Dig: A Story About Dermatillomania

Content warning: This article contains discussions of compulsive skin picking and body dysmorphia.

Image source: Juan Miranda Ferris on Unsplash

I am 17. My alarm goes off at 5:30 a.m., and I dread the next hour of my life. While most of my classmates are still asleep, I sit cross-legged in front of my full-length bedroom mirror and begin the painstaking process of covering the skin I had picked, squeezed, and cut into with cheap drugstore makeup. It’s a tedious process — camouflaging my skin so that I can hide in the hallways of my high school. I want to be invisible.

I knew virtually everyone popped their pimples only to have an angry red patch of skin to remind them of their overwhelming urge to exorcise the pus just beneath the surface. I also knew that what I was doing was different. I picked because I hated my face, and I hated my face because I couldn’t stop picking.

I had no sense of time during my nightly extraction episodes. It was nothing for me to spend an hour or more in front of my bathroom mirror, scratching at every blemish, bump, or perceived imperfection.  I used my nails, needles, pins — anything to aid in excavating my skin. I was a mad archeologist disfiguring my face to uncover a pain I knew no other way to express.

When I was “done,” I’d step back from my mirror in disbelief at the bleeding and red-marked face, looking back at me — like an alcoholic slowly emptying a bottle one shot at a time, wondering who drank all their whisky. I was always horrified and confused by my reflection. Did I do this to myself, I’d think, and if so, how could I? I couldn’t make sense of my auto-sadistic behaviour.

Next, I’d wash my face with Clearasil, Oxyclean, Noxema, or any burn-inducing cleansers used by 16-year-olds in the late ’90s. The harsh chemicals would sting my face as they penetrated my open and oozing skin. I’d slather on a thick layer of Vaseline and bury my face in the tie-dyed pillow on my bed until the burning subsided. It was a bizarre bedtime ritual I felt compelled to perform. Some people drink tea. I cut into my face.

Those were miserable, self-loathing years spent mostly in my bedroom furiously scribbling in my diary or in front of the TV, wishing I was Joey Potter on Dawson’s Creek with her perfect porcelain skin. I didn't go out, I didn't go on dates, I didn’t go to prom, and I didn’t even go to my graduation party. I was a prisoner to my pain, my reflection — the beast who knew no one could love someone so hideous.

Like any teenager with an affliction, I just knew I was the only person in the world doing what I was doing. If nothing else, I could feel unique in my misery and distinguish myself from every other unhappy high schooler with my particular brand of pain. I took a few stabs at anorexia, but I could only ever manage a few weeks in the size 25 Calvin Klien jeans I purchased for such occasions. But this, the mutilation of my face, I could commit to.

One afternoon, I was channel surfing as we elder millennials often did during the years before Netflix became ubiquitous, and I came across an episode of the Dr. Phil show. I hesitated before changing the channel in hopes that he would be tearing into some spoiled 16-year-old headed to one of those troubled teen camps in rural Montana. Or a clueless married couple who couldn’t understand why their open marriage was causing issues in their relationship. Alas, it was two sisters discussing their incessant skin picking, or “dermatillomania”.

I was dumbfounded. What I was dealing with was a real thing, and I wasn't alone. I felt satisfied in the way that it feels good to find out when other people dislike someone you also dislike and strangely vindicated by the knowledge that I had a real problem. Dr Phil said so.

The Mayo Clinic categorises dermatillomania or excoriation disease as the most common body-focused repetitive behaviour, along with nail-biting and hair-pulling. According to Psychology Today, skin picking is classified as a DSM-5 (Diagnostic and Statistical Manual of Mental Disorders (DSM) organised under obsessive-compulsive and related disorders.

Unlike occasional skin picking, which nearly everyone engages in throughout their lives, dermatillomania is characterised by regular skin picking leading to skin lesions, efforts to curb or stop picking, distress over one’s lack of self-control, and even shame. Check, check, check, check. I had it all.

Putting a name to what I was dealing with gave me some relief, but unlike Dr. Phil’s guests, I wouldn't be gifted the therapy and dermatology visits I likely needed to stop picking and heal my skin. I did, however, convince my mom to throw down the $29.99 for a month's supply of Proactive—the millennial's answer to acne endorsed by everyone from Jessica Simpson to P. Diddy. The proactive did little to change my skin or curb my incessant picking. I gave up when I didn’t see immediate results.

At 39, I have more control over my compulsion. I still find myself obsessing over my skin – staring at it with a small, magnified hand mirror, searching for even the slightest blemish – but I draw a strange comfort from mapping my imperfections. I know their exact locations on my face and the distance between each of them. I still have to keep track of them, as if knowing precisely where will keep them from surprising me.

Ultimately, unbelievably, I grew so sick and tired of my self-destructive behaviour that I began to fight my urges with real fortitude. At the time, my skin was young and resilient, but I knew if I continued to indulge my compulsions, it would lead to scarring and infections. I had caved to my immediate need for relief for so long that it was nearly impossible for me to even look at my reflection without immediately attacking my face.

Breaking my habit was a slow, arduous process. I’d be “good” for a week, then something would set me off, and I’d take it out on my face. It took years for me to develop the discipline to combat the impulse to pick along with a low dose of antidepressants, but above all, I had to learn to like myself enough to care how I would feel after picking my skin. I guess I finally did.