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Guest Blog: I Can't Stop Picking At My Skin by Sara

Here's a guest blog with a bit of a difference - it's a Question & Answer session with Sara, who suffers from dermatillomania.
 
Tell us a bit about yourself!
I'm 27 and live near Manchester, England. I work in a special school helping teenagers with learning disabilities to communicate; it's insanely rewarding and tends to spill over into my personal life, with volunteering and study. I'm a old fashioned girl; my favorite things to do are drinking tea with my friends, sewing, reading & caring for my pet chickens! I'm also a total clothes junkie; I'm a Style Icon on Chictopia and write & take photos for my blog.
 
How did this disorder start?
It's something I've done for as long as I can remember. I grew up with a mother with massive untreated mental health problems, and was a very anxious child. One of her quirks was to always keep the house cold, and I can remember lying in bed each night picking the goosebumps off my legs.  It gradually grew more serious and pervasive as I grew older, and as life got more complicated.
 
What exactly do you do?  And how does it make you feel? 
I use my fingernails to scrape and dig at my skin. It often starts with something normal like an insect bite or an ingrown hair; I pick at that, then I want to pick more. Even if there's nothing else to scrape at, I'll find something. Any unevenness of skin texture or tone becomes a 'flaw' and I have to remove it. In my head, I'm removing the problem and creating super-smooth, flawless skin. Obviously in the real world, I'm making scabs and sores, and the next day they're bigger and uglier, and I feel the need to pick at them all over again. 
 
Once an area has my attention, I'll pick at it more and more, sometimes using tweezers or manicure tools. Sometimes I will spend several hours a day picking, and so it very quickly becomes a vicious cycle that never heals. I'll usually have one area I'm struggling with at any one time, and then I'll find a 'flaw' somewhere else and the focus suddenly shifts. An area I'm picking at very quickly begins to looks like a really bad case of chicken pox. 
 
It's something I do on a semi-conscious level.  Usually I don't know I'm doing it - I'll be watching TV or reading a book and recognize the stickiness of blood on my fingers.  Other times I will notice I'm doing it but can't stop, because I know I'm not 'finished'. There's definitely a compulsive aspect to it, and medical professionals link skin-picking to OCD and Trichotillomania (compulsive hair pulling) for this reason.
 
 Even though it's gross and it hurts, I find it incredibly calming and soothing. I can almost be trance-like when I am picking, and lose track of all time.
 
Unfortunately, eventually that feeling fades, and I'm left with horrible ugly, scarred, painful skin and huge feelings of regret.
 
Have you sought treatment? Has any treatment been effective for you? 
I take medication to manage my anxiety, have had a course of Cognitive Behavioural Therapy. I'm also on the NHS waiting list for psychotherapy to address some underlying issues. At the moment I don't think I have my symptoms completely under control, and find myself compulsively picking whenever I'm feeling anxious.
 
Do the people in your life know about this?  How do they react to it? 
The people closest to me know and accept it - we can even laugh about it! My boyfriend hates it, but tries hard to understand.  A surprising number of my female friends can relate; picking at  ingrowing hairs in particular seems to be a past-time for a lot of girls, and what I do is sort of just an over-extension of that.
 
Sometimes my friends or boyfriend will ask me to 'just stop', and I really wish I could. The best analogy I can think of is good posture; you know why you should sit up straight, you don't want to slouch, but you can only hold yourself in that unnaturally upright position for as long as you think about it. As soon as you're distracted or relax, the old habits sneak back in. 
 
How does this affect your life on a daily basis?
The most difficult thing is trying to keep it under control when I'm in public. If I'm feeling anxious, the urge will creep up on me unnoticed. Sometimes I'll be in a meeting at work, or in a cafe having lunch, and realize I've been picking in front of everyone for the last half hour. Awkward.
I'm often sore, have some scarring, and sometimes have to dress around it, but mostly I'm just frustrated that it is so beyond my control. I love to look my best; I spend so much time and money on my clothes and makeup, I run and eat healthily and keep in shape, and then I do this mindless thing that defaces my body and harms my self esteem. It's a constant tug-of-war inside of me and it's hard when there's only yourself to blame.
 
That advice would you give to others who are struggling with issues like these?
Look after your skin - regular exfoliation and moisturizing can limit the 'pickability' of your skin and stop you damaging it.
 
Identify the times when you are picking, and try to occupy your hands in other ways.
 
Keep problem areas covered up with tight clothes if possible, to try and limit 'accessibility'.
 
Most of all, speak to your doctor. It's way more common than you think, and you deserve to be free of it!

lizzieni wrote on 10 | 25 | 2012
I pick my skin. Last year I looked it up online as I was concerned about it. The result was dermatillomania. I took the info to my psychologist, thinking this was what I had. I hadn't discussed it with him previously. He said that it was linked to ocd, and usually treated with antidepressants. As I was already on a high dose of antidepressants, this was not a correct diagnosis. It was simply a symptom of my depression, perfectionism and low self esteem /image. But I still recognise so much of what you've posted. I do go through stages of doing it, sometimes related to anxiety levels. Could it be that there is a strand of it not related to ocd or not treated by antidepressants? Confused!
Neil-H wrote on 10 | 24 | 2012
So this is a real mental health condition, wow I feel so much better now, I do the same and can completely relate to everything you have written. I too tend to pick in areas that are normally covered, so it’s not something even my closest friends know about. I’ve been doing this on and off since childhood and I really thought I was the only one. I have also suffered with depression and anxiety since childhood, but didn’t finally give in to it until 12 months ago when I have a complete meltdown, sending me to seek medical help. As you say the picking gets you stuck in a vicious circle, I get lost in my own world, thinking I am doing good removing these lumps, bumps, spots, whatever doesn’t look or feel right. I often do it without realising, then the next thing I know I’ve got cuts a blotches everywhere, which look horrible, so I keep going at these same places for days with my nails, pins and tweezers thinking it’s going to make things better, but obviously not! This sounds horrible just writing about it, and it often ends up making me feel worse about myself, which does nothing for my depression. I must be honest and say I’m not sure I’m ready to go to my GP about this, even though he has been fantastic over the last 12 months since he diagnosed me with clinical depression. So what can I do in the way of self-help? Thank you so much for opening up, I could just be the push I need to get help.