My Secret Life as a Skin-Picker

I know -- intellectually -- that I am a good person. But the disorder skews this perception, making everything about the shame of my outer appearance. How can I be a good person when I do this to myself?
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Trigger warning

Currently, in my vanity drawer, there are 16 varieties of concealer, four foundations, mattifying cream, two primers, redness corrector, and three types of makeup setter. I can't recall a time in my life before age 17 where I didn't wake up and rush to the mirror to put something on my face to hide it. I've mastered this art, my face a canvas in reverse.

I can predict with scary accuracy the nature of my pimple-pops: the velocity, color, texture of what will be expelled. Like a scientist, I have spent years and years conducting thousands upon thousands of experiments. My practice has made me imperfect.

Like as many as 1 in 20 people, I have skin-picking disorder, also known as excoriation disorder or dermatillomania. The condition involves the repetitive picking at one's own skin to the extent of causing damage, and falls under the umbrella of OCD. An obsession and a compulsion.

As far as causes, they are many and varied: Emotional or mental trauma seem to be the most common instigators, but dermatillomania can also be a symptom attached to other illnesses like body dysmorphia or depression (my most likely culprit). In some cases, genetics may also be involved. Dermatillomania is much more common in women.

One online diagnosis quiz asked: How many hours, on average, do you spend picking? I had no idea. I lose track of time. Cumulatively, I guessed it added up to more than I thought. I waste my time, but I can't help it. There are so many other things I could be doing. Worthwhile things. I am sometimes unaware of it, trance-like before the mirror. I can't stop. I both want to and do not want to. I need this, and I also need this to end.

I thought about setting a timer every time I stood in front of the mirror, to calculate the minutes blurring into hours, but I knew I would be performing, I would be distracted, I would not get lost.

Lost, the way you get lost in a lover. Time stops. Focus is singular. Nerves are sensitive. Adrenaline builds, awaiting sweet release. The only difference is the aftermath -- more like war than love.


Even though one online article called them "the new porn," pimple-popping videos don't do it for me. My desire isn't just for release, after all -- it's to punish, to excoriate.

For so long, I didn't think of my disorder as a form of self harm, but the ritual parallels that of a cutter. Many cutters have kits, and I have my tools: three kinds of tweezers, a needle or safety pin, four kinds of acne cream, sensitive skin lotion, Neosporin, scar cream, coconut oil, two face masks, special hydrocolloid bandages that are supposed to speed up healing, and scissors. My vanity is littered with the white plastic backs of bandaids and tissues spotted with blood, pus, oil, makeup.

I feel an urge build: My desire is not for pain exactly, but for release of pain. Also for magic: I hope the blemishes will disappear faster, disappear altogether.

There are times when my self-inflicted wounds were so severe that I wanted to disappear altogether. In my shame, I've been unable to make eye contact with people, even those closest to me.

When I was a high-school teacher, I had to be on constant display. I'd slowly lose confidence throughout the day, feeling that pull to retreat to the girls' bathroom. On days when my skin had been particularly painful, I'd find myself changing lesson plans so the students' eyes would be trained elsewhere. If they were writing in their notebooks, then their eyes would be cast down, and I could sit, safely, behind my desk. On the worst days, I would call in sick in a panic, often without a lesson plan. My first year, I used all 10 of my sick days, even though I'd never really been sick.

The following year, in my interview for a full-time position, my supervisor brought up my absences, and I could not explain. When I didn't get the job I had expected to get, I was devastated. I cried on the dirty floor in the girls' bathroom before heading to the mirror.

Every day, I carry the shame of my husband seeing me with my face covered in sores. He's seen me give birth -- an arguably more grotesque scene. But birth is normal. My behavior is not. And now, my two sweet daughters have words for them: Owies. Bumps. Boo-boos. They sound so tame. They ask me, without judgment, What happened, Mama? Who or what hurt me? And I can't tell them it's me: It's me who keeps hurting me.


When I lived at home during college, I went to an evangelical church that believed in the ultimate power of the Holy Spirit to heal almost any physical, emotional, mental, or spiritual impairment. I wanted to believe in that kind of miracle, too. I was depressed, but no one knew the depth. I wondered if they saw me as immature and vain, upset about a couple of zits, too focused on my appearance.

My parents could not afford actual therapy for me, and were skeptical of its power anyway, but our church had recently hired a Christian counselor, a woman whose children I'd babysat when I was 13. As a member of the church and a youth group leader, I was able to see her free of charge. I only recall one session where I tried, red-faced, to explain the problem.

Like a shrink's dialogue in a bad made-for-TV-movie, she said, "So you're saying you want all of the bad stuff that's inside [dramatic pause] to come out?"

I shrugged. "Maybe."

She gave me a sheet of paper out of a file with a heading at the top that said, Who I Am in Christ. Below, a pyramid of Bible verses pulled out of context, all beginning with the words I Am. I was to think of them like mantras. I am loved. I am a child of God. I am a temple. I am chosen.

She also told me that when the urge came, this voice, the Devil, I was supposed to say aloud: "Stop picking on me." A play on words. My defense against years of repetitive, harmful behavior and deep depression.

To be fair, I hadn't told her everything. Like how I thought about dying a lot -- passively. Wanting to be killed, but not killing myself. Longing to be hit by a car or swallowed up by the ground. I didn't tell her because I thought that Christian counselors were probably exempt from confidentiality laws. Her framed certificate, hanging on the wall of her windowless office, looked like something you might print out online. And maybe she had. I worried she would tell my parents.

But I said the silly words, kept the mantras folded in my pocket. I wanted the miracle, to break the spell, those words like magic words. I wanted to be healed. To be saved.

I searched the Internet for other methods of help once those didn't work. Hiding mirrors was a frequent suggestion. Letting them fog up when you were in the shower instead of running the fan. Leaving the lights off when you went to the bathroom. Some people even said they covered their mirrors completely.

When a Jewish person dies, covering all of the mirrors in the house is part of the mourning ritual. A reminder that our bodies lack permanence. An attempt to focus on one's character rather than one's exterior. I know -- intellectually -- that I am a good person. But the disorder skews this perception, making everything about the shame of my outer appearance. How can I be a good person when I do this to myself?

Other suggestions for avoidance included covering any preliminary bumps with bandages to avoid scratching at them. Or taking up cross-stitching or knitting, something to keep your hands busy. Maybe in today's culture it's scrolling on your iPhone until your hand is all pins and needles.

But how do I un-busy my mind?


On days I think I look pretty (synonym for my skin is mostly clear) I will often post a selfie to Instagram to serve as a reminder that I am not as hideous as I imagine. Sometimes I also take a selfie after I have washed off all the makeup, when my skin is inflamed and scabbed, as a reminder of the consequences of my picking. But I always end up deleting it because it makes me sick to my stomach. Somehow, on camera, I look even worse than in the mirror.

There is a hashtag for women who want to go barefaced and advocate natural beauty: the #nomakeupselfie. Only most women posting these photos have flawless skin. I wish I didn't have to wear makeup -- and I know, intellectually, that I don't -- but it makes me feel protected. Unblemished. Healthy. A coping mechanism that ensures I can leave the house.

Even when my skin is decent and my makeup is done, I can still spy every tiny imperfection in a photo. I am sure to blur them out before I post. People who only know me peripherally would have no idea that my skin is covered in sores a great deal of the time. I have gotten so good at hiding everything. With filters. With makeup. With smiles.


As I write, as I pause to think about what's next, my fingers unwittingly scan my face for rough edges of skin, for scabs, for sores, for the tiniest prick of coarse hair on my chin--an excuse to flee to the mirror. Search and destroy. I need to type with both hands, be satisfied with the click-clack of the keys, hypnotize myself with words, with this attempt to understand why I am the way I am.

It's a common admonition in the church when discussing sin that the pain we keep hidden will fester, that only light can drive out darkness. We are supposed to confess to one another, to be exposed, to expose ourselves at our worst. Because if someone else knows what we've done -- or what we do--then it's no longer secret. Accountability is the evangelical terminology.

Similarly, I write this essay to be exposed, to expose myself, an image without the blemishes blurred.

This piece by Amanda Miska originally appeared on The Establishment, a new multimedia site funded and run by women.

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If you -- or someone you know -- need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.

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