"Are you aware of what you're doing to your hands?"

When my dermatillomania started remains unclear as my habits are predominantly subconsciously made with little or no awareness. My habits were first pointed out to me by a friend at university as she worked beside me. I remember her asking me, “Are you aware of what you’re doing to your hands?!” As I looked down, my hands were covered in red sores and severe excoriation (scratched skin). I was almost bleeding, feeling incredibly embarrassed and with a sense of shame.

I was diagnosed with Generalised Anxiety Disorder when I was 16 and have struggled with anxiety since a child. Symptoms manifest in varying ways, however I mostly cope my picking and scratching my skin. This is paired with (often stress-induced) dermatitis, which feeds into my obsessive habits and rituals.  When I feel stressed, upset, under-pressure or any negative emotion, I immediately start picking. As the years have passed, I’ve been able to identify certain triggers, such as socialising with new people, exams, boredom, anxiety attacks or simply imagining the sensation of an itch.

Anxiety induced skin picking

I begin by seeking a bump or blemish to pick, rough or dry skin to peel, or to find a real or non-existing spot to squeeze. From my lips, hands and legs, I become entranced on finding a blemish to pick and fixate on. My mind feels calmer, focused and disassociated from what is going on around me and momentarily distracted from my own anxiety. Ultimately, I feel satisfied and soothed.  My picking rituals also consist of feeling my skin, looking for bumps or imperfections to ‘smooth out’, or analysing areas which I tend to focus on such as my thighs. Although I predominantly use my fingers and nails to pick, objects can often come into play and usually occurs without awareness or subconsciously, such as using the steering wheel whilst driving to itch or rub, chairs and tables whilst sitting in an exam, sharp pencils and so forth.

As my anxiety subsides, so does the impulse. As I enter more stressful periods of life, more time is spent picking. However, no matter how little anxiety or stress I may be experiencing, I never fully trust myself when exposing my legs by wearing shorts or a dress. The urge can be so overwhelming it totally pulls me away from where I am, who I’m with and what I’m doing. In the end, my legs become a reminder of the anxiety I had felt and the compulsions I still feel.

Misconceptions of dermatilliomania

I’ve delayed seeking help for my habits due to avoidance, with anxiety over potentially trying to communicate with someone who doesn’t empathise, understand, or has awareness on what I’m experiencing. Facing the potential stigma and the misconceptions which surround dermatillomania – or implications of mental health as a whole – was too daunting. However, with the endless support from my partner who helps me identify and stop my habits, I don’t feel the need to be embarrassed. I simply try to be mindful and kind to myself in that moment (if I can).

Mental health and skin picking

Learning to be aware and control my behaviour and habits which cause me such harm has been difficult and is a daily task. Some days I am able to fight against the urge, allowing them to flow through me and not be consumed by them, other days I can’t. Yet I allow myself to keep learning, maintain awareness and try again. Without self-compassion and mindfulness, you can’t move forward.

Despite the on-going difficulties I have with dermatillomania, the experiences I’ve have had has enlightened me on the complexities of mental health conditions and how those affected cope – both through healthy and harmful habits. It has also introduced me to a whole new realm of skin conditions, which are either caused by a psychiatric condition or refer to implications which are associated. In turn, this has provided me a whole new aspiring career and is a passion of mine.

Positive steps for the future

I am moving forward by hoping to help people affected by skin conditions and to help raise awareness through my research in Clinical Dermatology at the University of South Wales. My research aims to provide answers to questions whilst exploring the complex relationships between the psych and skin, in hope of eliminating the stigma which myself and many others experience. I’m also continuing to take control of my condition, with help of connecting with people through blogging and sharing my research on my Instagram and Twitter

Phaedra Longhurst

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