Dermatillomania and Me

TW: skin picked images!

I originally wrote this post for social media. I’m posting it here too! With more in-depth writing on the subject to come!

Something I’ve been wanting to talk about for a while is skin-picking disorder, or dermatillomania. It’s something I’ve had since I was a small child, and it’s something people who’ve spent any time around me have probably seen me doing.

More skin damage caused by dermatillomania

It is a subset of OCD (obsessive-compulsive disorder) and what is called a BFRB, body-focused repetitive behavior. These are things I just learned this past month, at the age of 33! It is, in fact, not just a “bad habit”. Mere bad habits don’t usually wind up with blood!

Body-Focused Repetitive Behaviors

This is different from onychophagia, which is nail-biting. Incidentally, I also did this in my youth before my teeth became too weak to do so comfortably, meaning my nails are okay now for the most part. (Note: these photos are from last March.)

Something more similar, on the other hand, which you may have heard more of, is trichotillomania, the act of hair-pulling. I have also experienced a highly focused version of this — I was missing a lot of my eyebrows and most eyelashes in high school senior year.

(Catch me excusing myself during class to get tissue for my raw and bleeding fingertips. And they were calloused and rough even back then… Removing glasses to pull at your eyelashes is also awkward at best.)

They’ve mostly grown back now. It turns out that a lot of people actually have these conditions (1 in 20 I think?). Just no one else I ever knew¬†😂 At least not to my knowledge/extent! And it seems to produce varying levels of shame, or at least heightened self-consciousness.

I don’t have a lot of shame around the disorders — after all, aside from my immediate family, people actually did seem to express genuine concern when they said anything at all. And it’s a wonder I’d never had an infection or got sick.

I’ve mostly just had frustration, and it’s come to a head during these extremely stressful months of coronavirus and social upheaval. How exactly do you reverse such a condition that you’ve had pretty much your whole life in the middle of this?

I’ve made no efforts to hide it — after all, I couldn’t stop it. Why go with the extra stress on top of that? (I have a theory that internalizers tend to be more prone to this… Internalizing the extra stress, too! Like acting foolish in public!)

How do you just…stop being stressed and anxious?? How do you achieve this independently??? I had already removed the most obvious stressors from my life, but the general anxiety and paranoia remained, lingering like a ghost…

And I KNOW for sure now that I have a problem, because years of braces (in my preteen days) and months of contact dermatitis (not so long ago) weren’t enough to get me to stop picking, even though the physical barriers had been there.

“It takes 21 days to break an addiction”? DEFINITELY not true.

And, like everyone else, with the onset of the pandemic, I REALLY needed to stop touching my face AND putting my fingers in my mouth. Not to say I do this very often at all while shopping or touching unfamiliar things, but STILL.

Mindfulness

So, I found myself in a fortunate enough position to start therapy this year with the direct and specific intention of handling this problem, and maybe some other things along with that, which led to some immediate help and new ideas.

First, if you have a BFRB, inositol, a supplement that affects serotonin, may help you — it seems to help me quite a bit! It’s the only thing to really account for my calm these last few months.

(Because there is NOTHING to be calm about right now.)

I also started taking ashwagandha again. If you see it in the store, it may say “for anxiety” on the bottle. I don’t know if both this and inositol together are especially effective or not.

(I do know that¬†ashwagandha, which I’ve had in the past, and pretty much any other supplement won’t work if you are still in a stressful/triggering life situation. I was prescribed Paxil in high school. It wouldn’t have helped, either.)

During this time, I also became conscious of some of my stress/picking triggers — things like body discomfort (say from eating the wrong things, like dairy, or pulling a muscle), allergies (especially eye irritants), and work stress/feeling overwhelmed. It was eye-opening!

“Mindfulness” is getting thrown around to the point of meaninglessness these days, but truly being aware of your body, what you’re doing, your triggers, and other little things can help immensely. Deep breathing helps when I’m having any kind of muscle pain.

Recovery

My fingers have gotten SO much better in a short amount of time. It’s a world of difference, over just a few months — control, vs the feeling of hopeless I’d had, thinking I’d carry this “habit” to my deathbed. It’s been months since I had an out-of-control picking episode that left the fingertips raw!

(The color is even starting to return to them a bit! And the layers of skin are regrowing.)

The other thing I started doing recently is using the KeenSmart bracelet. It’s pricey, and it’s also difficult to calibrate for my particular problem (biting the fingers), but it is a very sophisticated piece of hardware that is ideal for larger, repetitive motions.

Ideally, I’d have one for each wrist, but just one may be enough for me. Just having it on keeps my awareness up as well. It’s good to be aware of what your hands are doing in general with a BFRB.

Anyway, all this is to say there is hope and there are options. But if you’re ashamed of your BFRB, don’t be — you’re beautiful, and you’re SO not alone! And even if the things mentioned here don’t help, there IS help for you out there!

Some relevant videos:

Designer, artist, author, comic enthusiast, and geek about visual design/video games/Japan/human rights. Among other things!

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