Me And My Dermatillomania

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[Content note: talk about anxiety and compulsive skin picking – information on skin picking/dermatillomania available here and here]

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If you know me – whether in real life, or simply via twitter, you might know that I have OCD – obsessive compulsive disorder. And no, I don’t have it in the common jokey media sense of ‘I’m sooo OCD, I just hate it when things are out of line’ – I have it in the actual sense. The kind that ties your brain up in knots over things that most people can happily ignore. For me, it’s mostly centered around food, with bonus tie-ins of socialising and intrusive thoughts. I try to be pretty open about it, which doesn’t always work out when people think I’m lying or ‘just a bit stressed’, but I’m getting the hang of it.

I mean, I can get on a bus to leave the house again, so that’s good.

The one thing I don’t tend to talk about is that I’m a compulsive skin picker. It’s probably part of having OCD, but it might not be. It’s only been talked about recently, given the name dermatillomania – a sister to trichotillomania (which is hair-pulling). It’s not pleasant – and, unlike most of my obessions/compulsions, it leaves physical evidence behind.

I’ve had spots since I turned ten. I’m twenty four now. I haven’t even had a single week of clear skin – I literally do not know what it’s like to have a nice complexion. Sometimes I wear foundation – especially if I know there’s going to be pictures taken that’ll be important (like at weddings), but mostly I’m too lazy and I usually end up scratching through it anyway. It’s not just my face – my upper back, my upper arms, my neck and my chest are all fair game when my brain gets going. There’s little circle scars, little dents embedded up and down my skin – the kind you might think were chickenpox, except when I had chickenpox I got a grand total of three (and don’t you know, my OCD keeps telling me one day I’ll wake up with shingles). No, these are scars from picking – conciously and unconciously.

Do you know what I learned last year? That those things I thought were blackheads, dotted around my nose, my chin, my forehead? They’re not. They’re not dirty, they’re not spots, they’re just a normal occurance. Apparently, they’re called sebaceous filaments. So, you know, thanks advertising (seriously, see at 4 second in this advert for what I mean) for persuading ten year old me that my face was dirty. Though I didn’t know then what I know now – namely, that I have OCD – I certainly had it, and discovering that my face was dirty was just one more push towards a problem I still have today.

Of course, that wasn’t the cause. Just a handy reason to add to justify something I was already doing.

Funny thing: saying ‘just stop picking’ is about as effective as telling someone to ‘just stop throwing up’ when they’ve got a stomach bug. It’s irritating and doesn’t help. Neither does hitting my hand away from my face, or suggesting I wash my face. I do wash my face. In fact, teenage me was so anxious and convinced that that would solve her problems, she overcleaned it and made it worse. (Also, thanks clearasil for literally burning away the top layers of my skin to the point where I had to take a day off school before it settled down).

Sometimes it’s concious – hunting over my skin in the mirror for every tiny blemish, every possible raised bump, every hint of a problem. Sometimes it’s not – looking down mid-videogame to find there’s blood on my fingers and then trying to work out which scab I’ve opened. I can spend literal hours in front of a mirror, part of my brain trying to persuade me to look away, the rest telling me ‘just one more’.

I’ve left social events before, having gone to the bathroom for the loo, and ended up spending ten minutes in the mirror before panicking and realising I really can’t be seen in this state. Having a well-meaning person say ‘there’s something on your face – oh, no, sorry, it’s just a scab/spot/blood’ is enough to send me back in there, scouring each and every inch of skin they can see until it’s gone. Backless dresses? No chance.

I got a tattoo this year – it’s still in the works, I’m waiting to get enough money together to finish it – on my right arm, covering up years and years of tiny scars. It helps. I don’t pick – the colour hides what my brain wants to see as imperfections, and I’m more worried about ruining the tattoo than the minor spot I’ve noticed. It’s hard, sure, but it helps. Someday I’m going to link it up to a backpiece and something on my left arm – hiding all the little marks that I’m pretty sure only I can see anyway.

On bad days, I try to pick at a sponge instead, but there’s not the same sense of bizarre satisfaction. On the plus side, there’s not the revulsion, anxiety and sadness after I’m finished either. I’m learning. When my anxiety peaks, my legs get it too. Forearms, stomach, upper thighs all become fair game on a bad month. These are harder to pick – but easier to hide.

I’ve never had an infection – yet, my brain adds, a part of me always aware that it might happen. I’ve gotten deep enough for it to be a real problem too, picking the same place over and over again, burrowing down under layers and layers of skin until it doesn’t look like skin anymore. Then comes the panic attack – the conviction that this time, this is the one that’ll get infected. This is the one that’ll send me to the hospital. It’s not happened yet. I’m trying to stop before I get down there. Plasters help, except my skin is now so sensitive that they leave behind marks of their own.

So that’s that – that’s my dermatillomania. If you hear me talk about how I hate my face, or how I look, it’s usually that. I like my face shape, my eyes, how I look – if I could get rid of the redness, the marks, the imperfections I obsess over. Trying to move my brain away from thinking of ‘getting rid’ as being ‘basically clawing your face off’ is the hard part. But I’ve started.

Anyway. Here’s a song that teenage me related to quite a lot. Some people read it as being about self-harm, and apparently Amanda Palmer has said it’s about picking at the skin around her nails. For me, it sounds like my dermatillomania given voice.