The Ant Hill That Lies Upon My Skin

In 2022, I first mentioned my skin picking to my then-psychiatrist. During this appointment, she first thought it was a form of self-harm, but realized it was dermatillomania (or, excoriation disorder) after I further explained it. I was briefly aware of trichotillomania, but I didn’t know that dermatillomania was a health condition. I thought that most people picked at their skin when they were upset or stressed. I didn’t know that feeling a sense of relief upon peeling was not typical for the majority of people. 

After my appointment, I thought about it more, and it started to make sense. 

Childhood years

When I first began picking my skin, it was something that only those closest to me knew about. For years, I picked the skin on the bottom of my feet when alone or at my grandparents’ house. 

It came about during childhood, trying to find a way to self-soothe my anxiety as I sat in time-out at my grandparents’ house. It was easier to peel the wrinkled skin on my feet than stare at the porcelain dolls my grandmother had on top of her china cabinet and try to understand why I was in time-out. I was their only grandchild, and they didn’t know how to help me self-regulate. 

Over time, I continued to peel my foot skin. Even though I hated the way wet socks felt, I would keep my shoes on and not let my socks dry out. After every bath, I would immediately sit on the floor and pick before putting a fresh pair of socks on.

I began biting my nails at eight years old. While not the same thing as excoriation disorder, it’s similar in nature. I can recall the first time I ever bit my nails, and the reasoning for it. I got to know someone who lived near my maternal grandparents, she was older than me, and we had a mutual friend. She’d throw rocks at me and often exclude me from playing outdoors with her.

Her parents weren’t the nicest, either. Her mother made me anxious whenever I would go to her house, and I began biting my nails as a way to relieve my undiagnosed anxiety. I remember one day, I was standing on her porch, having a conversation with her mom as my friend and I waited for this older girl to come to the door. Her mom caught me gnawing on my finger nails, and looked down, telling me that biting my nails was bad for me.

I didn’t know what to say, since she was the reason I started doing it in the first place. I’ve attempted to use no-bite nail polish, but I learned how to get through the bitter taste. As a teenager, I tried acrylic nails, but I bit them off after two weeks. 

For years, my skin picking was somewhat managed, or at least I thought it was. Biting my fingernails and hangnails moved the focus off of my skin. After the age of twelve or so, I mostly picked every once and a while. It was, I believed, a habit I had outgrown.

College years

During my first year of college, however, I started to notice that something had changed. Around the end of 2021 and the beginning of 2022, I began picking my scalp and wrists. I was under the impression that it was just from the stress of college, as well as my brain’s way of processing grief and PTSD. The major differences between how it manifested in my childhood, versus then, were that this time it wasn’t something I could hide: I began to pick at my scalp.

Although my friends on campus never directly said anything to me, I know they’d noticed. The signs were there. The variety in the way I part my hair each day, the sudden incorporation of beanies, the redness and irritation that came with visible scabs. As much as I tried to use my hair to hide the scabs, it was still pretty noticeable. 

The most noticeable thing was when I ended up picking my head in public. I hated the new attention I received from it, especially when I would subconsciously pick while trying to focus during classes. There’s nothing worse than seeing someone stare at you during your picking session.

Sometimes, I would be so hyperfixated on picking that I would lose track of time or miss something a professor had said. I often would try to sit away from others so I could have enough desk space for my items and not disturb others with my picking. I once caused one of my peers to change seats because they couldn’t tolerate sitting next to me while I was picking.

Where I am now

My brain is a force of destruction. I’m 24, and I don’t think I’ll ever outgrow biting my nails. I stopped going to nail salons due to the cost and the shame I felt whenever a nail technician noticed the length of my nails. 

Over time, I’ve begun to peel the skin surrounding my nail beds. If I forget to bring a fidget device with me to a crowded environment, I resort to biting my nail beds again. This harmful habit is more difficult to hide; unlike my head, I can’t cover it up. It’s out in the open. 

The body-focused repetitive behaviors tend to manifest further whenever I’m depressed, and I’ve been in a depressive episode for the last two years. I also tend to pick more frequently when I am overstimulated, anxious or stressed, or extremely focused on something. Science shows that for those with dermatillomania like myself, the act of picking provides a soothing effect in the form of a dopamine boost. When I feel the compulsion, it comes over me suddenly like a wave that builds, then slowly crashes. The crash is only achieved after I have engaged in the behavior. Once the wave stops, discomfort and shame cover me like an itchy blanket. As I look down at a pile of scabs, an anthill upon my skin, I regret the physical damage I have caused. 

I don’t know how to stop.

I’ve tried snapping a rubber band whenever I feel the urge, attempting to distract myself, and using picky pads. None of the methods I have tried seem to work. I take a lot of medication as it is, and I don’t know if it would fully help or manage my body-focused repetitive behavior. 

Every few months, I re-dye my hair, and ignore the warning label that says to not use the product on broken skin. It tingles on my scalp, but the outcome of temporary confidence from a $12 box is worth the risk. 

A little over a month ago, I decided that I wanted a shorter haircut. When I informed my hairdresser about wanting shaved sides, she told me that there are small bald spots that would show. Three years of constantly altering my scalp resulted in minor hair loss that was caused by damaged follicles. I’ve been killing my scalp over time through my picking.

I often purposely increase my chances of picking, such as when I peel my sunburns, although I know it’s awful for my skin. I have discoloration in places where I’ve damaged the layers of the skin on my shoulders from peeling. This is irreversible.

I hope that someday, I will be able to properly manage my dermatillomania and figure out a plan that works for me. I would like to have a moment of time in my life where I will go without picking. Although maybe this is just wishful thinking, I would like to believe that I will eventually get there.