One of the problems I specialize in working with is repetitive skin picking (also known as excoriation or dermatillomania). People struggling with this problem experience intense urges to pick at blemishes or perceived imperfections in their skin. They may spend a few minutes to several hours (e.g., 8 hours or more) picking at many places on their body. The result is usually scabs, bleeding, and scarring—and everyone I’ve worked with experiences intense shame, guilt, and embarrassment immediately after they stop actively picking.
Many struggle to hide their picking for years without realizing that there’s a name for their condition—that other people struggle with similar problems. Even fewer are aware there is treatment. Unfortunately, few therapists are trained in what are called body focused repetitive behaviors such as skin picking.
I recently came across a first person account by a woman who struggles with skin picking called “My Secret Life as a Skin-Picker” that I think captures the experiences of many of the people with whom I’ve worked. She captures the urges to pick, the methods used, and the myriad ways people try to cover up the damage afterward. The author notes how she experiences urges to pick even as she types her essay:
As I write, as I pause to think about what’s next, my fingers unwittingly scan my face for rough edges of skin, for scabs, for sores, for the tiniest prick of coarse hair on my chin—an excuse to flee to the mirror. Search and destroy. I need to type with both hands, be satisfied with the click-clack of the keys, hypnotize myself with words, with this attempt to understand why I am the way I am.
I encourage readers to check out the full essay in The Establishment. I think it articulates the struggles of people who pick their skin extremely well.