Hi,

I'd like to share my story so that it might help someone else, and so that I might relieve my own shame and alienation.

I started picking when I was probably twelve or thirteen. Before then, I'd noticed a few breakouts, but I considered them part of teenage life and didn't worry much about them. Then one day outside my ballet studio as I was on my way to class, my dad stopped me to point out a blackhead on my face. He told me to scrub my face more, insinuating that I had poor hygiene, and attempted to squeeze it with his dirty fingers right there in the parking lot. I was annoyed and ashamed.

I think after that was when I began obsessing over my skin. My bathroom was covered in mirrors and had marquis lights so I could see every tiny impurity. I spent hours scouring my face for pimples and blackheads using the extracting devices my father bought me from the pharmacy, my fingers, and when those failed, a needle, thumb-tack, or safety pin. I would wait to attack my face until my sister, with whom I shared a bathroom, finished her nightly routine so that I had privacy - I was ashamed of my dermatillomania (although I didn't know that's what it was back then).

At a certain level, I always knew that what I was doing was wrong. I knew that picking can cause scarring and/or exacerbate acne, but I couldn't stop. I didn't realize it was a compulsion. I felt guilty, ashamed, and alone. I like to eat the sebum (hardened oil and skin particles) that squeezes forth during extraction, which is so strange and embarrassing that the only way I can excuse my behavior is by reminding myself that I'm an animal, and other animals do similarly weird/disgusting/self-destructive things. Some dogs need to wear ridiculous cones round their heads so they don't chew their stitches, for instance.

I may have little more control than a dog, but I at least have a degree of confidence that I'm more intelligent. I think I understand the causes of my dermatillomania. My mother died of cancer when I was six; my father and I had (and to a certain extent still have) a very conflictual relationship. I was not physically abused, but I never felt safe at home. I lacked secure friendships because I believed that I was not worthy of love. I pretended to be whatever I thought people wanted me to be I was so desperate for attention and affection. I lost touch with my true self and my needs.

Picking gave me a great sense of relief. I frequently spent between 15 minutes to perhaps an hour popping pimples and squeezing blackheads - I don't know because I would lose track of time. While picking, I zoned in on my task and allowed all else to fade away. I also think it provided a sense of control or autonomy, especially appealing since my father has a very authoritarian (i.e. undemocratic) parenting style. I think I felt that by reducing the duration of a breakout, I was ameliorating my situation. I was so desperate for any relief whatsoever that the prospect of lifelong scarring was no deterrent. This hypothesis is supported by difficulty I have delaying gratification in other domains (e.g. intimate relationships), impulsive and risk-taking behaviors.

For others suffering from dermatillomania, perhaps it would be helpful to disclose the ways in which the disorder has manifest.

I sucked my thumb until I was seven or eight, and while I am unsure that this is related to dermatillomania, due to the abnormal persistence of this behavior and its "oral" nature, I think it is plausible that there could be some connection.

I have always bitten my nails and cuticles, and I don't spit them out but chew and swallow them.

Due to over-exfoliation and use of topical acne creams like benzoyl peroxide, dry skin has been nearly constant, and I have often attempted to scratch off what I call "peelies," or dry patches of skin.

Whilst studying, particularly, I have caught myself scouring my skin, particularly that of my face and scalp, for bumps to scratch off.

I occasionally use my fingernails to scratch the plaque off my teeth.

I have eaten the calloused skin which I have removed from the soles of my feet.

I have picked the "split ends" of my hair - at times in much the same way as when I have picked my face, in that I "zone out" and lose track of time and I know it's bad for the health of my hair.

I confess my "deepest, darkest (and grossest) secrets" here because I hope this will help me gain the courage to do so in person, to the people I love. The only way to overcome shame, the fear of rejection, is by sharing it with others so that we may prove to ourselves that we are still worthy of love and acceptance, that we really have nothing of which to be ashamed.

I know what I have to do, but it's still mortifying! I've gotten much better since I went to college, partially because I no longer live with my father, who stresses me out, and partially because my education has equipped me with better coping skills to deal with stress, but I still struggle to resist the urge to pick almost daily. I still do it during stressful periods, like exams, and often while studying I catch myself unconsciously feeling my face for bumps to pick. Even so, what I struggle with most now is coping with the scars and acne which my dermatillomania cause(d).

I have scarred or enlarged pores all over my face which host a plethora of blackheads, whiteheads, and the occasional volcano-sized zit. I significantly exasperated what was in all likelihood a mild case of acne and caused permanent, unseemly scars - lots of them. When I'm under bright lights or in close proximity to others, I get very self-conscious. I fear they can see the destruction I've wrought, that they're disgusted by it - but worst of all, that they know that I inflicted this all upon myself - that I'm sick.

Dermatillomania has delivered a terrible blow to my self-esteem, and I suffer from borderline obsessive thoughts about my skin, especially when I'm stressed out: I beat myself up for damaging my skin in an irrational attempt to prevent myself from inflicting further harm. Irrational because I am a *compulsive* picker - to great extent, it is beyond my control. I cannot blame myself. If one had to pinpoint one single cause for my plight, it would be my mother's death - and that was not my fault.

The best I can do is learn what triggers the behavior and attempt to avoid it. Beating myself up only exasperates my anxiety, and stress is a major trigger (and it encourages breakouts, so it's a double-whammy). I try to avoid mirrors. Most importantly, when a negative thought about my skin intrudes, I try to remember that my acne and scars do not render me unworthy of love.

I am lucky: I have a few wonderful friendships and a wonderful relationship with one of my aunts, which reinforce my belief that I am not a hideous monster who warrants rejection. My skin isn't great and I have issues, but I have worked hard to learn how to cope with these setbacks, and in the process have gained courage which I know to be admirable, and I am proud of myself. In our image-obsessed culture it can be hard to remember, but I know that my dermatillomania, paradoxically enough, has made me a more beautiful person, not on the outside but on the inside.

I suspect dermatillomania will be a life-long struggle for me, and accept the challenge. I'm constantly on the lookout for positive coping skills, activities which can help relieve stress in healthy ways like bike-riding, cooking, reading, etc.

My advice to anyone else suffering from dermatillomania: you have to convince yourself that you are good enough just the way you are.

If you can afford it, consider seeking help from a therapist (cognitive behavioral therapists are probably a wise choice). I've actually benefitted more from studying psychology, myself, though. It was my college minor, but I also try to read all that I can, listen to podcasts (check out Philosophy Bites), watch TED Talks (I highly recommend Brene Brown's to absolutely anyone and everyone), and talk with whomever is willing. My therapist mostly helps me by enabling me to test the waters before opening up to people in the real world: when I tell her my most shameful secrets and she doesn't run for the hills or have me institutionalized, I gain the courage to open up to the people I love and be honest about who I really am. That way, they can help me deal with my problems so I don't always need to pay a therapist.


Best of luck to anyone reading this. You are worthy of love, no matter who you are. Dermatillomania's perhaps a bit peculiar, but I'd be willing to bet that if anyone else walked a mile in your shoes, they wouldn't judge you for it.