I Have Dermatillomania. Here's What Finally Helped Me Stop Picking
As told to Lindsay Kellner by Ross Erin Martineau, a stylist, podcast host, yoga teacher, and self-diagnosed dermatillomaniac—a fancy term for obsessive skin picker—in recovery, but not fully recovered, taking it one day at a time.
It's a really isolating issue for me. Everybody struggles with skin picking or likes to do it on some level—but I think it's just on a spectrum of intensity.
I've had a skin obsession since I was young. It wasn't always in the form of picking. I have a fair amount of moles and was incredibly self-conscious about them as a kid. My mom was vocal about her own struggle with "bad skin" and how frustrating it was. She'd be hyper-focused on it. She was constantly looking for the next product to help her. She continues to be vocal about her skin and products she's using. While growing up, I subconsciously took cues from her minor obsession.
Once I got sober from drugs and alcohol in 2009, picking my face became my drug of choice.
Before I was sober, I certainly went through phases of picking. For instance, in college, I would over-pluck my eyebrows. Technically that's trichotillomania behavior, or the obsession with pulling hair out, but this did not spiral out of control the way picking eventually did. My facial picking didn't become a full-fledged obsession until I stopped drinking.
Dermatillomania and trichotillomania are sister neuroses—they're body-focused repetitive behaviors, or "BFRBs" for short. As the picking started to take off, I didn't perceive it as THE issue. I wasn't aware of the terminology for a long time. I just thought I had really bad skin. I'd think, "What's wrong; why can't I find the right treatment?" I slowly realized over time that I was exacerbating things by touching or "scanning," the behavior that leads to a picking episode in which you are looking at your face or running your fingers over it, looking for something to pop.
Traveling happens to be a trigger for me because I want my skin to look a certain way in pictures or not have to worry about wearing cover-up, so I give myself permission to pick, thinking—with completely backward logic—I'm improving my skin, but then it inevitably spirals out of control. I had a really bad episode of picking two and a half years ago when I was on vacation. I remember waking up with painful scabs on my face and putting makeup on because I felt super self-conscious. I was anxious while having sex with my partner because I thought my makeup was coming off. It was miserable. Completely uncomfortable and not present whatsoever.
It took another vacation episode to realize that everything—my mood, my ability to participate—became completely wrapped up in my skin picking behavior. Sometimes I just wasn't willing to "do life" after a bad round of picking, and this was one of those times. I got to a friend's family house, bee-lined it to the bathroom, and completely destroyed my face. I got totally out of hand. I spent that whole vacation isolating. My face was in pain, with literal open wounds. What started out as a few minor blemishes, which would have gone unnoticed, became painful wounds. It was physically and emotionally so painful and exhausting. I was feeling so alone. At this point, I recognized my picking for what it was: a very specific brand of self-harm.
So I started Googling support groups.
I didn't feel like I was in control. As a sober person, I know what unmanageability looks like, but I also know that support groups work for me. So I figured I'd give one a try.
I found a group for BFRBs, and it was exactly what I needed. The other people in the group had behaviors similar to mine, including the level of obsession. In group we worked on checking expectations of ourselves and holding ourselves back from doing certain things. It was only ever women in the group—shocker. I think women are more apt to reach out and look for help. I immediately felt much less alone and really connected to these women.
One of the best things I did to stop picking was to change my self-talk about my skin. I shifted the narrative from "I have bad skin," to "I have a problem picking my skin." Here's the thing: Nobody's skin is perfect. We're human; we're flawed; this is who we are. In my fantasy, I'm airbrushed at all times. It's so unreasonable!
You have to do a lot of 'tricking yourself' out of it when the obsession feels all-consuming.
Even after going to the support group, I was still struggling with picking. I realized I needed more support. Last year, I found out about Annette Pasternak, who does online coaching through Skype. Working with her has been game-changing.
I absolutely think that self-care and having a spiritual practice have helped. I really need yoga and meditation to feel OK in life, and I think they've helped immensely with dermatillomania so much because, on a deeper level, the skin picking is a manifestation of depression, anxiety, self-loathing. I'm retraining my brain out of that stuff.
If I'm feeling the urge to pick, I ask myself: What is it about right now that makes you want to touch your face? What's coming up for you? Annette had me do affirmations (which I still sometimes remember to do) that were counter to whatever self-loathing feelings or thoughts arose. It has been immensely helpful.
And of course, there are practical things and physical barriers that are absolutely necessary.
The most dangerous place to be when you have a problem with picking your face is in the scanning phase. For me, it's most likely to happen sitting on the couch, after work—I begin to mindlessly touch my face. It's a dissociative state and kind of relaxing. But preventing an episode is about getting myself out of that state as soon as I notice I'm there.
The fidget toys are also helpful—it gives my hands something else to do while I'm negotiating with my brain. Some people tape their fingers. Some people, myself included, will wear white cotton gloves so there is a physical barrier and a reminder not to pick.
I teach yoga, so I often look to breathwork and breathing techniques too. They can change my state quickly.
I also keep my bathroom mirror completely covered at all times. Thankfully, my husband is encouraging and supportive. We have a towel over the mirror that is binder clipped to it. That's why travel can be challenging—it's difficult to escape bad lighting or a huge mirror you can't cover. I need tangible barriers.
Putting Manuka honey on my skin has helped, too, because it's healing and sticky.
Some people watch videos of skin picking or popping, but for me, videos like that ultimately trigger me more than they are helpful. I need to not engage that part of my brain and to find a solution that has nothing to do with it.
At the end of the day, it's all about habit. Even still, I struggle. It's become a daily practice of trying to be good to myself.
A big part of my recovery from dermatillomania is to be more open and less ashamed of the behavior.
I didn't realize skin picking was an emotional coping mechanism until I was really injuring myself. In that way it led to a bizarre relationship with my body, one that's so compartmentalized. I think it's potentially similar in nature to eating disorders. In my opinion, women are more susceptible to various forms of body dysmorphia due to marketing, societal pressure, and the infinite list of patriarchal crimes. Not to say that men and gender nonbinary people can't suffer from this. We all have pressure on us to look and behave in certain ways, and some of us deal with this pressure through body-focused repetitive behaviors that we may not even be aware of.
I'm a married, 36-year-old woman, and I have finally begun to feel really good in my body. Ultimately, I want to get to a place where I just don't give a shit. I'm tired of giving so much of a shit for things that don't serve me. You know when you get to a point where you work so hard on a habit, you don't have to think about it anymore? That's where I want to be. If I continue to be softer and easier on myself overall, I'll continue to be in a better emotional place. It's a daily practice, it really is.
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