What is dermatillomania?

From writing a couple of little ancedotes about my experiences with dermatillomania on here, quite a few people have said that they hadn’t heard of it before, and didn’t know what it was. And understandably so! It’s a big, long funny sounding word, and it definitely isn’t talked about as much as other mental illnesses, such as anxiety or depression. So I thought it would probably be helpful to make a factual sort of post, explaining what dermatillomania is, and how it is generally expressed in different people. I hope this doesn’t come across as lecturing or condescending, or like I’m demanding that you learn everything about dermatillomania, but merely if you are interested, here you go! 

So first things first, dermatillomania is also known as skin-picking disorder or excoriation (another complicated sounding word) disorder too. It’s classified as a BFRB, which stands for Body Focused Repitive Behaviour, and that’s actually quite an informative acronomyn. There is also a big debate about whether dermatillomania is more closely linked with obsessive compulsive disorder, impulse control disorders, or body dysmorphia disorder.

From a technical perspective, dermatillomania is defined as the “repetitive and compulsive picking of the skin which results in tissue damage.”. It’s estimated that about 2% to 3% of people experience dermatillomania. This can present itself in many different ways across the population of people who experience it. For some, it’s all about removing anything that is percieved or deemed as a blemish or irregularity, regardless of how small, while for others it has a more obsessive nature. However, across all, the urge to engage in picking feels uncontrollable, and there is always physical harm as a result.

Most people pick with their hands, however tools after often used too. This happens can happen primarily during times of stress, tension and anxiety, and can also occur absent-mindedly, without the person even realising what is going on. The focus is generally on the areas of the body with the most percieved impefections, however once the skin becomes too damaged, other areas can be targeted too. The most commonly affected areas are the face, scalp, limbs, shoulders and chest.

It’s also important to note that most people do pick their skin from time to time, that it’s just something that lots of humans do. However it’s the significance of the effects of the picking, including physical, mental and social, and all the chaos going on in the brain surrounding the skin picking, which sets it apart as a mental illness – dermatillomania.

The physical consequences of dermatillomania aren’t too fun, and many provoke the continuation of the disorder. Picking, squeezing and scratching the skin, for what can be hours each day, has significant, long term effects. Scarring, both temporary and permanent, is really common, as is pain and skin discolouration. Infection and tissue damage is also prevalent, which can be a nasty surprise when you are convinced that your skin picking is nothing to worry about. A blog post over at Fkin Realistic, BFRB Put Me In Hospital, describes really wonderfully the severity of dermatillomania. It’s a great read.

From a mental perspective, dermatillomania rampages here too. The embarassment, guilt and feelings of shame that arise from skin picking are apparent, and it also really doesn’t help with self-confidence, self-esteem, or resilience either. It can also result in social issues, such as interfering with work and social lives, and having to hide the condition away.

Treatment for dermatillomania is a bit of a tough topic, as not a lot of research has been done. Also, it’s estimated that less than half of people with dermatillomania seek treatment. The embarrassment and shame can be huge. The physical consequences on the skin of dermatillomania can also mirror drug abuse in some instances, and the stigma surrounding both is harmful to accessing treatment in both cases. However, success has been found in the use of anti-depressants for reducing skin-picking severity and intensity. Behavioural therapies have also proved useful in many cases. It’s all about trying out as many options as possible, until the individual finds out what works for them.

Anyway, that concludes this little introduction to dermatillomania. I hope it didn’t come across as too boring, or like I’m some sort of expert, because that is definitely not how it is! I’m just an ordinary person who recently got diagnosed, and who is trying to learn more. If you got this far, thank-you so much for sticking through, and I hope that this has helped in some ways whether you are just interested in learning more, or if this is something that you identify with. It’s really important that if you see your skin-picking and thoughts around it as a problem, or if others have expressed concern, that you do get in touch with a doctor or mental health professional. They truly can help, and you don’t deserve to live all alone with no tools to use against dermatillomania. 

This article by SkinPick, Everything You Need To Know About Dermatillimania, does a superb, detailed job at explaing it all much better than I can. 

If you would like to read more of my posts about dermatillomania, you can check out finding some good in dermatillomania, dermatillomania, bees, and buttercup, and dermatillomania and self harm – twins or neighbours? All involve big old rambles and yarns, if that’s more your jam.



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Finding some good in dermatillomania.

A couple of months ago when my therapist began talking about dermatillomania with me, everything clicked into place.

It all made so much sense. Why I find it near impossible to just leave my skin alone, and why I’m constantly running my hands down my limbs, face and scalp, searching for any imperfections to remove, regardless of if they are real or not.

Dermatillomania causes arguments in my relationship with my husband, because for him it’s painful to see somebody he loves and cares for, hurting themselves. And for me, what it really comes down to is that it’s an impulse control disorder, so it can be really tricky to mitigate and explain.

It makes me self-conscious. Right now, my face is a mess, not from acne, but because I remove anything I classify as “blemishes”. My legs also look rather bad, because I got a couple of mosquito bites while in the forest at the weekend. They would be fine, however dermatillomania mixed with insect bites does not go well. So what began as a few small bites have now turned into a nasty red, painful jungle, spreading over my legs and feet. I had to put plasters over all of them to try and preventing them being touched and to be given a chance to heal. But then all the plasters looked silly with the dress I wanted to wear, and I wanted to avoid questions from people I knew, so I had to wear jeans in this 27°C, 95% humidity weather. A weird little reminder to the many summers of having to hide self-harm scars. But different. Better, much, but still a bit of weird nostalgia.

I don’t know how to explain dermatillomania, other than all I feel is that I have to do it. Sometimes I’m aware of it, and sometimes I’m not. It can kind of be like a trance?

Anyway, all of this feels super whingy and complain-y, which doesn’t help anyone. I’m also not very good at explaining what dermatillomania is, why people with BFRBs do what we do, and what it all feels like.

So, I turned to tumblr for some help, and found some absolute gems which made me laugh, a lot!

I like laughing at how illogical and silly my brain can be. It helps me, and these follwing images describe perfectly what goes on inside my head.

I get worried that people will be offended that I can laugh about my mental illnesses or whatever, but I’m trying to push that aside. Mental illnesses aren’t funny and they aren’t meant to be the brunt of every joke, but it’s okay to find good, warm things in your own experiences. If laughing about your own mental illnesses helps, then by all means, go for it! Perhaps we could all use a little bit more silliness and light-heartedness sometimes. These following jokes help me cope with my experiences, and hopefully they will help somebody else out there too!

Therefore, instead of wallowing about in the I Don’t Know What To Do About Dermatillomania phase, I thought why not share what I found, because not only are they insightful (each one is literally how my brain works), but humorous too!

And I truly haven’t seen anything more apt than below (my favourite)!

The next ones are fabulous too!

And these are like my brain speaking into an internet microphone –

And to end with, here is a sweet, little bundle of hope.

I hope you got some light-heartedness out of this too! Let’s work on spreading flowers, on spreading hope, on spreading kindness. It begins with ourselves.

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.

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:
http://www.skinpickingsupport.com/2013/01/09/12-dermatillomania-myths-dispelled/ and
http://www.canadianbfrb.org/2014/08/11/dermatillomania-vs-self-harm/