Contains mentions of blood, and substance abuse disorders
My legs are, without a doubt, one of my best features. I cherish them. After a history of negative body image, it is important to me to have a part of my body I like. But for the majority of the month of September, I have been hiding them. Despite hating the cold weather and feeling a great sadness that the summer is coming to an end, I have been glad to have an excuse to break out the fleece-lined tights and jeans early. I cannot begin to entertain the idea of being seen with my legs bare anymore, because since the beginning of the month, my calves and thighs have become a torn canvas of irritated skin and dried blood.
Dermatillomania, or excoriation disorder as it is formally known in the DSM-5, is an impulse control disorder which causes a person to pick, scratch, squeeze, or pull at the skin on their face, back, arms, legs, shoulders, lips, fingernails, anywhere, more or less. It could be triggered by anxiety, or just boredom, and it could be something like OCD, or it could be something like a substance abuse disorder! The DSM-5 is the first one to feature Derma, so one can imagine how new it all is. Understanding exactly what is going on has been difficult, and the only thing I can be completely certain of is that I am ruining my skin one picked-open sore at a time.
I have scabs running the length of my shoulders and legs, scars fading across my cheeks, and blood resting underneath fingernails. “Keep contact with skin limited to avoid triggering picking,” they say, and I try. Oh, how I try. Band-Aids on the problem areas, a spinner ring to keep my fingers busy, long sleeves to create a barrier between my hands and my face, thick coats of nail polish (because picking at that is better than picking at me), but once it starts, it’s a hard process to stop. I would go out and buy a pair of gloves, and I really should, but gloves are a bit impractical in the summer months (and all of my devices are touchscreen…).
Objectively, the worst part about Derma is the picking, but subjectively, the worst part is the healing. I know in the logical part of my mind that the command telling me to pick, pick, pick is bad, and that I need to put an end to the picking in order to put an end to the stress and embarrassment that it causes, but my mind is at an impasse with itself, as not all of it agrees that I need to stop picking. No, I don’t like the scabs or the blood or the pain, but there is a reason Derma has been compared to a substance abuse disorder. It’s like an addiction, and the worst part is always the aftermath, when I see all of the damage I’ve done and know that I have to live with that until the swelling goes down and the scarring fades.
I am thankful for makeup, because sometimes foundation can be the only thing that gets me out of the house, confidently, while also keeping my hands away from my face all day. My desire to keep my makeup intact is one of the few stronger than my desire to pick, as luck would have it. In the end, my vanity wins! If only the same could be done for my legs and shoulders, and if only makeup weren’t so expensive, and if only, really if only, my mind and body understood each other, and could communicate this strange behavior I have without leaving me scarred and bloody all the time. I’m thankful for mosquitoes, because sometimes the red marks can pass as really bad mosquito bites, and I’m even thankful for acne from time to time, because people thinking anything is better than them knowing I’ve done this to myself…
But I don’t feel hopeless. Waiting takes a long time, and it’s harder when I can barely understand why I’ve done what I’ve done, but it won’t all be waiting. Sores will heal, scars will fade, and one day maybe I won’t make so many new ones? Maybe one day I’ll buy that pair of gloves. As time goes on, even the newness of Derma will fade into scar tissue.
Unruly Bodies 
It’s awesome that you ended that with a hopeful note because that kind of larger outlook can be so hard to have sometimes. Although it’s not the same, I’ve struggled with self-harm and dealing with the scars has definitely been the worst part for me. Maybe the reason why the aftermath is so hard, apart from worrying about scars and their visibility, is that we lose control. When doing the act that creates the scars, there is control over how and what the body is feeling, but when the act is done, there is only the feelings and thoughts that come after. In my opinion, those could make someone feel very out of control. The possible regret and guilt about the act, shame about people seeing and asking questions or making judgments, or realizations that one’s body now deviates more from the “standard” beauty norm could all be reasons why the aftermath is the hardest part.
I have two friends who have the same condition. Its enlightening to hear you talk about your
because my friends, even though we are close, have never spoken about it with me. It didn’t really occur to me how complicated of an issue it is. Thank you so much for sharing.
I have OCD, and I remember my brother asking me what would happen if I *didn’t* “obey” my rules. It’s so hard to explain that *not* obeying really simply isn’t an option. Except when, through hard work, I’ve realized it is. Thank you for sharing this.
I was diagnosed with dermatillomania yesterday. I was advised that you can treat it holistically with N-acetylcystine, 600mg 3 times a day. You can purchase this through Puritans Pride .com. It will take a month or so to build up in your system. I completely understand what you are going through.