I currently have 16 small scabs on my arms and shoulders. For the past twenty months, this is the closest I’ve come thus far to allowing my body to heal from the challenging condition known as excoriation disorder, dermatillomania, or plain old skin-picking disorder.
Beyond a bad habit, dermatillomania is a true compulsion, an addiction. It’s often discussed along with trichotillomania (hair-pulling) as both are body-focused repetitive behaviors (BFRB) and diagnosed as obsessive-compulsive and related disorders (OCRD).
I should tell you now that I’m self-diagnosed. After taking a self-assessment test online, attending online seminars, and living with this hell for over a year and a half, I feel qualified to make that assessment. At its worst, I had close to 200 wounds at once, across both arms, both shoulders, my upper legs, my chest, and my lower back. I know. I counted them.
At Gwen’s insistence, I sought help from both my therapist and my doctor. However, it is beyond embarrassing to talk about this and I couldn’t convey the severity of the situation. Accordingly, the response from both of them was also downplayed and somewhat dismissive. Both my therapist and my doctor have been amazing in every other area I’ve approached with them. But I didn’t have the courage to explain further, to show them, to get them to understand that it was far more than picking at a few small blemishes.
If the sessions had been in person, I would have taken off my hoodie and allowed them to see the wounds, some of which were the size of a nickel. The impact would have been understood immediately then. On a video call, though, the thought of holding my arm up to a camera stopped me cold. And what felt like a confession of personal failure eluded vocalization.
TRUTH: Battling the urge to pick your skin is a 24/7; 365-day battle for Dermatillomania sufferers. Both the physical and mental effects of the disorder impact quality of life.5 Misconceptions Around Dermatillomania, Picking me foundation
So I’ve tried to get through this, to find a way out, the best I could. I downloaded an app geared towards breaking the patterns related to skin picking. It made me want to pick more. I keep my nails super short, which helps some. I’ve also tried substituting all sorts of tactile and fidget toys. One helps, a silly-putty-like substance that keeps my hands busy when I’m watching a movie or television.
The putty isn’t an option, though, when I’m in bed trying to fall asleep or awake in the middle of the night. I’ve ruined at least one set of sheets from making myself bleed at night. And I’ve taken far too many 3 am showers. Getting into hot water is one of the few things that takes the urge to pick away almost completely. At least long enough for me to fall back to sleep.
The approach that has been the most helpful for me is setting reachable goals: “Let these two heal,” for example, selecting the two wounds that looked like they were most at risk for infection. “And don’t add any more.” I’d count again the following Sunday. Slowly, very very slowly, it’s been working. Sometimes the number spikes back up after a particularly stressful week. But overall, it has been cycling down since I’ve focused on stopping gradually rather than all at once. 16 yesterday. A new record low.
I know better, though, than to proclaim myself healed. I’ve thought I had figured this out before and yet… here I am, twenty months after this round of skin-picking started, still counting active wounds. Right now, only two of the scabs are larger than the size of an eraser. Although the scars from the other wounds aren’t fully healed yet, and sometimes I force them back into rawness, that’s also getting fewer and further between. This is an improvement.
I really don’t recommend going it alone for anyone who recognizes themselves in these words. If it wasn’t for the pandemic, I would have sought out in-person help a year ago. And, honestly, I’ve spent far too many months in denial, telling myself I could make it stop any time. But it has been much harder than I’ve anticipated. It’s really not easy to talk about this. At the very least though, I’ve started being honest with myself about it. And nothing can truly change without that critical step.
Here are some resources I’ve found helpful: