0 
0 By Be Kind To Your Mind
Compulsive skin picking, dermatillomania, or the much scarier sounding excoriation disorder, is an impulse control disorder. It’s categorized under the Obsessive Compulsive Disorder (OCD) spectrum. This is because the skin picking is often repetitive, ritualistic and anxiety-reducing. Dermatillomania has also been linked to body dysmorphic disorder.
What is it?
“The primary characteristic of Compulsive Skin Picking (CSP) is the repetitive picking at one’s own skin to the extent of causing bleeding or damage to the skin, to relieve anxiety or urges.” – OCD Action
I’ve been trying to figure out how to write this post for a long time. I’m very open and self-aware about my mental health; Be Kind To Your Mind wouldn’t exist otherwise. However, there is an area of my OCD that I haven’t really talked about before. Not because I haven’t wanted to, but because I’ve struggled to find the right words.
Oblivious to the harm I’m doing
The urge to pick is with me 24 hours a day. Even when I’m asleep, I dream about it and wake up with bloody bed sheets. I can lose hours searching my body for any hint of a bump, pimple, scab or impurity. I enter this addictive and determined trance where time does not exist. I’m completely dissociated from the world around me and oblivious to the harm I am doing. I can turn the tiniest unsuspecting pimple in a huge, disgusting, weeping hole and I am unable to leave it alone.
In hindsight, I’ve had the problem since I was young. I have this random, yet vivid memory of being sat with my mum doing maths homework when I was about 8 or 9. I was fascinated with peeling off scabs that I got from the bug bites I always seemed riddled with, or typical playground injuries.
She said, “You need to stop picking, Megs, because the dirt from under your nails will go into your skin and make you poorly.” I don’t think I really believed her, so it was like I had a point to prove. My “need” to pick was always too overpowering.
My fault?
As I struggled through my teens, I just thought it was a bad habit. I assumed I was a typical spotty teenager who didn’t have enough willpower to resist a good squeeze in front of the bathroom mirror.
My problem with picking stepped up a gear when my nan died a few years ago. Although she was taken by cancer, my OCD blamed me. I’ve talked a little about this before. It was a heartbreaking time where I lost the most important person in my life to an incurable disease. Then my own mind told me that it was my fault.
Logically, I know very well that one cannot give someone else cancer. But, I could hear my OCD scrabbling around for any string to add to the bow of accusation. All logic went out the window and I was overpowered by guilt. I was convinced I had carried some sort of deadly disease under my skin that I had passed onto my Nan as easily as giving her a cold.
No logic
My mind told me I had to break into my skin from then on at the sight of any slight imperfection or feeling of an impending barely-there bump. Otherwise the same thing would happen to my mum and dad. Scabs are something that form over a wound to protect it from infection while it heals. Logically, I know this. But logic does not exist to the OCD mind. I see a scab and I think it’s protecting the “infection”, keeping it inside my body. Therefore, I must pick the scab off to “cleanse” it.
Skin picking has become an essential task in my everyday life. Sometimes it’s due to the paranoia of hosting a disease. Other times it’s just an unignorable urge. According to the NHS, dermatillomania is a form of addiction that can cause serious damage, just like smoking or alcoholism.
Everyone picks, I think. Whether it’s scratching off that patch of dry skin on your elbow or squeezing a juicy pus-filled zit, it’s a common guilty pleasure. However, when the picking interferes with your life and causes serious infection and permanent scarring, that’s when it becomes a diagnosable illness. Sometimes I do it without even realising. I pick my lips a lot, especially when I’m concentrating. For years I’ve suffered with sore, cracked lips that are unable to wear lipstick.
Is it self-harming?
Tearing your own skin off sounds like a painful task. Which, of course it is. However, as I’m digging into my dermis, a form of cognitive distortion takes over. I’m blissfully oblivious to the pain or the mutilation I’m creating. I’ve been told it’s a form of self-harm and I’m projecting my anxiety and low self-esteem onto my body. I don’t see it as that though.
I admit, dermatillomania picked up the baton when I stopped self-harming. However, I am ignorant to the fact that picking my skin relentlessly is the same as breaking it with a blade. Some have told me it is the same, others have disagreed. I don’t think it’s the same. The act is similar, but the context as to why the act takes place is completely different; at least, in my mind it is.
The cycle is relentless. The urge to pick penetrating every thought. The attempt at resilience met by twitching fingers, a tingling feeling under my skin and the inability to concentrate. If I’m in a public place, I’ll be as discreet as I can be about it. If not, I’ll sneak off to privacy. To my bedroom with my phone’s torch, or to the bathroom with yet another “dodgy stomach”. I know I’m going to be a while and, like with other addictions, lying is too easy.
Relief and regret
I scan for any sign of a blemish or a blocked pore I can purge on. Sometimes, I’m pretty sure I imagine imperfections just to give me an excuse to pick, or I’ll itch until I bleed, as I know, in a couple of days, a new scab will settle for me to rip off. My focus is mainly on my face, lips, fingers and legs. The time of day is irrelevant; whether I’m in the middle of my work or it’s 4 am, my mind doesn’t care. I feel a sense of release and calmness.
Occasionally, I’ll abandon my fingernails and use the precision of tweezers or the back of an earring.
1in4 UK Book Store:
[amazon_link asins='1977009336' template='ProductGrid' store='iam1in4-20' marketplace='US' link_id='ffcb5f04-1297-11e8-8b2c-c721ea9703cc']
Then, I’ll wash the blood off for the billionth time whilst cursing that I’ve run out of plasters again. I’ll stare at the weeping holes and grimace, feeling a weird paradox of relief and regret. Achievement quickly turns into failure and the despair of giving in. The pain starts; the exposed patches of flesh are sore and quickly destroy any shred of confidence.
The repeating cycle
The cycle restarts due to one of two reasons.
1) I feel overly self-conscious of my skin’s appearance and strive to make it better by “getting rid of” the impurities. If it’s on my face, I’ll clog up my open wounds with foundation and suffocate it with concealer. Let me tell you friends, despite what it says on the tin, concealer is not designed for hiding big gaping craters in your face flesh. It ends up a mix of beige paint and bloody discharge, which makes people say, “Hey, I think you’ve got some food on your face.” Embarrassing, much?
OR
2) My OCD will take the mic and scream, “YOU ARE GOING TO MAKE YOUR PARENTS SICK, YOU SELFISH BITCH. GET. IT. OUT!” drop it, and then storm off.
I’ve tried wearing fake nails to prevent myself from picking, but I just end up ripping them off, taking half my natural nail and the surrounding skin with it. Fidget cubes don’t really do it for me and being hypnotised by the turn of a fidget spinner doesn’t last long. I am yet to find a distraction that is powerful enough to stamp on the urge to pick.
This post wasn’t written as a success story, as it’s not yet a battle I have won. It was written in honesty and awareness for a disorder that is not commonly known. If you have any advice relating to dermatillomania, or tips, I’d be very grateful.
Reproduced with permission, originally posted on bekindtoyourmind.org
UNITED STATES
UNITED KINGDOM
