Saturday, 16 July 2011

Dermatillomania (compulsive skin picking)

It is probably fair to say that my dermatillomania problem is more an issue for one of my alters than me as a whole, but it certainly affects me as a human being.

Dermatillomania, as defined by Wikipedia (the answer to all of life's definition dilemmas) is 'an impulse control disorder characterized by the repeated urge to pick at one's own skin, often to the extent that damage is caused'. The way in which a person may suffer, depends on the person: for some it might be picking at bits of rough skin, spots, any blemishes or imperfections. For others it might be peeling off cuticles or scratching at skin.

It is also known as 'Complusive skin picking' but on this blog we will stick to using the more obscure title of dermatillomania simply because the thought of  'compulsive skin picking' incites nauseating mental images that result in the feeling of impending hurling.

Dermatillomania tends to be caused or worsened by anxiety and stress. It is certainly the case for me and my anxious alters. In my experience, the problem tends to lead into a spiral where it gets worse and worse: the more you scratch and pick, the more damaged and scabbed the skin becomes, so the more there is to scratch and pick at and so on...

When my dermatillomania takes off (as it is not consistently a problem, but if I switch to a specific alter or if I am very stressed it will become problematic) I find myself picking and scratching at my skin: mainly my face, head, behind my ears, my upper back, arms and chest but it could be anywhere. I don't consciously do it, but I will run my hands over my skin looking for any rough or loose skin, any blemishes or lumps and will then pick, squeeze and scratch at said parts uncontrollably.

At the moment, I am a sight. I've got several really ugly sores on my face where I perceived there to be a spot developing and squeezed and picked it to death. I am sure if I hadn't, the blemish/spot would be long gone by now (if it even was one at all) but instead I have ugly scabs which I can't leave alone. Every time they scab over again I pick them off again. It sounds rather disgusting when you think about it.

Today in work I was scratching away behind my ears (OK that makes me sound like a dog... just to clarify, I wasn't using my foot) for so long that it started bleeding quite a bit and then I had to mop it up with tissues whilst hoping no one would see.

So what helps dermatillomania? Well, since it's often induced by stress and anxiety, it follows that reducing these symptoms will help reduce dermatillomanic tendencies (easier said than done, we all cry). For me, when it is at it's worst, the problem in itself adds to my anxiety, because I want to stop but feel out of control. At times like this, it is often my husband who is the help. He notices it more than I do (because I'm not consciously doing it but it upsets him to see me damaging myself) so will keep telling me off and may even resort to holding my hands so I can't use them anymore. This can actually be really helpful in the middle of an uncontrollable scratching session (woof woof) and can give time for the urges to pass.

Something else that can help is to find tasks to keep your hands busy and your mind distracted. This is one I haven't really tried, because as I said, it tends to be unconscious, but it seems like a good idea. You might want to try wearing soft gloves (you could also do a mime act with these...that might distract you).

This next suggestion may seem a little odd but really works. I have found myself in the past, pasting PVA glue onto my skin, letting it dry and then peeling it off. It gives the satisfaction of the action but without the damage. I guess it doesn't really help to break the habit, but it is fun!

Anyway, I'm not going to try to advise any more than that, because I am hardly one to talk, with a face currently resembling a map of the Northwestern Passages but if you are a fellow dermatillomaniac feel free to give me some suggestions!



JustEliza said...

My solution was just to wear long pants and long sleeves. Even if I just wear short sleeves, it limits the picking to my face/neck/arms. I have found a good moisturizer and use that on my lower arms. Picking at a slick surface is somehow less fulfilling.

I cannot shave because the resulting bumps and itchiness would make me go haywire with picking and scratching. Waxing is better.

My husband regularly stops me from picking my face subconsciously. I am always, always, always pulling at, scratching or rubbing something. Apparently, it is primitive (infantile) attempt to ground ourselves and contain the anxiety inside. So perhaps we can use it as another 'sign' for when we need to express something or listen to ourselves?

Seems to me if that were true we'd be perpetually listening to ourselves.. ;-)

Candycan said...

interesting point about it being a grounding technique. I hadnt thought of it that way.

nikki said...


My name is Nikki and I have also been diagnosed with DID.
i came across your post on NHS about picking and noticed that you have been diagnosed aswell.... well i just thought that was amazing.

I dont really know how this type of site works (it has taken almost an hour to find out how to add a post)

my email address is

i have so many questions (and you prob dont want to hear them and thats ok, im feeling very excited.

castorgirl said...

I do this as well. I've always had what people would call "nervous habits". I find that grounding and doing diversionary techniques (keeping on doing other things with my hands), are the only ways to ease the problem. I'm told that it's something that will ease with continued healing, awareness and ability to self-soothe.
Take care,

Candycan said...

Hi Castorgirl, I'm glad to see you back on our blog :) Nervous habits is a good name for this. I think my habits are more limited to one alter. I'm going to the doctors about it soon, but now that that alter hasnt been very active this week my skin is starting to heal up so I won't have any 'evidence' to show her! I don't really know if they can do anything for it anyway.

Candycan said...

hi nikki, i sent you an email from my account, feel free to email me back. C

Anonymous said...

Wearing a hat on my head (my scalp is a haven for scratching), keeping my finger nails really short, putting moisturer on before bed, for some reason this makes my skin harder to scratch and pick at. Grounding myself by pretend running (Peter Levine's Somatic Experiencing technique). You sit and pump your feel up and down as though you are running. It's a natural response to anxiety to run away and increased anxiety is because you are trapped. This 'running' triggers a release in the brain. My therapist also suggests looking for the spaces in between objects and wrapping myself tightly in a blanket. The first is about engaging the right brain over the left and the latter is about re-establishing skin boundaries. All make me feel safe again.

Anonymous said...

Hi, I only just discovered this was a condition yesterday, I've been doing it for 5 years and just thought I had developed a bad habit. I'm 30 now and my skin is much worse than it was when I was a teenager. I've been meaning to see the doctor now for almost a year about going back on anti-depressents and will mention this when I eventually get round to it. I pick on my face, lips, boobs, lower and upper arms and my legs, plus anywhere else I might find a lump or puckering of the skin. It's driving me insane! A quick shower takes me an hour because I need to check every inch of skin I can reach for a spot to squeeze. I also chew my tongue and inside cheek til they bleed. I don't necessarily want to be normal, I just don't want to have these habits! Sometimes I don't even realise I'm doing it and it'll turn out that I've been picking for half an hour! Help!

Candycan said...

Hi Anonymous, I only just found your comment. It sounds like a real problem for you. I hope you have been able to talk to your doctor about it and get some help. I saw some good videos on Youtube about it once from. If you do a search you might get some good advice.
One thing that I think is important for me is to keep my hands busy with something else. Crochet is a good one for when watching TV

Anonymous said...

oh dear here i go again its me anonyomous ;/ ;) :) picking is what one of my me's have learnt when anxious and it has spread to other alters also other coping methods but im not going to talk about them just the picking, im so glad again that you have done this blog on picking as i scour my body for imperfections but its manly my arms and legs that get repeatedly attacked, i have some times when with my husband when we are having sex felt his body and mapped his body as a way to cope , this may sound bizarre but i do, and when he cuddles me i get anxious and say ohh you got a spot and its the most minute thing that iv found but i have to gouge at it and call him a baby for complaining it hurts as a part really wants to hurt him like i felt, and this happens when i do it to my self, sometimes we can be talking about my sessions at group or with my T and i have to go up stairs to the toilet and pick at my arms, i have told my husband about this so now when i say im going to the toilet he will shout up stairs to see if im ok as iv took longer than needed then it knocks me out of it and i/another part comes out feeling guilty yet relieved,so thats one of our techniques to try and stop it at moments, if we watching tv and something as triggered me i just take off to the loo , then he shouts, but when he not here its difficult but my T says to asks one of my me's to check in and say enough now you ok , sometimes i hear the me and im out of there, but in the past hours have gone by and the damage is hard to hide and summertime is worse with short sleeves so i have mant cardigans in all calours :)

Elizabeth said...

Hi there,

I just came across your blog. Thank you for having the courage to speak up. I was diagnosed with PTSD 18 years ago and with DID 7 years ago. I usually know who I'm dealing with depending on what color I'm wearing, how coffee affects me (weird hunh?!), if I have a migraine or if I feel creative. I never attributed my picking habit to anyone of my gang (that's what I call my alters) though. Frankly, I always thought of it as normal. I pick at blemishes, pimples, that sort of thing but the worst is around my genitals. Boy, this is really hard to talk about. Come to think of it the picking began when I was 9 years old, soon after being raped. Huh, light bulb moment here. To hold myself together, I use a writing technique to communicate with my gang. I will ask which of us does the picking. If this can help anyone, I don't mind sharing. If nothing else comes of this, your blog helped me speak of the picking for the very first time in over 40 years. Thank you for that.

Anonymous said...

Hey there. I just discovered your blog and can relate all too well. How does one contact you? I can't find any email or other contact option. If that is on purpose, my apologies.