A Day With: Dermatillomania

Every night, I tell myself I'm not going to do it. And every night, I feel it take over: the irresistible urge, the search for imaginary and real blemishes on my body, an outward release of swirling anxiety.

Every night, I lose an hour or more of my life. I do it when I'm bored, when I'm anxious, and many times for what feels like no reason at all. For as long as I can remember, I’ve been a skin-picker. More specifically, I pick at my skin by popping pimples, both imaginary and real, the result of having keratosis pilaris, a skin condition that causes excessive keratin buildup. I hide away whenever I get a chance, searching for a stray bump that may pop, hunting my own skin like a lioness searching for prey. And I hate it. I hate that I've ruined my body. When I watch movies or see pictures of women dressed in their best, I don't envy their small waistlines, perfect hair, or smiling faces—I envy their bare skin, the smooth flesh of the arms and backs they dare show in public, while mine is riddled with scars I created with my own hands. A few years ago I discovered that skin picking is an actual disorder, with a name and everything. Skin picking is a form of Obsessive Compulsive Disorder (OCD)—realizing that there is a diagnosis for what I have done to myself could make me feel relieved, but instead, it just makes me feel crazy. Coming to terms with mental illness is complicated, and over time I have learned to accept that this is my "thing." In my mind, everyone has their "thing," the one thing they hide from the world. Mine just happens to be picking at my own body until I’m ashamed of myself.

Someday, I hope to get to the place where I can find relief. I am mortified by it, especially now that my kids are getting older and noticing. My five-year-old once asked me why I "hurt" my arms all the time. I cried alone that day and vowed to never do it again, but of course, OCD is not so easily willed away. Deep down, I had thought of mental illness as something that kept people from functioning in normal society: maintaining careers or raising kids or getting through the day without revealing a big secret. As it turns out, long sleeves can hide a lot of hurt. For me, a day in the life with dermatillomania starts at night. It’s when I am exhausted, and the demands of my young children wear on myself, my husband, and our marriage. My husband and I start to turn on each other, I replay the ways that I’ve failed that day, consider the tasks of the following day, and scan the awful news stories I can’t resist clicking on. Then, I slink away to the bathroom and lock the door—blocking out my husband, my children, the messy kitchen, stacks of unfolded laundry, unfinished work, the hurts, slights, disappointments, and a sense of impending political doom—and pick. If I have just showered, the urge is even more compelling because it feels like a blank slate. I’ve become adept at knowing which skin bumps will be worth the squeeze. I run my fingers along every last inch of my arms and shoulders, twisting and turning to get the softer, fleshier part underneath my arms, feeling for that tell-tale raised skin, the signal that there is a lesion ripe for the picking. Each pop feels like a small victory, as the warm sensation rushes over my skin. Sometimes, even as I’m picking, I tell myself I need to stop, that it’s awful, that I am a monster. But I never stop.  

Someday, I hope to get to the place where I can find relief. I am mortified by it, especially now that my kids are getting older and noticing. My five-year-old once asked me why I "hurt" my arms all the time. I cried alone that day and vowed to never do it again, but of course, OCD is not so easily willed away. Deep down, I had thought of mental illness as something that kept people from functioning in normal society: maintaining careers or raising mindful kids or getting through the day without revealing a big secret. As it turns out, long sleeves can hide a lot of hurt. For me, a day in the life with dermatillomania starts at night. It’s when I am exhausted, and the demands of my young children wear on myself, my husband, and our marriage. My husband and I start to turn on each other, I replay the ways that I’ve failed that day, consider the tasks of the following day, and scan the awful news stories I can’t resist clicking on. Then, I slink away to the bathroom and lock the door—blocking out my husband, my children, the messy kitchen, stacks of unfolded laundry, unfinished work, the hurts, slights, disappointments, and a sense of impending political doom—and pick. If I have just showered, the urge is even more compelling because it feels like a blank slate. I’ve become adept at knowing which skin bumps will be worth the squeeze. I run my fingers along every last inch of my arms and shoulders, twisting and turning to get the softer, fleshier part underneath my arms, feeling for that tell-tale raised skin, the signal that there is a lesion ripe for the picking. Each pop feels like a small victory, as the warm sensation rushes over my skin. Sometimes, even as I’m picking, I tell myself I need to stop, that it’s awful, that I am a monster. But I never stop.

I continue on in a trance-like state, sometimes for up to an hour, until I realize what I’ve done, and feel horrified by the bleeding blotches covering my arms. I feel remorse and regret and immediately vow never to touch my arms again. I dress quickly and offer to rock the baby to sleep so my husband will not see my arms. I confessed to him recently that my nightly hour-long “shower” wasn’t all showering; now he will give me a knowing look and shake his head, sins written all over my face, sometimes quite literally. I rock my baby to sleep, notice her perfect skin, and my heart twists in a way that hurts. I consider whether I’ll pass this humiliating disorder on to her; someday she may marr the beauty I see in her, and she might seek to release real pain through her adorably-dimpled arms. Again, I vow that tomorrow, I will do better. But in the morning, I forget. I stumble into the bathroom, and under the bright lights like a bewildered animal, my eyes scour my skin, looking for a raised spot to pop. The cycle starts all over again. I know I am not alone. According to the International OCD Foundation, skin picking affects around 1 in 20 people, a higher percentage are female. I’m beginning to accept that this is a bigger problem in my life than I have ever let on—and that, for me, will hopefully be the first step in healing. I can’t imagine a day when I don’t pick at my skin, but I have to wonder if it’s out there. And maybe even more importantly, if it’s not too late to stop from passing my shortcomings on to my own daughters, who already bear the tell-tale signs of bumps along the back of their arms. Right now, skin-picking controls my life. But I hope I will someday take back that control, even if the scars may always remain.