Dermatillomania (AKA “skin picking disorder” AKA “excoriation”) is pretty much what it sounds like. Its an impulse-control disorder, related to OCD, where people continuously pick at their skin until it causes wounds. While dermatillomania frequently co-occurs with other psychiatric conditions, it has recently been added as a unique category to the DSM-5. To receive diagnosis, in addition to displaying the body-focused repetitive behaviour (BFRB) symptoms, an individual must (1):
- Experience clinical distress or impairment because of it
- Not have any other medical, dermatological, physical, or psychological condition that could better explain its cause.
As usual, deciding treatment for dermatillomania is a uniquely personal decision between an individual and their health care team, depending on the extent to which sufferers feel it disrupts their lives or causes them distress. Like many other psychological disorders, treatment might involve cognitive behavioural or pharmacological intervention.
For me personally, my skin picking has caused me significant distress, however I’m not currently in a place where I can focus my treatment on this one thing alone as I must address other underlying issues. Regardless, I thought I’d share some of my own thoughts on living with dermatillomania.
- It feels pretty unconscious.
I do it without even realizing. Almost all the time. In fact, in most photos of me, you can see I’m doing it.
2. It’s fairly constant but not always disruptive.
3. I have to carry bandaids around with me everywhere I go.
4. I often can’t wash my hands without pain.
5. I’m embarrassed of the way my hands and fingers look.
I always get called out for it if I go to nail salons (to the point where I can’t really even go any more).
6. It can be very distracting.
Sometimes I feel like I surrender control to the compulsions and can spend extended periods of time not really doing much else.
7. It can cause me anxiety to be prevented from doing it.
I know the goal is to try and reduce symptoms or cut back but in many occasions its incredibly stressful to do so. My boyfriend knows to gently try and distract me rather than actually intervene at this point (at least until I develop better coping mechanisms).
8. It caused me to get in to a minor car accident years ago.
This one I’m super embarrassed to admit. I consider myself to be a pretty attentive and safe driver, but in this circumstance I was completely distracted. I know my anxiety was also high at the time which could have also contributed to the lapse in attention.
9. Where I pick and how much I pick can change over time.
10. It’s worsens when I’m anxious.