatments, Botox. I use expensive creams on my face. Seeing beautiful women online makes me jealous and frustrated with myself.' She said her disorder impacted her social and sex lives: 'I insist the lights stay off when I’m intimate with my husband so he doesn’t see my ravaged skin.'
Jacobson says: 'Young people are inundated with false realities. Even if they are aware that many photos are airbrushed or the person has probably spent hours with a professional make-up artist, it still triggers self comparison.'
'All mental health issues are less talked about than they should be, but stigma always benefits from positive exposure. Not talking leaves sufferers feeling ashamed and alone. When we talk about things and realise we are 'not the only ones' then we feel less isolated, and can start to have more compassion for ourselves, instead of being controlled by shame.'
Dermatillomania and the skin positivity movement
One way that we're seeing a counter-narrative to impossible skin standards start to emerge? The burgeoning skin positivity movement.
One YouTube activist, Rocio Cervantes, actively highlights her acne with make-up to stick a proverbial middle finger up to a society which tells her to hide it. The @getyourskinout movement, spearheaded campaigner by Holly Dillon, aims to crush the stigma around skin that's dealing with psoriasis.
Lauren McKeaney runs the only nonprofit worldwide dedicated to skin picking disorders, Picking Me, and told me she had struggled with the compulsion for over two decades. Her organisation aims to encourage 'individuals to choose themselves over the mental illness that chose them by #PickingMe over skin picking.'
It’s ironic that a disorder whose sting is in how overly visible I feel also renders me invisible. The very lack of representation of skin that looks like mine is what can shudder me into attacking it.
Of course, this disorder runs deeper than aesthetic issues and how I want to look: it's bound up in issues of anxiety and shame and myriad other things buried in the darkest parts of myself.
But, as I lie in bed furtively scrolling, seeing a beauty shot of someone with visible ‘imperfections’ may dim my urge to pick. It might not. I do feel, though, that since my anxious fingers are scouting for 'perfection,' seeing the word rewritten to include myself –and others – could make a difference.
How do I know if I have Dermatillomania?
According to the NHS, the below are they key signs that you have dermatillonamia, or skin picking disorder:
you cannot stop picking your skin
you cause cuts, bleeding or bruising by picking your skin
you pick moles, freckles, spots or scars to try to 'smooth' or 'perfect' them
you do not always realise you're picking your skin or do it when you're asleep
you pick your skin when you feel anxious or stressed
If you identify with the above, the NHS recommends you:
keep your hands busy – try squeezing a soft ball or putting on gloves
identify when and where you most commonly pick your skin and try to avoid these triggers
try to resist for longer and longer each time you feel the urge to pick
care for your skin when you get the urge to pick it – for example, by applying moisturiser
tell other people – they can help you recognise when you're picking
keep your skin clean to avoid infection
When should I seek help for Dermatillomania?
If you are worried that you have skin picking disroder, the NHS says that you shoud see your GP if:
you cannot stop picking your skin
you're causing serious damage to your skin by picking it, like cuts that do not heal within a few days
picking your skin is causing you emotional distress or affecting your daily life
What are the treatments for Dermatillomania?
Your GP may offer you a series of cognitive behavioural therapy sessions in which you learn what triggers your skin picking and how to replace the picking with a different, less harmful behaviour.
Some people may also be offered medication to help, such as one of a family of antidepressants known as SSRIs (Selective Serotonin Re-uptake Inhibitors).
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