I’m Coming Out

Dermatillomania and dermatophagia sounds like bad words, and those closest to me know I rarely curse.

Many people pick at their skin. It is not out of the ordinary to remove a hang nail, bite nails, or remove a zit. These behaviors are akin to grooming. Some folks do it occasionally, some do it compulsively. I’m in the latter group.

Around the year 2003 (I THINK!) when I was still in high school, I started biting my cheeks. As crude as that sounds, I would literally spend periods of time moving my cheeks closer to my teeth so I could pick away at the soft skin inside. I didn’t think much about it at the time. I had no idea what I was doing. The only people that noticed, my mother and sister, weren’t sure what this was either. They would tell me to stop, but I’d keep going.

A few years later, I became more concerned about what I was doing. If it weren’t for the internet, I don’t know where I’d be now. While at that point I found very few resources about cheek biting, what I did find was that I was not alone. There were forums filled with people with similar concerns. However, there were few answers.

I was led to a book called The Habit Change Workbook, which referenced everything from cheek biting to gambling. I tried using its suggestions, failed miserably, and stopped trying since. This isn’t to say that from the moment I started to now that I haven’t tried stopping. In fact, stopping is a daily battle. I was full of worries. I’d wonder about the long-term repercussions of the damage I was causing. But I was also too embarrassed to talk to anyone. How do you tell someone “so I bite my cheeks and I can’t stop”? I avoided going to the dentist during my worst “episodes.” The few doctors that I told had never heard about what I do and would tell me to just stop. I felt less and less in control every day.

In 2013, I tried the internet again, and finally, thank goodness, there were resources.

Dermatillomania. Derma-skin, tillo- pulling, mania -well, you know. Mania means madness, which is so fitting. On that very same year, dermatillomania had been classified under the OCD spectrum along with its counterpart trichotillomania, or hair-pulling disorder. This is what I know: Dermatillomania, or skin-picking disorder, is a mental health illness. I suffer both from dermatillomania and dermatophagia, the latter being skin-biting. Some people put it under the Impulsive Control Disorder category and others say it’s akin to substance abuse. Often, people with this disorder want to stop, intend to stop, but find it difficult to do so. While there is a pleasure involved in the habit, skin-picking is not self-mutilation. From my very basic understanding, self-mutilators engage in the behavior to cause harm to themselves. Skin-pickers may cause some harm, but that is not their primary intent. Often, they don’t feel pain and describe engaging in the behavior for a variety of other reasons. Some feel it’s like an itch to be relieved, others feel that that their skin is full of imperfections. I know that personally, if I feel a little bit of skin, I have to smooth out the surface. Sure logically it doesn’t make sense. After all, skin heals and I should trust mine to do so.

There is so much more I could share about this disorder. There are plenty of resources online now, but what I would like to point out is that there are still many questions. I suppose because its uncommon there is still much research left to be done. The most common questions that come up for those of us with dermatillomania is: how does it start? From conversations with fellow derms online, some point to a time of emotional trauma, but some don’t remember experiencing such an event. Some recall doing it for as long as they can remember. Some say they grew up seeing a relative do it. There is no clear cause. Is it genetic? Biological? Behavioral? What seems to be the trend is that even if there was an initial triggering event, once enough time has passed that we’ve essentially coped with the trauma, the behavior is in a sense removed from that incident. What I mean is that we no longer pick just to relieve stress, anxiety, etc. Sometimes we pick when we’re watching TV, reading, on the subway, etc. There doesn’t need to be a period of “high stress” for the behavior to occur.

Also, how do you stop? I myself have yet to try the most aggressive of methods. I’ve heard of Cognitive Behavior Therapy (from what I understand, it’s a focus on the behavior itself and replacing it with a different more “positive” behavior that makes you feel the same), some have done hypnosis, and lately I’ve seen crash courses and seminars that promise to help you stop. The latter seem kind of bogus to me. Personally, I’ve been in therapy for a year, not so much to address dermatillomania specifically, however, I feel it’s really helped me to both reduce and accept my behavior to a point where I’m not hating myself for it every day. I also track the habit and figure out when are my most triggering days and times. I have some great days and some not-so great days. I know I could be trying other methods, but I’d like to think I can do as much as possible on my own. Don’t get me wrong, I 100% want to stop. I know some folks choose to accept and or/reduce the behavior rather than stop it, and that works for them. But in my ideal world, I am no longer biting.

So I share this now for a few reasons:

1) If you suffer from, or think you might suffer from, dermatillomania or dermatophagia, please reach out! I’d love to share more of what I know and be of support.

2) If you think you know someone that has these conditions, please STOP telling them to stop. I know you have good intentions, but you’re not helping. Be there for them instead. Most of the time with mental health disorders, when you tell someone to stop, you’re looking out for your own comfort. When you support the person in a way they want to be supported, you’re looking out for them.

3) If 1 or 2 apply to you, talk to health professionals! I am shocked that my doctors, my dermatologist, and even my own therapist did not know about this before I told them about it. It is their responsibility to be up-to-date. Arm yourself with the knowledge and share with them what you know.

Meli is an educator and musician. She considers it her life’s mission to help others. In her spare time, she writes video game music: www.marbletonemedia.com