Allowing My Skin to Heal
Bringing awareness to dermatillomania
I recently found an old school picture of my fifth-grade self. I was wearing a Tennessee Titans jersey, and in the beginning stages of a bowl cut. I wouldn’t have kept my eyes on it for much longer, but I noticed something when I looked to my smile: my lips were picked.
I’m not sure when it first started, or how long I’ve been doing it, but if the picture was taken near the start of it, then I’ve been picking my skin for around 18 years. I didn’t think much of it growing up. I thought it was just something that added to the classification of me being an “odd” child. Plus, it was satisfying.
I knew that when I was bored or when I was stressed, I could pick at my fingers or pull at my lips and feel some sort of satisfaction. A visual image of a job well done when blood started rolling down my fingers or I could taste copper in my mouth. Self-harm wasn’t the goal here, it was completion. When my mind couldn’t focus and I was getting frustrated with myself, I could bring my mind into a state of calm by performing repetitive picking.
Skin picking, known as dermatillomania or excoriation disorder, is a body-focused repetitive behavior (BFRB). Psychology Today notes that to be diagnosed with excoriation disorder under the DSM-5, a person must pick enough to cause damage, there are attempts to decrease or eliminate the behavior, and the picking causes mental distress or any other impairment.
This is something that affects 1.4% of the population according to Psychology Today. This is probably why I felt so alienated. I didn’t pick in front of other people, though surely my family must have noticed it? But, I don’t remember them ever saying anything about it. I know for a fact that the results of my picking were not discreet. If I could see them in old pictures then it had to be even more obvious in person.
My parents, as well as other adults — whether extended family or teachers or coaches — should have noticed and thought, I wonder why his lips looked chewed up, or his fingers raw and scabbed over? Seeing these old pictures or videos, I wish I could go back and help myself. Find the root cause of all this. Maybe I will one day, but for right now, I need to focus on healing myself mentally and physically. In regards to anything, that is always a personal process. Where do I even begin?
Skin picking, like most things, is very personal. There can be similar underlying causes and Psychology Today states that it may even be genetic. But for me, I feel I pick the most when two things come up: boredom and frustration. The boredom issue is going to be easier to address. I need to keep my hands busy. I’ve always loved working with my hands, but in recent years I haven’t had much time to dive into more interesting hobbies, like music or gardening.
I’ve been working my days away and though I am constantly using my hands there, my mind can drift and I can still find time for “mini-sessions.” This rolls into the frustration aspect of my skin picking. Though really, I could say it’s anytime I feel negative emotion. Skin picking feels good, and that’s the main reason I do it. When I’m frustrated that a project I’m working on is giving me trouble and I feel like I’ll never complete it, I’ll pick at my skin.
When I’m upset about something, I’ll pick at my skin. It may even be due to my body dysmorphia. All of my negativity bundles together and is alleviated with this physical action that I’ve been doing for at least 18 years. You can see how much it affects me when I can’t stop a section until it’s “perfect” and I got rid of any hanging skin. Psychology Today even brings this up and mentions that it will lead to over-grooming of the affected areas. I believe this is part of the reason why I pick: perfection. The other reason is most likely control.
Awareness is the first step to healing. Realizing that there is something you want to change and noticing how often you do that something that negatively affects you. That’s where I’m at now and where I have been for the past few years. But only in the past year, have I actively worked on reducing my behavior. I am started to mentally think to myself, STOP!
My partner has been helping me as well, telling me when it’s happening because it’s so automatic that I don’t even have to think about it. I get a mental block while working on a problem and my hand goes right to my lips to start tugging at the skin or pulling the skin around my cuticles. My partner is the only person that noticed, out of how many people in my life. That may be inaccurate to say, though.
Rather, I should phrase it that my partner is the only person who has brought it up and questioned why I do it. And that is what sparked awareness. That is what allowed me to think, Why DO I do it? This awareness is allowing me to work on my repetitive habits, which go beyond skin picking, and while it causes some distress at first, it is leading to the end goal of acceptance. Acceptance of myself and who I am. That imperfection is perfection.
Dr. Lisa Zakhary at Harvard Medical School discusses some of the tips on breaking the habit of skin picking and I’m focused on their first and second tip right now. The first tip is knowing your triggers. I now see what my triggers are and I’ve been able to stop myself, or at least largely reduce, how much picking I do.
What used to be hours of picking is now a few minutes, or even less than a minute. I’ve been getting over my “all-or-nothing” mindset and am allowing myself to take small steps. The second tip is to make the process of skin picking difficult for yourself.
For me, I cut my nails and trim any skin I see that could otherwise be used for picking and pulling. I am putting myself into more positive mindsets and when I feel like I’m starting to become more negative, I take a deep breath and focus positive intention inwards. Eventually, I want to completely stop my skin picking, and I’m getting there, one day at a time.
For anyone that is suffering from dermatillomania, know that you are not alone. It’s alienating and painful in more ways than one, but there are others out there in different stages of healing that can help you or that you may be able to help. While searching for information about skin picking, I came across Picking Me, a foundation founded by Lauren McKeaney advocating for sufferers of dermatillomania.
It’s an amazing feeling to find an organization that is working to spread awareness for something you didn’t know had an official name for until you were in your 20s. Hopefully, other people will learn about this condition and help those in need when they spot it. With more awareness comes more avenues for help and healing and acceptance that people that suffer are still loved.