A dermatillomania update

Last year I wrote about my experience with dermatillomania, also known as compulsive skin picking. It’s part of the OCD spectrum of behaviors, where I have the compulsion to pick at the skin on my fingertips and lips, often until they’re bleeding or scarred. It’s worse when I’m nervous or stressed because I oddly find it soothing, but I’ll also do it absent-mindedly. If you want to learn more, check out my original post.

So why am I talking about it again? Well for one thing, people often ask me about it. I’ve had so many people coming out of the woodwork saying “Holy crap, I do that too!” Mental illness has so much stigma that it helps to remind people that “Hey, I’m not totally right in the head…but that’s perfectly fine.”

But I also want to mention it because someone (who also suffers from dermatillomania) knew I was seeking treatment, and they asked me if it was effective. Honestly…not really. That doesn’t mean no treatment for dermatillomania is effective. I was going to my university health center, which doesn’t specialize in this particular disorder. I really liked the therapist I ended up meeting with over the summer, but she had never tried to treat someone with my condition before. I’d likely have better luck controlling my compulsion if I went to a specialist, but honestly my problem isn’t bad enough to shell out the money.

Talking to a therapist about my dermatillomania did help me out in one important way: I no longer feel guilty about what I do. And the guilt was one of the worst things about it. I felt terrible trying to explain my scarred fingertips to someone who happened to see. I felt ugly and unattractive after chewing on my lips too much. I felt like a failure because I couldn’t control my own behavior.

But talking to a therapist reminded me that it was okay to not be in control sometimes. People with cystic fibrosis or nearsightedness don’t get told that they should just control themselves better. We accept that they have health problems that they didn’t choose to have. I’ve now accepted that I didn’t choose this mental health disorder, and it’s okay if I have a hard time dealing with it.

This is post 26 of 49 of Blogathon. Donate to the Secular Student Alliance here.


  1. says

    Thank you!

    I am so happy to see a blogger point out that mental illness is the same as physical illness. Why do people assume that depression is voluntary, but a broken leg isn’t? Why do people talk ad nauseum about an appendectomy, but clam up about anxiety? Treat a epilepsy as a disability, but schizophrenia as a shame?

    The best response I saw was an art installation: flowers in a mental hospital.

  2. FossilFishy says

    Why do people assume that depression is voluntary, but a broken leg isn’t?

    This. A thousand times this.

    I cannot tell you the number of times I tried to explain to people that I could not “just” get over it, or “just” suck it up, or “just” anything with regards to my depression. There is no “just” when your brain will not function. It’s like sayint to someone with a broken arm “Just do a few quick push-ups, go on you’ll feel better. I works for me.” Bah!

  3. says

    You continue to kick ass by talking and de-stigmatizing brain health. Thank you.

    Do you mind sharing what kind of therapies were tried?

  4. K.D. says

    Thanks for talking about this. I have pretty much resolved trichotillomania, I will still occasionally pull a hair or two, but the remaining habit is just quite obsessive hair-playing. I don’t like that I do it but I think it definitely has to do with stimulation levels (over or under). Unfortunately my dad still gets on my case about it and can’t understand why I often don’t realize when I’m doing it (hair-playing). Or he’ll start feeling my hair and make fun of me (REALLY want to punch him when he does that)… not cool. I also had therapy for the actual hair-pulling a long time ago which did nothing at the time. It involved tracking how many hairs I pulled a day, snapping a rubber band on my wrist when I felt an urge. Eh. Some people have found relief taking N Acetyl Cysteine, I guess.

  5. Azkyroth, Former Growing Toaster Oven says

    But talking to a therapist reminded me that it was okay to not be in control sometimes. People with cystic fibrosis or nearsightedness don’t get told that they should just control themselves better. We accept that they have health problems that they didn’t choose to have. I’ve now accepted that I didn’t choose this mental health disorder, and it’s okay if I have a hard time dealing with it.

    I have reservations about this idea. For problems like yours it makes sense, but I’ve been too seriously harmed by the symptom-consistent behaviors of various friends and loved ones with serious psychiatric issues (bipolar and various personality disorders, mainly) – and in some cases, had “it’s a DISEASE, I can’t help it!” brandished at me too many times as a self-serving cop-out – to be comfortable with all the implications. Where do we draw the line where “symptom” behaviors (or at least the failure/refusal to fucking fix oneself) cause enough harm to be blameworthy?

  6. says

    I think if your disease is hurting yourself and/or others, then you should seek treatment. Dermatillomania doesn’t really affect me drastically other than being an annoyance and a quirk, and it doesn’t affect people around me. But if you’re hurting others, you need to get help. It’s not a perfect analogy since you can’t “infect” people with depression, but it’s sort of like having an infection disease and getting other people sick because you don’t personally want to deal with it. Of course you have to deal with the fact that the traits of a lot of mental disorders make it even harder for someone to be motivated or rational enough to get treatment, so it’s a really muddled situation. I’m just saying what helped me.

  7. Lindsay says

    Huh, I’ve always picked at my lips compulsively since I was little and I never knew it was an actual “thing”. Thanks for posting about it, actually I’m picking at my lips right now dammit! I’ve gone through ups and downs where sometimes I can keep myself from doing it by using chapstick when the mood strikes, but at other times, like now, I pick past the point of bleeding and it’s embarrassing going to work with busted up lips. I’ll have to look into what types of treatments are recommended.

  8. Eric Dutton says

    I love this post. I work in a psychiatry clinic and I try to stay involved with the anti-stigma movements, so it makes me feel good to read posts like this.
    I have a condition called misophonia. The New York Times published an article about it last year: http://www.nytimes.com/2011/09/06/health/06annoy.html
    It’s very frustrating that (like your condition) there’s no treatment for it, but just learning that the disease exists felt liberating to me. At the very least, I felt like I could talk to people about it without having to explain that I knew that what I was about to describe would sound absurd and irrational, but. . . .

  9. thunk = ∫ SQRRAWK! d(MQG) + C says

    I tend to have a nasty thing of chewing-mania. I just need to chew– something, anything, whether it is gum, fingernails, or small metal objects (especially the latter). My own hair (ever since I grew it out) is another target.


  10. Cynthia says

    This is crazy. I remember this first time I found a website about trichotillomania- as I read through the member comments and posts I spontaneously started to cry. I was just overwhelmed by the fact that other people had this too! Trich wasn’t the hugest problem in my life but reading my own experiences coming from other people’s words was mindblowing. I had a similar experience when I discovered your blog except there wasn’t any crying, just happiness and excitement. I knew other atheists existed out in the world but didn’t know they like, talked to each other and stuff! So anyway, this intersection of 2 big issues in my life: atheists with dermatillomania. is melting my brain.
    I’ve been trich free for a year and a half now, my chunks of hair have grown in, and my skin picking is pretty mild. It was a long process to stop, and this is a simplification of it but right at the end among other things I did a lot of tai-chi; it relaxed my hands. And I would buy myself things for good behaviour :P

  11. steve says

    isn’t a lot of mental illness physical. That is due to chemical inbalances in the brain. Hopefully as time goes on scientists will you understand more about a really complex organ and be able to really help.

  12. Lindsay says

    Jen – Thanks so much for posting about dermatillomania. I read your post a year ago, and also realized I did the same thing. I’ve been in therapy for it and have made major strides in reducing the incidence of picking. But even more, I realized that the picking was being caused by severe problems with anxiety, which were seriously reducing my quality of life. Therapy has also helped me deal with my anxiety in much more constructive ways. It helped me through the end of my Ph.D. (VERY stressful) and my quality of life will be forever better than it was.

    Because of YOUR POST on dermatillomania a year ago, I am quite literally living a better life today. Thank you! :-D

  13. That Guy says

    ” It’s like sayint to someone with a broken arm “Just do a few quick push-ups, go on you’ll feel better. I works for me.” Bah!”

    Belated comment but I wanted to mention that regular exercise is a proven aid in treating depression.
    My depression was moderate to severe, but I now manage it almost exclusively through exercise. I still sit down with a therapist several times a year and have access to my medication if I require it, but my primary form of treatment is between 30 and 120 min of exercise daily.

    The comparison of a broken arm isn’t really fitting, a broken arm properly treated will require no more than to be rested to heal to full strength. I’ve had physical therapy for an injury as well as mental therapy for my depression and I think that’s a much better comparison: My body had suffered trauma and reacted to protect the damaged area, without being treated the damaged area never healed correctly and became weakened, which resulted in repeated injury. My physical therapy involved training my body to use my muscles in the correct way and strengthening the parts that had atrophied.
    My therapy for depression had a similar theme in that my pysche had suffered trauma and had not properly recovered. Much of my treatment involved training my mind to react differently to situations than it had done. Like training my body it was difficult at first and required thinking about it constantly, but the more I stuck with it, the less effort it required.

    Like my injury, my depression will never fully go away, but with proper guidance and a consistent effort on my part both have reached the point where I can go months at a time without noticing them.

  14. Skrollan says

    Hey Jen,

    every few years I find someone in the internet who talks about this kind of behaviour, and every time it makes me feel good to find out that there are so many others who share my behaviour!

    When I was a kid, I tended to suck on my thumb, I think that is kind of normal, right? For some reasons I replaced it with biting on my nails, ever since I can remember. My parents told me to stop countless times, so in trying to obey, I stopped that – only to switch to the skin of my fingertips. So since I have been maybe 12 or so, I don’t bite my fingernails any more, but I just can’t leave my finger tip skin alone. It’s just impossible. Like you, I do it when I’m stressed, scared, or bored. And indeed I actually like it, for some reasons it feels good.
    I also pick on the skin of my mouth, but fortunately I always stop before it starts bleeding (that’s something I learned when I started to use chapsticks – although in the beginning I like them because they made my lips heal faster so I could start to pick again earlier…).

    There were times when I forced myself to stop, when I left my fingers alone so they could heal. I thought, once they are healed, there would be no more urge to start picking… but I was wrong. Not only was it very very hard to stop doing it, I also started to act weird when I was stressed, I started to hurt myself in other ways (for example hitting myself if I had done something wrong). Also the urge to pick never left me, even when my lips and fingers where fully healed. I would relax, and 2 weeks later everything was back the way it was before.

    I still don’t know what the real issue is that lets me act this way. Maybe I’ll never find out. What’s a real help is that my boyfriend knows that it’s a disease so he doesn’t try to force to stop me, that’s a relief to me.

    I don’t know if I will ever be able to stop, but at least I stop the picking early enough so my skin hardly gets infected anymore, and most people don’t notice it.

    Anyway, thanks for the blog.

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