Dermatillomania and self harm – twins or neighbours?

A few days ago, I walked into my therapist’s office and was diagnosed with dermatillomania. This had been a long time coming, but in my usual way I didn’t really think there was much to be concerned about. I don’t really know how I feel about it all. In one way, it’s kind of relieving to know that it’s not just me being weak, or lacking discipline because I cannot stop. There are other people doing the same weird things I do! Hooray! In another way, I feel at a loss with my brain at the moment, and the handful of confusing words I lug around to apparently describe what goes on in there. Brain, what am I going to do with you?

I don’t know if even writing this is the right thing to do. Is it a good idea to be this open with the internet world? The reason I am continuing, that I am still going with this piece, is simply because it scares me. And something that has been colossal throughout recovery so far, is that my fear doesn’t serve me. It has gotten me approximately nowhere (though probably backwards, if we wanted to get all geographical about it). So here I am. Honest and afraid and uncertain and all.

Dermatillomania a funny word. My very first thought was why it includes “mania”. I’ve been reading the information my therapist gave me, and it isn’t exactly light reading. It’s loaded with dire, long-term consequences, and professional arguments of whether or not it is part of obsessive compulsive disorder and body dysmorphia. But that stuff isn’t what I need to write about today. Today, I need to write about dermatillomania and self harm.

Purple Petaled Flower

For over a year now, I haven’t engaged in what I know as self harm, and this is a massive, rocky accomplishment for me. But as my therapist and I were talking, she felt it was important to explore if I could be self harming still, though through dermatillomania. However, from my own personal experience, they do not appear as twins to me. But I see how the two are closely related in some regards. Perhaps they are neighbours?

With self harm, it was all based upon strong emotions I didn’t know how to cope with otherwise. I needed the release, the physical sign of mental anguish. My intentions were those of pain, and of what I believed I deserved.

Yet with dermatillomania, things are very different. For me personally, I think it is more related with anxiety, and with how I view my body. It something that has more spiralled out of control. With dermatillomania, I am not actively trying to hurt myself, nor is that my intention. Sometimes that happens in the process. But I don’t mean it to, because self harm is something I am actively working to overcome.

However, similarities can be drawn between the outcomes of self harm and dermatillomania. The large impact it can have on your body is shared, as is the physical harm, and the dangers of this. Both can be a cause of shame, embarrassment and isolation. They are both often misunderstood.

I have been trying to find out more information on dermatillomania and self harm, to clear things up in my head. Some websites clearly distinguish the two, talking about how they are separate. Others label dermatillomania as a form of self harm. Maybe it’s different for everybody?

If anyone reading this experiences dermatillomania, I would love to hear from you. This is a confusing new land to have reached.

I am very new to this term and what it all means. These websites helped a lot if you are in the same boat: and


10 thoughts on “Dermatillomania and self harm – twins or neighbours?

  1. I have not been properly diagnosed by a professional, but I believe I have symptoms of dermatillomania, with the actual picking of scabs or skin being worse or very mild during different periods throughout my life. I do think mine originates from anxiety. The earliest recollection I have of having a bad outlet for anxiety was when I used to chew on the whites of my nails. Somewhere along the way during those years, I started picking scabs on my back. Now as an adult, I have a ton of scarring all over my upper back and still have healing scabs from my repeated picking. 😦 It’s a vicious cycle. I’ve toned it down somewhat but it’s hard. There are times I can actively be in the mindset of realizing I am anxious and feel the urge to pick and I can prevent myself from doing it. Other times it’s like the anxiety just balloons in my head and I feel so out of focus not knowing how to deal with it that I start mindlessly picking without knowing how to stop. That’s the anxiety part, but also I know I’m insecure about how I look, particularly when I have a little bit of acne and I am self-conscious about the skin being bumpy or uneven. I don’t know if my picking can be considered self-harm. I don’t actively pick to feel pain, but it’s like a mindless activity I do because that’s what I go for when the anxiety gets to be too much. I used to pull out strands of my hair as an outlet for anxiety too, though with that, there was a point where I felt I was consciously pulling in order to feel pain and also because I thought (in a scary way) that I was “improving” my looks by removing hair strands I deemed ugly or unattractive.

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    1. Thank-you for sharing your experiences Nat! Although I am so sorry that you too experience this, what you wrote really resonates with me. Thank-you for sharing your perspective, it helps me to expand mine. Sending you hugs and good vibes (:

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      1. If a diagnosis would enable you to access treatment that you may want, then it’s probably a good idea to bring it up with a professional. But either way, a diagnosis doesn’t change what you are experiencing, and you can work through it if you want to, regardless of an offical word or not ❤


  2. You needed to write this, turns out I needed to read it! I self harm for similar reasons that you raised, releasing strong emotions or punishing myself following binge eating or sometimes to feel something, anything, beyond numbness, even when it’s pain. I found that when I experience urges to self harm but cannot act on them (i.e. with a knife), then I will scratch instead. It has happened during every hospital admission (three). Frenzied, awful scratching, across my chest and arms, and legs if i am seated. Think the frenzied nature is where the “mania” part fits into it all. Similar to you, I think its connected to my anxiety, particularly in new and overwhelming social situations, but a part of it is also about hurting myself. It really ramped up while I was hospitalised for safety concerns and I think because it’s not “self harm” with a sharp object it was kind of ignored… like sure, I scratched at my body until it bled, and I had no skin left on my chest, but it wouldn’t scar beyond a few weeks, it wasn’t deep, it didn’t seem like self harm to the nurses who watched me do it. But it was. It hurt. It felt good. It made me feel real. It helped with the anxiety. I certainly don’t think they’re twins, but neighbours does seem accurate. and I also think both are seriously misunderstood, stigmatised aspects to mental illness. However, I think because I tend to lean more towards the ‘real’ (and i use that word pretty lightly) kind of self harm, and scratching is a rare and last resort only in severely anxious, distressing and triggering situations, dermatillomania doesn’t really fit with me. Not discounting the possibility, just not sure it’s a diagnosis I qualify for. just another fucked part of my mental health experience – which i can also thank my brain for.

    (also i’m having such a ball reading your blog, thank you for all the words you’ve shared here)

    Liked by 1 person

    1. Rosie, thank-you so so much for sharing your experiences with me. It’s such a tricky thing to work out why we do things, and what they can be understood as. Your insight definitely helped, and I feel honoured that you shared part of your story with me! I’m so sorry that you have had these experiences, but I do thank you for your understanding and support. I too would scratch my skin as a form as self-harm, when I wouldn’t be able to cut, however the dermatillomania I deal with day-to-day is a bit different to that. It’s hard to explain though. It’s more of needing to get rid of any “imperfections”, even if they are invisible to others, kind of like a soothing thing. I get drawn to anything raised, bumped, discoloured, and I just need to take it off. It’s weird. My mental health is weird. If nothing else, writing about these things has allowed me to meet some pretty rad people – you included! And that, I am thankful for. I’m looking forward to following alongside you blog, and reading about what you choose to share! Hope you are having a loving and kind day today lovely Rosie 💛


      1. Mm yeah, even as someone with her own plethora of fun abbreviations to deal with, the obsessive side to it is not something I’ve experienced myself. I have gotten into pimple / imperfection squeezing frenzies but I don’t think it qualifies because it’s infrequent and mostly controllable… I think mental health is weird in general -you’re not alone in having that thought! Maybe weird isn’t even the right word, I think extremely misunderstood, and so NEW as a branch of medicine. Woohoo here’s to rad friendships over the internet ❤ I wish the same to you and have loved loved loved all the posts I've poured over so far 🙂

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