‘When I Stop Picking My Skin I Will…’

woman with a bandaid on her shoulder

Although widely experienced, compulsive skin-picking is a little known, often undiagnosed condition that an estimated 2 to 5 percent of the U.S. population has. If it is so common, why do we know so little about it? And why are there so few mental health professionals who are skilled and knowledgeable in the treatment of it?

I have heard the experiences and heartfelt “confessions” of countless people struggling with compulsive skin-picking via the online therapy program at, and often I hear expressions of guilt and shame around the act of picking and extreme embarrassment about the condition of their skin. Compulsive skin-picking, also known as dermatillomania, was included in the most recent version of the Diagnostic and Statistical Manual (DSM) in 2013 under Obsessive Compulsive and Related Disorders as excoriation (skin-picking) disorder. Because there is so little awareness around it being a clinically recognized disorder, if you compulsively pick your skin you may often feel like you are “weird” or “gross” and therefore never seek any help.

Compulsive skin-picking varies in severity and is triggered by different things for each individual. For some people it may be triggered by stress, for others anxiety, while there are also many who pick automatically without even realizing it. In its most severe form, repetitive skin-picking can lead to infection and permanent scarring. Skin-picking often has a detrimental impact on self-esteem and impact negatively on your social functioning, with many of my skin-picking clients reporting that they often avoid meaningful and enjoyable activities or social situations for fear of others seeing their scars and being harshly judged the way they already judge themselves. A common phrase used by people with skin-picking disorder is “When I stop picking…” However, a regular blogger over at Diary of a Skin Picker published a post stating that you shouldn’t wait:

“Don’t put off today’s happiness, for some imagined happiness tomorrow.”

I am not a skin-picker so I can never claim to understand or know what someone with this sometimes debilitating condition feels or is going through, fighting the irresistible urge to pick every day. So I would never preach to you or your loved ones challenged by this disorder to just get on with life and not let it bother you. But from the experiences of the many clients who have completed our program, I can report that often engaging in those very activities you avoid because of the picking is what also breaks the cycle of picking.

In cognitive behavioral therapy (CBT), which shows the greatest evidence of effectiveness in the treatment of skin-picking disorder, acceptance and commitment therapy (ACT) is a modality that discourages the resistance of negative thoughts and emotions, instead teaching the client to embrace them and accept that they are part of our human experience, but that we have a choice in how we respond to them. The client is encouraged to reflect on their personal values in life and to identify what occupations (role-based activities) and behaviors are aligned with these values. Clients often find that the very occupations they value are also the occupations most affected by their disorder. This becomes a vicious cycle whereby the more you avoid doing the things you love and enjoy, or avoid pursuing your passions due to skin-picking; the more likely you are to be mentally and emotionally unhealthy and therefore the more likely you are to engage in unhealthy defensive behaviors such as skin-picking.

In the profession of occupational therapy, the key core philosophy is that we can achieve well being through engaging in meaningful occupation. The belief is that we are on a continuous path of development throughout the lifespan, and doing helps us fulfill who or what we want to become as human beings. Therefore, instead of waiting till you have skin-picking under control, perhaps it is doing what makes you happy and fulfills you that is what is needed to help you overcome skin-picking in the first place.

There is a well-known saying that goes:

“Life happens while you are making other plans”

So live your best life today!




It’s time to get to the bottom of the reason why you bite your nails, pull on your hair, and pick at your skin. 

Image result for a surprising new finding about dermatillomania

We tend to think of compulsive behaviors — such as hair-pulling, nail-biting, and skin-picking — as coping mechanisms used to deal with stressful situations. But, new research suggests there could be more behind these habits than we think.

The study, published in this month’s issue of the Journal of Behavior Therapy and Experimental Psychiatry, looked at a group of 24 people dealing with these body-focused repetitive behaviors (BFRBs). Compared to 23 control participants, those in the BFRB group reported a much greater urge to engage in nail-biting, hair-pulling, and skin-picking in a variety of scenarios — including those situations designed to create feelings of frustration, boredom, and impatience. Interestingly, these feelings aren’t traditionally thought of as triggering compulsive behaviors.

From here, the researchers conclude that these compulsive behaviors have a common root: perfectionism, which makes it difficult for people dealing with them to relax and do things at a “normal” pace. These people may be extra prone to boredom and frustration in addition to stress.

The most recent version of the Diagnostic and Statistical Manual categorizes nail-biting, hair-pulling (trichotillomania), and skin-picking (excoriation or dermotillomania) as being related to obsessive-compulsive disorder. This is distinct from impulse-control disorders, which are often characterized by urges to harm oneself.

It’s estimated that about 1-3% of the U.S. population struggles with hair-pulling and up to about 5% deals with skin-picking, while nail-biting is thought to be more common. The classification of nail-biting in particular has been somewhat controversial, with many people seeing it as simply a bad habit. Although this is likely true for some, for others, it may be one version of a disorder with serious consequences.



This is long,Dermattilomania but maybe one of you can see something I can’t.

So I’ve been lurking in this subreddit for months now and first of all, I love it! I think this place has changed the way I look at my skin, so thank you guys who contribute, it’s hugely appreciated.

That being said…I’m at the end of my rope with my skin. I’ve always had acne prone skin but slowly started using the Beginner’s Routine and had good results. This was me Mid-September, when I had the best results with the routine. Minor chin acne, but besides that this was the best my skin had looked in years!

Image result for dermatillomania


  • Wash with Cerave morning and night
  • Stridex Pads in the morning
  • St. Ives’ Pads at night with OCM with Sesame Oil
  • Cerave Lotion morning and night

…Then my skin decided to have a stress breakout. I’ve broken out before, but this was the worst one yet. It also doesn’t help that I battle dermatillomania on a daily basis. This is what my skin looked like around Late October and then 2 WEEKS LATER.

Now please know I’m not a very dramatic person, I can usually take many things in stride. But this is the point where when my doctor asked me to come to my consultation without makeup, I almost cried.

But still, I went to a dermatologist and was prescribed a .01% Tretinoin [Late October/Beginning of November] and Amoxicillin to be taken everyday. (I’m not usually one to take pills so I was a little reluctant to start, but I knew I needed it.) I also began to take precaution measures like changing my pillowcase daily, drinking more water, working out everyday, cutting out dairy, taking fish oil pills, adding tea tree oil to my OCM. (All of these showed no impact, for better or worse.)

With the tretinoin I went through the ‘worse-before-it-gets-better’ phase which lasted about a month. I began using a sunscreen I had spot-tested and found nothing wrong with. I eventually plateaued with my improvement on Tretinoin around mid December, better on some areas but not all. After going back to my dermatologist, she prescribed me Ziana (.025% tretinoin) and told me to keep taking the Amoxicillin.

This is around the time I changed my routine to what I use now:

  • Morning: Splash with water, Cerave Lotion, Neutrogena Sunscreen, Makeup
  • Evening: Remove with Hypoallergenic Baby Oil + Tea Tree, Wash with Cerave, Ziana, Vaseline on cracked skin, Cerave lotion on unaffected areas

Beginning of January I don’t leave my house without a full face of makeup. My skin flakes like a snake even with Vaseline and I was embarrassed for anyone to see it. The Ziana was working though, so I kept taking it, along with the fish oil pills.

Fast forward to today. After 2 months on Ziana it still helps, but not as much as when I began using it. My dermatologist prescribed me some Minocycline and told me to stop taking the Amoxicillin, but keep using Ziana. I suggested birth control, but she said we would try that as a last resort if this doesn’t work.

…I just don’t know what to do anymore. It’s like throwing a pail of water into a forest fire. Nothing seems to really have any effect anymore. This is the longest post I’ve ever written before, and I realize I sound diatribe-y but I really just want any suggestions you guys can think of. I just can’t believe 5 months ago my skin looked so amazing and now I have so much PIH I’ve been considering laser treatments.

This sub has helped me so much before, I guess I was hoping just by creating a timeline someone could see where I went wrong. Thanks everyone!




Do you pick your skin to the point where you're embarrassed to leave the house? You may have dermatillomania.

I may seem like I have my sh!t together. But you know what? I don’t. I wear HEAVY makeup on my face because I obsessively pick my skin. I wasn’t always like this…in fact, I had GORGEOUS skin clear up until my senior year of high school. Then I got a whopping zit in the middle of my forehead.

Right.Before.Prom. This thing had its own zip code. It was huge, it was massive, and it was right between my eyes. I was positive the Hubble could see it. But you know what? In retrospect, if I’d left it alone it would have gone away in a few days. I know this. But I picked, and then I picked again, then I picked some more.

I created a monster that took nearly a year to heal because I just couldn’t keep my hands off of it. I can hear my friends, my boyfriend, my mom all saying “stop picking!” But you know what? I didn’t even realize that I was doing it. That’s right. I was gouging holes in my face (and my right arm) compulsively, unintentionally…and when the holes scab over? I pick them, too.


Dermatillomania is a condition where a person feels compelled to pick at their skin, to the point where it causes visible wounds.

Dermatillomania is an impulse-control disorder where the person is unable to stop themselves from picking their skin.

And for awhile, I got it under control. In college, I was busy…and then all of a sudden I wasn’t.

DermatillomaniaAnd I have tried (and failed) to quit picking my skin for years. In fact,when Smalls got sick, my Dermatillomania got So.Much.Worse.

Y’all. That’s my face, no makeup…in real time (well, April, 2015). →

And to answer the questions I’m sure you have:

  • Yes, I’ve been in therapy.
  • Yes, I do have OCD.
  • Yes, I really don’t know I’m doing it.
  • Yes, I wish I didn’t pick. I wish this Every.Single.Day.

I am absolutely mortified at how horrible my skin has become. And worse? I’m starting to see signs that Smalls is following in my footsteps. So, I’ve promised myself that I have to do something. Anything. I need to stop picking. I need to be more aware. I need a change.

Everyone has different triggers, and mine are (mostly) anxiety-based. The higher my anxiety level, the worse my face (and my right arm) look.

I’m tired of the scars, and it breaks my heart to see my beautiful child picking his face because he sees me doing it.

So, I’ve been brainstorming. I need to keep my hands off my face as much as is reasonably possible. In order to accomplish this, I have started using some coping techniques that help to distract myself from picking.


  • Using a cotton ball to apply moisturizer/facial oil.
  • I tossed my magnified mirror into the trash.
  • Keeping my nails short.
  • I wash my face, or apply a mask at least 3 times a day.
  • Exercise!
  • Set a timer for 5 minutes and focus on something else.
  • Keep skin clean to avoid infection.
  • evianFind something to do.
  • Meditate.
  • Moisturize or hydrate your skin (this really, really helps me-I keep a bottle of Evian Hydration Spray in every room, and in my bag).
  • Do yoga.
  • Call a friend.
  • Take a shower.
  • Get rid of tweezers, or any other instrument that may tempt you to pick, pull, or dig at your skin.
  • Use a stress ball.
  • Eat CLEAN.

Since I took that photo, my skin has gradually improved. I have been working really, really hard to stop picking. So far, what’s been working for me has been using my 5 minute journal, and practicing mindfulness. The Whole30 didn’t hurt either, but it didn’t give me miraculously clear skin. Rather, it made it better.


I’ve been following Abundant Yogi for a while, and right after I began this post so many months ago, I ran across Kris’ Overwhelm Eliminator, and it was like a revelation to me. A super simple system to help me deal with the things that really are out of my control.

If I follow the advice, and do The Work, I don’t pick. It’s crazy! On days that I forget to current photojournal, and let my stress fester and boil, my face is a mess, which then takes weeks to heal. It’s horrible. But it’s getting better. Here’s a selfie I took last night (July 2015), with NO makeup… →

…I think that it’s much better.

I made a commitment to myself to work on my stress level, and it’s really helping. I don’t feel like I need to wear heavy makeup all day long. Between my journaling, “AY”, and my Evian Spray, I’m actually doing pretty well! It’s not perfect, but it’s far, far better than it was.

I’m still very much a work in progress. But at least I’m making progress now! If you unconsciously pick at your skin-on your face, your arms, your legs, your chest, your back…talk to someone. Find help, or find a way to deal with your triggers. Because I’m convinced that is the only thing that is allowing my face to heal (that and keeping a clean diet).


Here’s how you can help them:

  1. Stop telling them to stop. Trust me. If we could stop we would. NO ONE wants this.
  2. We’re not crazy. Maybe you bounce your knee, or drum your fingers. Picking is our “quirk.”
  3. Just because our skin is clear or doesn’t look “that bad”, doesn’t mean we aren’t suffering.
  4. Most of us really don’t have “bad” skin.
  5. This is not “normal.” That’s like saying someone who consistently drinks a case of beer a night is just a light drinker.



Inside Dermatillomania: Personal Tales Of A Mysterious Condition

“It all started when I went back to work full-time,” my single mother used to say. She was talking about the scabs that started showing up on my arms, legs, and face. I was eight years old and I had a picking problem, though I wasn’t really aware of it at the time. The wonderful thing about childhood is the lack of shame—shame one might experience when doing such horrible things as scratching dime-size holes into her still-poreless complexion. Being asked if I had chicken pox became a daily occurrence for me, and little circular bandaids in neon colors were my day-to-evening accessory.

A doctor’s appointment and a biopsy for what the physician assumed was eczema or early-onset psoriasis is what it took for both my mother and I to realize that I had a problem. A large scab appeared on my hand, and I told my mom I didn’t know where it had come from, even though I knew very well I had put it there myself. To this day I have the scar from where they cut it off of me to test it. Needless to say, the results came back negative on all counts—it was just a scab.

It wasn’t until I was in my early twenties that I found out from Oprah that the weird thing I had been doing all my life had a name: dermatillomania, aka an irrational habit of picking one’s skin. I couldn’t decide if giving the condition an identity made me feel more or less insane. Before, it was just a thing that I did. But that day it became a thing that I had. Unfortunately, unlike a cold, I didn’t understand how to make it go away.

I work as a model today, but I’ll forever be shadowed by my earliest perceptions of myself—a confused 13-year-old middle school student with a full-blown case of skin picking. My teen years were shrouded with self-inflicted blemishes to the point where I would go to great lengths to cover my scars under makeup and clothing. Family and friends began to perceive the worst. People thought my long sleeves and arm warmers were covering track marks or scars from cutting. Once, I was asked if I’d been doing methamphetamines. None of those were the case, but I remember thinking that any of them would be better and more logical than the truth—that I just couldn’t stop picking my skin.

It’s amazing to me that so many others suffer from this disorder as extremely as I do. That other people, too, have wasted hours ruining their complexion in front of the bathroom mirror after everyone else has gone to bed. That so many of you have also hidden pins, needles, and even small blades in the medicine cabinet to use on your faces and bodies. That maybe as some of you are reading this, you’re picking right now and don’t even realize it.

Do you make excuses, too? “Damn, this eye makeup is taking forever to get off” has been a favorite of mine when someone would knock on the bathroom door after 30 minutes. Sometimes I let people come up with their own conclusions. “Are you still scratching your skin?” a boyfriend would ask me. “Does it hurt?” I’ve been asked on shoots as a makeup artist smears concealer on my forearms. I never want to talk about it, but until the scars are gone, it will forever be a part of my life.

What gets me about dermatillomania is that there is really no cure-all treatment. So far, medical professionals are still at odds over how to classify the condition. Some say it’s an obsessive compulsive disorder, others argue it should be considered an addiction. And watching Youtube videos and reading message boards online has left me with more questions than answers. All they recommend are gloves and bandages. Who wants to go to bed wearing gloves? Sticking bandaids on your fingers to prevent scratching? Not my idea of a good time. The YouTubers and message boards also tell me to stand away from the mirror when I’m in the bathroom, but that’s not exactly practical. The last resort always seems to be Prozac, which sounds like a whole new can of worms if you ask me.

I’m uncertain if this is a condition that me nor anyone else will ever completely overcome. I’ve found ways to reduce the damage significantly. Wearing dull acrylic nails has helped me immensely. What people forget is that the main issue with skin picking is infection. If you’ve ever gone to get a facial, you’ll remember the “extraction” part. It’s a funny feeling, having someone else poke and squeeze at your skin—it feels kind of wrong. And if you’re a skin picker, it’s almost perverse. But when a trained aesthetician or dermatologist performs extractions with a dull metal instrument and/or a clean pair of gloves, you know what? You wake up the next day with clean skin, not a face full of sores.

It’s scary to think that this is a condition I’ll probably just have to live with for the rest of my life. Finding “clean” ways to pick is not what I call a solution, but neither is barricading myself from doing it. Everybody has scars. Many friends have shared the proud tales behind their own, thrilling stories about fights or accidents or operations. I’m not nearly as ashamed of my scars as I once was, but I still find my story too tragic, and bizarre, and downright embarrassing to share with gusto.

And while I’m writing this story anonymously, I hope in time it inspires others and maybe even myself to open up and come clean about this condition and share their stories. They say the first step to recovery is admitting you have a problem. The trouble is, I’m not yet sure what the next step could be. All I know is, I’m not alone in this, and if you suffer from dermatillomania, neither are you.



What is Dermatillomania, Excoriation Disorder?

Skin picking disorder, aka excoriation disorder, is a perplexing psychological condition. Merriam-Webster defines excoriation as the act of abrading or wearing off the skin. This can happen inadvertently in any number of ways, such as scratching an insect bite, or wearing ill-fitting shoes, or even popping a pimple. This seems innocuous in and of itself, but the darker side of skin picking, excoriation disorder, is getting increasing attention from medical experts these days.

Getting To The Point: What Is Excoriation Disorder?

Trusted info on skin picking disorder aka excoriation disorder. Discover how picking skin becomes a disorder and what causes people to skin pick.Excoriation disorder is the act of compulsively picking skin. People refer to this disorder by several other names, including dermatillomania, skin picking disorder or compulsive skin picking. This skin picking disorder has long been recognized by mental health professionals, but now excoriation disorder officially appears in theDiagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-V). The DSM-V lists the disorder in the new chapter entitled, Obsessive Compulsive and Related Disorders.

People with excoriation disorder have trouble controlling very strong urges to skin pick. Viewed by experts as a form of self-mutilation, this condition falls in the same family as compulsive nail biting and hair pulling. Although it’s a separate condition, it’s frequently seen in people who suffer from obsessive compulsive disorder.

Classified as a body focused repetitive behavior, it targets the face, but affects other areas of the body as well. The causes of this mental illness still require research and examination, but the results create definite concern in family members and mental health professionals who deal with skin picking patients.

Flaws in the skin, real or imagined, can trigger an impulse for the people who suffer with this disorder. The victim feels the impulse to remove the flaw and proceeds to pick at it. Sometimes prompted by a bump, an itch, or just an area where the skin looks or feels different, the repeated skin pick action can lead to bruising, bleeding, or infections. Subsequent scars and permanent disfigurement can result.

Picking Your Skin –A Cause For Concern?

Generally, picking your skin as a form of hygiene should not cause concern. People often find they need to squeeze a pimple, scrub off dead skin, or remove a hangnail. Even the unconscious act of scratching an irritation until it gets worse does not pose a serious problem. According to the International OCD Foundation, “Skin picking is not considered a disorder unless it is often and/or bad enough to cause significant distress or problems in other areas of life.” Sufferers of picking disorders focus on various parts of the body, including the face, scalp, cuticles, and back. All the extremities – hands, feet, arms and legs – can become the focus of this behavior as well.

Reasons vary, but stress most often triggers the episodes. Sufferers resort to skin picking to relieve stress, but then experience increased stress from guilt or shame. Others, perfectionists, seek to eliminate flaws in their skin. Paradoxically, picking your skin leads to more flaws. Both of these examples show different self-perpetuating cycles that help lead to excoriation disorder.

Permanent physical damage stands as the biggest concern for skin picking disorder sufferers. In addition, sufferers eventually find they have to take measures to hide the physical evidence of their condition. They become ashamed, less social. Relationships become strained, potentially creating problems with family, friends, and at work. Left untreated, excoriation disorder at its worst debilitates its victims. If you have concerns that your tendency to skin pick could require medical attention, do not hesitate to bring it up to your doctor




This past week, I had the opportunity to spend several days at home from college while on Spring Break. As I sat at the kitchen counter chatting with my brother and his girlfriend, my dad came in and noticed the box of band aids lying near the cabinet where we keep all of our medications and first aid materials.

“The band aids are out. Well, we know Kayleigh’s definitely home.”

I laughed awkwardly, trying to brush his comment off.

He sighed and put the box away, then grabbed his coffee and left the kitchen.

I know that I use a boatload of band aids on a regular basis. At certain times, I can fly through an entire box in a week. But the reason for my dad’s comment was not the fact that I seem to have little regard for how much money band aids (don’t) cost, but the reason behind why I use them: I have dermatillomania, or a compulsive skin picking disorder (SPD).

It’s likely that I’ve had this disorder from the time I was a child, since I have distinct memories of picking my skin as far back as elementary school, but my parents never looked into it as a serious problem. In fact, dermatillomania is a relatively new illness to make its way into the realm of psychiatric disorders, so it’s not surprising that they thought very little of it. Even now, as more and more people are beginning to realize that this is more than just a bad habit, there are still many out there that don’t understand how this disorder works.

So in the interest of informing the general public, I’d like to clarify a few misconceptions that surround this illness and hopefully educate those of you out there who may know someone with dermatillomania or possibly have it yourself.

  1. Skin picking is just a nasty habit. In some contexts, it can be. It’s normal for people to pick at their skin every once in a while, such as when they see a pimple or dry patches during the winter. What separates dermatillomania from just a habit is the fact that it is constant and takes place over a length of time, eventually causing damage such as discoloration, infection, scarring, and, in severe cases, a need for skin grafting. Dermatillomania is classified as a Body-Focused Repetitive Behavior, meaning that the person’s habitual actions have the potential to cause harm to their body or physical appearance. It shares similar attributes to Obsessive Compulsive Disorder (OCD)—sufferers take part in ritualistic, repetitive behavior, often brought on by a need or urge to do so. The difference between the two is that people with a skin picking disorder find pleasure in their actions and those with OCD don’t. Dermatillomania is also very closely linked to another disorder known as trichotillomania, or compulsive hair pulling. People can pick just about anywhere on their body—face, hands, scalp, back, legs, fingers, feet, cuticles, etc. While there is usually one place that someone with SPD focuses their energy on, if that area becomes too sore or damaged, they will migrate to another part of the body until their main spot has healed. While the default tool for picking is the fingernails, sufferers will also use tools like tweezers and scissors.

Regardless of where or how someone picks, it’s important to remember that dermatillomania is a disorder—it’s not something that the sufferer can help or control.

  1. Skin picking is similar to/another form of cutting/burning. While there may be compulsive tendencies in someone who cuts themselves or burns their skin, the difference is that they want to feel the pain inflicted on them in order to take away emotional trauma. Skin pickers disassociate themselves with the pain in order to complete the “mission” that their brain has fixated on. It isn’t about the pain—it’s about satisfying the urge. For some pickers, looking down at their hands and seeing blood without even realizing they’ve been picking is a common occurrence. This is why pickers can often tear, gnaw, scratch, and dig at a spot for long periods of time, causing bleeding or serious pain, and not stop. Their brain has decided that it’s far more important to finish the “mission” and satisfy the urge than to stop on account of the pain or blood.
  1. People who have an SPD are on drugs. Nope. While the effects of usage for drugs like meth may involve picking away at imaginary bugs or other supposed invaders, their need to do so disappears once the effort of the drug wears off. SPD sufferers do not lose their urge. Their need to pick can come from various other sources, but a set cause is unknown. Most people have an underlying anxiety or depression disorder, but not all. For some people, it’s a compulsion that has come about from outside stressors or is the result of someone who is unable to cope with things in their life, such as big changes. During times of stress, strong emotion, or boredom, pickers are more prone to dive into their habit. But this is not the result of a drug problem.
  1. People who pick their skin and leave marks do it for attention. Just as with any other mental or emotional illness, there are people out there who seek to gain attention or affirmation by exploiting such disorders. But for the vast majority of us, there is nothing glamorous about dermatillomania. I would personally love to have all of my toenails and long thumbnails, be able to go to sleep without getting caught up in picking, and wash my hands without discomfort. It’s not about the resulting disfiguring that makes us pick—it’s all about that urge. In the moment, it doesn’t matter that we’re bleeding or the area is already scarred. Even if our actions didn’t result in disfigurement, we would still pick.

Not to mention that people’s general reaction to seeing the site of a picking episode is something along the lines of, “Oh my gosh, what happened to your face/hands/back/arms/etc??? It looks awful!” This draws attention to ourselves and makes us feel an incredible amount of shame and guilt because we know that the inflicted damage has been done by our own hands. It isn’t pleasant and it isn’t fun.

  1. People with an SPD can stop whenever they want. As I mentioned before, dermatillomania is a disorder and not something the sufferer can control. It isn’t about breaking a habit. The worst thing you can do for someone with an SPD is to yell at them to stop or try to inhibit their picking session. Calling them out brings attention to their actions and makes them feel ashamed, while not allowing them to pick increases their levels of anxiety because you’re preventing them from satisfying that urge. Both of these things only make the problem worse (not to mention they may resent you after the fact for it), and could result in a more rigorous and damaging picking session later on. The best thing you can do for an SPD sufferer is to just love them as they are. Be their friend, support them if they are feeling down, and encourage them to seek treatment.
  1. There’s no treatment for an SPD. The good news is that there are ways to treat and cope with dermatillomania, the most common and effective one being Cognitive Behavioral Therapy which includes Habit Reversal Therapy and Stimulus Control. Anti-depressant medications can also be used to help lessen the severity of the urges. There are even support groups dedicated to helping and supporting sufferers. TLC (Trichotillomania Learning Center, not the television network) has a program called Hands-Down-A-Thon that those who pick their skin and pull their hair can take part in. While it’s highly resistant to treatment, it is still possible to control the urges and reduce the amount of picking that takes place.




Learning To Love Myself With Dermatillomania

My rich ex-boyfriend called them “grandma worries.” We were sipping scotch I could never afford that was swimming among the hand-carved soapstone scotch rocks.

“Don’t worry,” he said, in an attempt to emulate real human empathy. “I don’t find them that gross.”

I sheepishly slid my hands under my jeans and averted eye contact.

I suffer from Dermatillomania, and have since I can remember.

Dermatillomania is a body-focused repetitive behaviour (BFRB) that can involve picking and biting of the skin, face, cuticles, etc., that often can result in tissue damage and permanent scarring. It’s closely related to Trichotillomania, a compulsion to pull at one’s hair. Dermatillomania is often categorised as an impulse control disorder under the Obsessive Compulsive Disorder spectrum, or can be closely linked to anxiety. It can be a conscious response to anxiety or depression or can be an entirely unconscious habit.

Roughly one in 50 people exhibit at least one BFRB. My vice is picking at the sides of my fingers, mainly my thumbs, until they bleed, scab, and scar. As a result of over ten years of this habit, my hands are permanently scarred and imperfect. Having them so damaged and imperfect is frustrating—it leads to more picking and scratching which only harms them more. It’s a vicious cycle of damaging, correcting, and damaging again.

Earlier this year I was arguing with my partner at a music festival, and began clawing at my legs. As we fought, I pulled and tore at the skin on my calf until blood was seeping into my socks and building up underneath my nails. I didn’t realise what I had done until I woke up the next day, my leg bloodied and bruised, and hobbled to the First Aid tent to be patched up. It throbbed for days on end; the pain so bad a whole week later I wept in my bathroom clutching onto Dettol.

At times of serious distress, I unconsciously claw at my arms and legs until the skin breaks and blood trickles out, leaving ugly red scars. There’s an unexplainable discomfort when a panic attack subsides, yet you are left with physical scars.

I recently stumbled upon a beautiful article on Everyday Feminism, which mentioned some tips that I found immensely helpful in managing my tendencies. They revolve mainly around being kind to and patient with yourself, distracting yourself, and reaching out to people.

While the prospect of wearing fuzzy gloves when the urge to pick or pull happens (which, in my case would be 24/7) seems slightly impractical, interacting with my body in a loving way, such as painting my nails, brushing my hair, and moisturizing, assists in fostering a positive relationship with my body.

I’m learning to be patient with myself—if I get to the end of a workday and see blood trickling from my fingers, I do not become as enraged as I used to. I lovingly treat the scars on my arms with BioOil and forgive myself for the damage.

Most importantly, I remind myself, and others who suffer the same compulsions, that this illness in no way invalidates my being and my ability to accept love.

Scars and all, I am not a failure.





In May of 2013, the Diagnostic and Statistical Manual (DSM) was revised to update its current literature on mental health conditions to include ones that were previously unrecognized and categorize them according to their similar characteristics. The addition of Excoriation Disorder, aka “Dermatillomania,” brought validation to thousands of sufferers by giving acknowledgment from the medical field that this is a mental health condition — not just a “bad habit.”

According to the TLC Foundation for BFRBs:

Excoriation Disorder is characterized by the repetitive picking of one’s own skin. Individuals who struggle with this disorder touch, rub, scratch, pick at, or dig into their skin in an attempt to improve perceived imperfections, often resulting in tissue damage, discoloration, or scarring. Skin picking disorder is one of a group of behaviors known as body-focused repetitive behaviors (BFRBs), self-grooming behaviors in which individuals pull, pick, scrape, or bite their own hair, skin, or nails, resulting in damage to the body.

Research shows that 2-5% of the population has a BFRB with approximately 75% of affected individuals identifying as female.

I Am One Of Those Females

By the time I reached my teenage years, my legs were filled with open sores. My face had already been a problem since I was a child and I went through periods where I picked at my upper back and chest. For years I suffered alone, barely telling a person because I believed that if everyone found out about this disorder, I’d be deemed a “freak.”

The effects of this disorder caused me to refrain from dating and believe that I was unworthy because I couldn’t control the mess on my body let alone the mess in my head causing it. It made me housebound for 2.5 years because I was too embarrassed to be seen in public most days, causing me to also drop out of university. While suicidal, I had a mental health nurse tell me that all I had to do to stop picking is to “grow up.” There was no help where I lived and Internet awareness pre-2010 was scarce. I never wanted anyone to experience the stigma and shame I did, which led me to releasing my personal memoir,FOREVER MARKED: A Dermatillomania Diary. My hope was for it to encourage others to come forward with their stories so that we could unite and create change for the next generation with BFRBs.

Educating Education

When it came to mental health in grade school I learned about bare-bone facts surrounding depression, anxiety, and eating disorders. I never heard of Dermatillomania, let alone a Body-Focused Repetitive Behavior. Teachers should learn the signs of BFRBs and pass it on to their students as a part of their education and provide fidget/fiddle/sensory toys in the classroom.

Teaching Therapy

Like many others with Dermatillomania, I’ve been told that I will live with this forever. With what I’ve learned after my therapy with Karen Pickett after appearing on “The Doctors,” I now know that this disorder is manageable with the right tools. With the DSM 5 out, mental health professionals should be required to update their skills to effectively serve the BFRB community. Learn how to become trained

Community Collective

I started my journey alone. By reaching out and becoming active in online forums I’ve met incredible people and organizations dedicated to the same efforts I am. The first time I met another person with Dermatillomania was across the continent while filming Scars of Shame; a few years later I was able to meet others in my area as more awareness and support groups were created in North America. This support has not only been imperative in my journey to raise awareness, but now sustains my own recovery.



Woman-spent 8 HOURS day picking skin recluse attempted suicide finally cured disorder thanks therapy


  • Angela Hartlin, 29, spent up to 8 hours a day picking her face and body
  • Suffered from dermatillomania – a rare impulse control disorder
  • It left her depressed, suicidal and she became a prisoner in her own home
  • Has been cured after having therapy to help her understand why she picks 

A woman left suicidal after battling a compulsive skin-picking disorder that left her body covered in scars has made a remarkable recovery thanks to therapy.

Angela Hartlin would spend up to eight hours a day picking her face, arms and chest due to dermatillomania, an impulse control disorder where a person is unable to stop themselves scratching.

Doctors were baffled by her condition and told the 29-year-old she would never recover. As a result, she fell into depression – and even tried to take her own life.

She eventually dropped out of university and refused to be seen in public, becoming a prisoner in her own home.

But now, thanks to life-changing therapy earlier this year, she has made a remarkable recovery – and her skin has completely healed.

Angela Hartlin, 29, battled a compulsive skin-picking disorder that left her body covered in scars             he has now made a remarkable recovery and her skin has healed thanks to therapy

 Angela Hartlin, 29, battled a compulsive skin-picking disorder that left her body covered in scars (left). She has now made a remarkable recovery and her skin has healed (right) thanks to therapy
Ms Hartlin suffered from dermatillomania -  an impulse control disorder where a person is unable to stop themselves carrying out a particular action. She is pictured with husband Jason on their wedding day

Ms Hartlin suffered from dermatillomania – an impulse control disorder where a person is unable to stop themselves carrying out a particular action. She is pictured with husband Jason on their wedding day

To spread awareness she penned a memoir, Forever Marked, and featured in a documentary on skin picking.

Ms Hartlin, from Nova Scotia, Canada, said: ‘I was picking for up to eight hours a day. I hated the way I looked but there’s a sense of relief when you do it.

‘It was very automatic but I didn’t understand why I did it or what was fuelling it at the time. I told myself I was a freak.

‘During my teens it was extremely rough; I didn’t tell a soul and just pretended the marks were acne.

‘In gym class I would change in the bathroom, I never showed my legs and it kept me from dating.

Ms Hartlin hit an ultimate low point when she went away to study.

She added: ‘At 18 I tried to take my own life – I was at university and I felt very isolated living with this disorder and I couldn’t stand the way I looked.

‘Doctors told me I would never recover and I would have to live with it forever.’

Desperate Ms Hartlin sought therapy and in 2014, she created a candid documentary, Scars of Shame, to raise awareness to dermatillomania.

Her life changed that year, when the film was seen by an expert psychotherapist, who contacted her.

Ms Hartlin would spend up to eight hours a day picking her face, arms and chest due to dermatillomania, and was left with scars that meant she refused to be seen in public         Ms Hartlin was cured after therapy and has since penned a documentary,  Scars of Shame, to raise awareness to dermatillomania.

Ms Hartlin would spend up to eight hours a day picking her face, arms and chest due to dermatillomania, and was left with scars that meant she refused to be seen in public. She is pictured before and after being cured

Through 12 weeks of counselling Ms Hartlin and her therapist were able to tackle some of the underlying issues that caused the picking.

She said: ‘I use different techniques to block the habit. My therapist provided me the tools to be able to talk myself out of the urge and identify different triggers.

‘I noticed an overall difference in how I experienced the world.

‘I’ve experienced an emotional wakening, because all this years of picking my skin were to hide my emotion that had been oppressed.’

Her psychotherapist helped her realise she had been oppressing her feelings every since her father suffered a brain aneurysm when she was young.

A psychotherapist helped Ms Hartlin tackle some of the underlying issues that caused the picking. She is pictured with her family at a young age

She said: ‘When I was 10 years old my father had a brain aneurysm and even though he lived it completely changed him.

‘It was hard to grieve as he was still alive so I suppressed these feelings.’

Ms Hartlin’s beautiful wedding photos of her marriage to husband Jason show her incredible transformation.

She added: ‘I’m still not pick free – I do have urges every single day and it’s a long process but I want people to know they aren’t alone, there is resources out there to help them.

‘Coming out in public has taken a burden off my shoulders. I don’t have to hide this other part of me.’