Skin Picking: Dermotillomania
Clinical evidence shows skin picking is far more common than most people realise. Young adults and adolescents especially are more prone to this unhealthy and destructive habit. Fortunately, most people recover successfully after taking specific, concrete steps without the need for medication or hospitalisation. This article explores aspects of the phenomenon, including why some people succumb to picking their skin obsessively, and how to go about stopping and eliminating the habit.
What is Skin Picking?
Compulsive skin picking happens when a person habitually picks at the skin, and shows little or no self-control to stop it. The medical term for it is ‘dermatillomania,’ a form of unconscious self-harm; for some reason the person dislikes themselves and directs aggression against the self through consistent skin picking. People who pick their skin will use any object, including the fingers, nails, tweezers, or hairpins to prod and squeeze scabs, pimples, or even unblemished, healthy skin. Mostly, they pick the face, chest, scalp or stomach areas.
The habit usually begins during adolescence and early adulthood as a response to perceived imperfections or stressful events. Adolescents who feel awkward about their bodies or appearance might start picking their skin both as a form of self-punishment, and as a way to solve whatever the problem is: the magical or fantastical belief is that if they could “get their skin right” or perfect, their emotional pain or discomfort will disappear.
However, some people develop the habit of skin picking from observing a significant other – a parent or older sibling, for instance – doing it as a way to deal with stress or anxiety. In addition, evidence shows that most people indulge in skin picking when they are inactive, such as when watching TV, reading, or having a telephone conversation. Moreover, because they want to keep it private, people with this addiction usually give in to the urge when at home or alone in the office. For some people, it’s the very first thing they do when coming home from work; going straight to the mirror to inspect the skin and choose an area to pick.
What motivates some people to pick their skin habitually for months on end? Here are a few common reasons why the phenomenon exists.
Motives for Skin Picking
Available evidence points to psychological reasons behind skin picking. It is often an attempt to deal with emotional pain, offers immediate, temporary relief from anxiety, and could be symptomatic of trying to achieve some sort of perfection in appearance. Some people indulge in the habit as part of a larger personality disorder or severe emotional disorder, like Obsessive Compulsive Disorder, for example. Not all people who pick their skin are seriously psychologically troubled though, which is why most people can and do escape the habit after following one or some of the intervention strategies that will be covered in an up and coming blog. Until then, here are some of the key motivators to skin picking:
Unresolved Emotional Troubles: Most people who skin pick show signs of fluctuating mood disorders and go through spells of depressive episodes. Some abuse alcohol and drugs, and generally don’t feel good about themselves, lacking self-confidence and self-esteem. Many can pinpoint the time when they started the habit; usually immediately after an emotionally traumatic event like the break-up of a longstanding romantic relationship or rejection by a trusted friend. Whatever the specific reason, it usually resulted in the person feeling a massive loss of self-esteem and profound gain in self-doubt.
Self-Punishment: Believing they are to blame for unfair treatment by others, or that significant others reject them because they are not worthy in some way, people who skin pick direct aggression at themselves as the source for their misery. Hurting the skin, the closest and concrete part of the self, is one way of meting out the ‘deserved’ punishment for not being good enough and likeable.
Stress Relief: Digging into the flesh with pointy objects is distracting; for a short while the mind is preoccupied with something other than worrying. Some people who pick their skin feel it is as if all their problems disappear when they focus intensely on their appearance, scrutinising their face or arms or other areas of the skin. Such present-moment awareness, as unhealthy as it is, prevents the person from worrying about the future or dwelling on why an ex-lover dumped them, for example. Many people who pick describe the experience as going into an almost relaxing, trance-like state, in which they are oblivious to everything but their bodies.
Perfectionism: Cultural pressure to look well-groomed, young and sporting unblemished, healthy skin at all times affects everybody. However, people who pick their skin to compensate for psychological vulnerabilities choose to fixate on the flesh as a way of improving their appearance and self-image. While most people don’t worry about a pimple or spot on the arm or cheek, people with this condition exaggerate its significance and make it a mission to get rid of it.
Consequences of Skin Picking
Of course, picking the skin as an attempt to perfect some perceived blemish or avoid dealing with emotional pain doesn’t work. In fact, it actually makes matters worse; people end up with bleeding sores, unsightly, deep scratch marks, or infections. In addition, while these should be a sign to stop picking, the individual interpret these manifestations as reasons to go on picking, believing that more picking will ultimately heal the skin.
The original emotional causes behind the habit persist in spite of consistent picking, and the individual spirals deeper into depressive episodes, anger, self-resentment, and unhappiness. It’s not uncommon for many to end up isolating themselves and avoiding socialising, as well as living in fear of being discovered as a ‘skin picker.’
Ultimately, this is a physically and psychologically distressing condition to live with, but there are some mental strategies that can assist people in their efforts to stop skin picking. These will appear in an up and coming blog.