My Battle with Dermatillomania

Recently I was told that the first thing we must do to overcome a situation is to accept it. So today I wanted to share something that has affected me for the past 13 years.

We are all human and we all have things about ourselves that we’re not happy with or bad habits that we’re trying to break. Dermatillomania is my bad habit.

This year I am determined to break this habit and hopefully help others along the way who may be suffering from the same thing.  See below for some tips to help you stop picking at your skin.

What is it?

Dermatillomania is also known as compulsive skin picking (CSP) and is part of the OCD spectrum. People with dermatillomania will pick at their skin anywhere on the body but the most common places are the face and hands, although those with this disorder do not necessarily pick everywhere and may just focus on one area.

The picking may start at normal blemishes such as freckles or moles, at pre-existing scabs or at acne. They may also pick at imagined skin defects that nobody else can see.

The reason dermatillomania is often categorised under OCD is that the picking is often repetitive, ritualistic and tension-reducing. You may also be completely unaware that you are doing it as it becomes a habit and you can be picking away at your skin whilst reading, watching tv or using your phone etc.

It can also be linked to Body Dysmorphic Disorder (BDD) as some suffer’s may feel that picking at these blemishes will make them look more ‘normal’. The picking can create more pronounced abnormalities and can lead to a vicious cycle.

My Story

I have had acne since I was about 13 and I have always picked at it. I know its gross. I know I shouldn’t do it, but somehow it made me feel better. At least, it made me feel better whilst I was doing it but afterwards, I’d feel guilty and miserable.

Last year I had a bit of light bulb moment. I found out about the condition called dermatillomania and I realised I was not alone.

Dermatillomania is more than just squeezing a few spots. It becomes ritualistic, so the first thing you do when you get home from school/work is squeeze that spot that’s been annoying you all day, and you don’t stop there before you know it you’ve been stood there for half an hour and your face is as red as a tomato.

Be learning more about the condition I found a level of acceptance and have begun my journey of breaking free from this destructive cycle.

After accepting that this is what I was doing, I began to look for my triggers. OCD like behaviours are often tied to external or internal cues, and once you’ve identified these cues you can start putting actions in place to disrupt the behaviour pathway.

Before pictures

I took these pictures a few weeks ago and looking back I think my skin doesn’t actually look ‘that bad’ and it’s been a lot worse before and that other suffers are a lot worse off. That little voice telling me that my feelings about my skin are not valid has stopped me from writing about this subject before.

Why do we feel that just because our issues are not extreme, they’re not worth talking about? Like when you’re unhappy with your weight and you can see yourself gaining pounds but because you’re not classed as obese you’re told to stop complaining about your weight or that ‘you don’t need to diet’. Baffling.

Your feelings do matter. You know your body best and if something is making you unhappy then it is important and others should respect that and listen to you.

Why do I do it?

My skin picking is focused on my acne, and I don’t pick at my moles or freckles and I am quite good at leaving scabs alone, so long as they’re not on my face.

I’m not sure exactly why I do it or why I started doing it. I think when I was a teenager I was very self-conscious about my looks and when I started getting acne I just wanted it to go away. In my mind, the quickest way to get rid of a spot was to squeeze it. Bonkers, I know.

Now that I am an adult and still suffering from acne that closely follows my menstrual cycle, I still find myself picking at my skin.

You can fill yourself with knowledge and understand the damage you are doing to yourself, but it doesn’t actually help you stop the behaviour.  I can see that it’s not helping me reach my goals of clear skin and this was just feeding my anxiety that it would never get better and I’d have acne til I’m old and grey!

The triggers are going to be different for everyone, and if you suffer from obsessive skin picking, the first step to stopping – after acceptance- is to identify/ become aware of when you pick. I asked my boyfriend to help me with this. He just lets me know when I’m touching my face and that is enough for me to become aware of it and stop.

One of my main triggers is feeling anxious or stressed. I wouldn’t say I have full-blown anxiety or panic attacks, but I need to get better at controlling these feelings and reducing stress in my life.

Tips to help you stop picking at acne:

See your GP – I’m not a healthcare professional, and If you think you’re suffering from dermatillomania you should make an appointment with your GP who will be able to talk it through with you and may be able to offer you some treatment.

Cognitive behavioural therapy (CBT) – Your GP may refer you to some CBT sessions, or you can book yourself in with a private qualified provider. These sessions will focus on the unwanted behaviour and the behaviours that lead up to it (the behavioural pathway) and look at implementing methods to change the way you think or behave.

Becoming more confident – look for ways to challenge yourself and step out of your comfort zone. This could be talking openly about the issue by sharing it with family and friends or sharing your story with a support group. But anything that challenges you to step out of your comfort zone is likely to result in a boost of confidence. Becoming more confident can help you feel more in control and happier whilst you tackle the cause of your acne.

Keep your hands busy – if you find yourself picking at your skin when your hands are idle then using a stress ball or some other similar object may be helpful for you. I leave a stress ball by my computer desk as this is the time I often find myself touching my face. Fidget toys like the one shown below could also help.

Stay away from the mirror – When washing your face try to do so away from the mirror; if you can’t remove the mirror from your bathroom try covering it up with a blanket or towel. You may want to cover up other mirrors in the house if you find yourself picking in front of those too.

Gloves – wearing gloves obviously makes it harder to pick your skin and could definitely help you become aware of when you touch your face. But gloves are not always practical – you can’t wear gloves and type!

Below are some more helpful tips provided by the NHS:

  • do not let your nails grow long – keep them trimmed
  • do not keep things like tweezers and pins where you can easily get at them
  • 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
The cause of acne is different for each person and usually, there is more than one cause. If you pick at your acne, then finding ways to reduce the severity of your acne whilst working on resisting picking may help you stop the cycle:

Drinking water – You’ve probably heard this a lot. But dehydration can make acne worse and slows down our bodies ability to repair itself. So drink up!

Cleaning up your diet – Sugary foods and dairy products have been found to worsen acne in some people. Be careful about cutting whole food groups from your diet though and always seek advice from your GP first.

Exercising more to de-stress – If stress is causing you to break out then exercise could really help you. Scientific studies have shown that exercise really does reduce stress and sweating a few times a week could help you purge any blocked pores too!

Facials at home and from a professional – Looking after your skin with moisturisers that don’t clog your pores and purging facials could help you reduce your acne. Getting a consultation from a skincare specialist could also help you identify which products would be best suited to your skin type and they should be able to recommend the best professional facials to get too.

Keep your glasses clean – If you’re a glasses wearer make sure you keep the nose piece and rims clean. Glasses pick up oils and dirt from our hands and face and can harbour bacteria which cause acne. The nose piece is a particularly troublesome zone as the constant contact with your skin traps and pushes the oils into your pores.

Using make-up – You’re probably aware that some ingredients in make-up can make you break out. But when your face is covered in acne it can be difficult to leave the house without at least a basic layer of foundation. I have also found that I am actually less likely to pick at my acne when wearing make-up as I don’t want to mess it up! Just make sure the products you use are not too drying, are non-comedogenic and you wash them off at the end of the day.

I hope you’ve found this post helpful. If your suffering with dermatillomania to any extent, remember that you are not alone. Your feelings are valid, and you can stop the cycle.

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