My Dermatillomania Destroyed My Skin, But Not My Self-Esteem

Photo: Dragana Gordic / Shutterstock
woman touching her face

If you saw my face in person, you would notice that it is covered from chin to forehead in pockmarks. Most people are too polite to ask what these marks are from.

If anything, they just assume that I had some sort of illness or injury that caused them. Usually, when people ask about them, I’ve learned to say that I got these scars because I had horrible acne as a teen. Still, that’s not the whole story.

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The truth is, I have dermatillomania. As defined by Psychology Today, “Dermatillomania, also known as excoriation disorder (per the DSM-5) or skin-picking disorder, is a psychological condition that manifests as repetitive, compulsive skin picking. It is one of a category of disorders known as body-focused repetitive behaviors (BFRBs) that are currently classified in the DSM-5 under Obsessive-Compulsive and Related Disorders.”

It’s not the same as the occasional picking at a blemish or an annoying bump on one’s skin. The main difference between normal skin-picking and disordered skin-picking is the frequency and compulsivity of the act.

 If you only skin pick every once in a while when you have a skin imperfection, you most likely do not have a disorder. If you find yourself constantly picking at your skin when you are bored, stressed, or overwhelmed, you may have the disorder. Naturally, only you and your medical providers will be able to determine whether your skin picking is a problem for you.

Why do I pick at my skin?

Everyone deals with stress differently. Some people overeat or undereat. Others distract themselves with books or video games or new purchases. As for me, when my stress level gets dangerously high, I pick at my skin. 

It’s an unconscious habit that I’ve been trying to break for almost sixteen years.

Even though I am now an adult with plenty of coping tools at my disposal, the problem still hasn’t fully faded.

When I have mild to moderate stress, I can catch myself in the middle of picking my skin and redirect to another coping skill. During times of extremely high stress, though, my skin picking can get more severe without me realizing it. 

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Sometimes, I won’t even know that I was picking at my skin until I notice that a spot on my face is sore and I see the scabs where I scratched myself. Thankfully, this level of severity has become rarer as I’ve aged and gained new skills. Still, because this maladaptive coping strategy is so basal for me, it comes back out when I’m too overwhelmed to turn to other skills.

Skin picking isn’t a “bad habit” or a “weird quirk”

I went most of my life thinking that this was just a bad habit that I needed to break. That’s how those around me viewed my disordered behavior, after all. 

“Stop picking!” was the refrain that I heard all throughout my childhood and adolescence.

Unsurprisingly, this tactic did nothing except make me feel more ashamed and “bad” about what I couldn’t help. My family didn’t help me to overcome it — if anything, they made me more likely to pick my skin with the way they handled it.

Rather than curing my skin picking, this only made it worse. I learned to pick at my skin in private. As a result, when I was going through a lot of stress or triggers, I would isolate myself so I could pick at my skin.

Sometimes, people in my life would feel like the supportive thing to do in regards to my skin picking is validating it as “just something Maya does.” This was as unhelpful as those trying to shame me into changing.

Dermatillomania is a disorder, not a personality trait. This doesn’t mean we should shame people for having it, but it does mean that we should encourage them to cope safely and get help if possible for it.

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Even though my face is covered in acne scars, I still feel attractive

For me, these are my battle scars. For better or for worse, they tell part of my story of survival. I used to try to get rid of them with scar creams and homemade scrubs. These “treatments” usually just left my face feeling painful and irritated. Oftentimes, they wouldn’t even do anything other than make my face red and swollen in addition to scarring. 

Scarring can be a blow to one's self-esteem.

Since I don’t have any means of covering my whole face, I have to either show my scars to the world or spend an hour filling in the marks with makeup. I choose to let the world see my face, scars and all. If someone finds me less beautiful because of imperfections, then they are entitled to their opinion.

I know that the alternative to having these scars was overloading my system with stress hormones. Although it wasn’t ideal, picking my skin soothed me as a child and teen when I had no other options to cope. In a perfect world, I’d have flawless skin and no need for any coping skills–maladaptive or otherwise.

This world might not be perfect, but it does have its perks. As weird as it might sound, some days, I am grateful for my scars. Since I have scars now instead of actively bleeding scabs, I see them as proof of how far I’ve come.

Truth be told, I have bigger things to worry about than whether these marks are noticeable on a given day. I consider myself lucky to be out of situations where picking my skin felt like the only way to calm down. What’s more, I consider myself fortunate to have coping strategies such as occupying my hands with a fidget toy, whispering “stop” if I notice myself picking, and even stuffing my hands in my pockets if necessary. 

There might not be conventional beauty in pockmarks and scars, but there is a special kind of beauty in survival, personal growth, and healing.

To me, that’s what my scars represent.

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Maya Strong is a professional writer who has spent the last six years blogging about relationships, LGBTQIA+, mental health, lifestyle, and cultural commentary online.