The Loneliness of Skin Picking

Dermatillomania is a little known condition classified as a Body-Focussed Repetitive Behaviour (BFRB) within the Obsessive Compulsive Disorder Spectrum. BFRBs in general have only recently received attention in the medical research fraternity, leading to increased awareness of the condition as a clinical disorder. Prior to its inclusion in the Diagnostic and Statistical Manual (DSM5), there was still much confusion and disagreement about where Skin Picking Disorder (SPD), now also known as Excoriation Disorder, should be classified. The limited awareness of SPD has meant that many people sufferring from dermatillomania, as well as the many other BFRBs have suffered in silence due to the embarrassing nature of the behaviour.

Secrecy and Shame

SPD is characterised by intense guilt and shame following the behaviour and often due to the damaging effects it inevitably has on the appearance of the skin. Therefore it is not easy for people to talk about their condition to others, especially friends and family, for fear of rejection or harsh judgement. Without awareness that it is a disorder and what the clinical features of the condition is, it is difficult for the individual to convey to someone they care about why they engage in this behaviour, becuase they do not know themselves. As a result, the person tries their best to cover up any physical evidence of their behaviour and keeps their "secret" carefully guarded.

Loneliness and Isolation

Unfortunately this often results in the person retracting from social situations, which often is a catalyst for increased picking. This negative action-reaction cycle can easily spiral out of control and in serious cases the person may end up totally isolating themselves from social interactions and can become very lonely. One example of this can be found in a reddit thread by a young woman who described how she hadn't seen her boyfriend in a week because she kept cancelling plans with him for fear of him seeing the condition of the skin on her face from picking. What follows on this thread are comments and responses from others empathising with her, expressing similar feelings of shame and embarrassment causing others to isolate themselves from friends or family.

photo by SCA Svenska Cellulosa Aktiebolaget

It is hoped that with intensive awareness drives by organisations like the Trichotillomania Learning Centre (TLC) and the Canadian Body-Focussed Repetitive Behaviour Support Network (CBSN) that people with all BFRBs, including dermatillomania will come to realise that you do not need to feel ashamed and that you are not alone. There are many others sufferring from the same condition and there is an abundance of information avaialble to help you help your loved ones understand your condition. In this way, your friends and family will be able to understand what you’re going through and can be a source of invaluable emotional supprt through the difficult journey of recovery. Even with the myriad of treatment options available, therapists working with this condition, such as the program offered on this website, have found that having the support of someone you trust to discuss and share information you learn about your condition has an immensely positive impact on outcomes of treatment.

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