Lesser Known Mental Illnesses: Dermatillomania

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When people first hear about skin picking, they do not think of it as a serious problem, or think of it as an extremely unusual behaviour.

What I originally thought was a “bad habit” started from the age of fourteen, when every perceivable blemish was subject to excessive picking even if the blemish did not really exist. Originally starting on only my arms, the picking fluctuated and did not really seem like a huge deal, although those closest to me knew there was something wrong about what I was doing and the marks I was leaving on my arms. I began simply covering my arms with make up to hide the marks when I wore short sleeves and carried on with life.

As I got older and had increasing stress levels with high expectations at school, friendship worries and having to make decisions that would affect my future, the picking started becoming far more frequent. I began doing it subconsciously on areas of my arms that were not covered, even during school hours. Other times I would do it because I felt like I just had to, or else the urge to do it would be relentless, like an itch that just had to be scratched.

And so the cycle continued. I would pick, leave sore marks on my arms, cover them up with make up and leave them alone until the urge to do it returned. On better days I could go without touching the most likely areas, but on the days that were particularly bad, the picking had travelled to my shoulders as well as my arms. It was at this point I felt the need to see a doctor, and after briefly explaining the situation I was prescribed cream to tackle blemishes that I would pick at. Needless to say that this was not fully effective, as I was picking at places that were blemish-free, and would not stop the urge.

It wasn’t until the end of Year 11, at the end of my GCSEs, that I started thinking I had a real problem. By now my arms, shoulders, back, chest and stomach were suffering substantially from my constant need to pick, and I was regularly covering myself in various Vitamin E lotions and make up to hide my scars. I began having a very low self-image, became panicked by the idea of getting changed for PE around others and started feeling increasingly anxious and depressed. I told no-one for fear of being mocked or judged, and when I summed up the courage to visit a doctor it was not recognised as a problem and was told it was something I would grow out of.

By sixth form and the life changes that accompanied it – changing relationships, trying to get a place at university, a terminally ill family member – I felt as though I was stuck in a perpetual cycle of depression causing obsessive, uncontrollable picking and obsessive uncontrollable picking causing depression. It had become so bad that getting changed or getting ready to have a bath or shower was impossible without the urge to pick at my skin. There were times where I would use objects like tweezers to do it, or I would go to brush my teeth and I would look in the mirror and begin to pick, locked completely in it. There were times where I would spend a couple of hours solidly picking in the bathroom while the rest of the house slept, as I just could not get myself out of it.

The worst part of it all was that I felt I could not tell anyone about it. I felt alone in my problem and thought that I was the only one who had this condition, and at the time was not even aware that it was a condition. I even kept it from my partner, and used make up to cover any marks in hope that he would not see them. But on a day where I had forgotten to apply make up to my arms, he asked me about them and I could not keep it in any longer. I remember telling him what I did and how long I had done it for, and I had never felt such a strong feeling of shame and hollowness as I was feeling at that moment. Thankfully he was very understanding and supportive, and began being more open about the problem to those closest to me. I finally googled impulsive skin picking conditions and discovered that the condition, “dermatillomania”, became classified as excoriation disorder by the DSM-5 in 2013 – four years after my problems with it first started. I discovered that dermatillomania is thought to affect between 2% to 3% of the general population, but it could be much higher as many cases are unreported, are not recognized, or are not given any media attention, so the prevalence of dermatillomania could be much higher. It is classified as a Body-Focused Repetitive Behaviour, where the person’s behaviour has the potential to harm or damage their body and physical appearance, and is related to Obsessive Compulsive Disorder.

I would like to say that since starting university just over two years ago skin picking is no longer a problem, but unfortunately these things don’t always work like that. I still have the problem, sometimes far worse than others, and I still often feel uncomfortable telling people about it, or putting myself in situations where skin is more exposed. I have been for hospital appointments where the practitioner involved has asked me about my skin, even though it was nothing to do with what I was there for. I have been told that my skin could affect my future employment if I do not cover up. But I am tired of covering up. This condition needs to be understood, because it could be affecting someone you love and you may not even know.

To find out more about dermatillomania and what can be done to treat it, click here.

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