[Written By Annegret Maja Fiedler]
[Image By Annegret Maja Fiedler//20th Century Fox Animation Studios]
Trigger Warning: Discussions of mental illness, blood (minor), body hatred and self-harm (ritualistic).
Since the age of eight, I have struggled with acne and dermatillomania, which also known as skin-picking or excoriation disorder. Dermatillomania is characterised by uncontrollable picking at skin on any area of the body, which can lead to emotional and physical damage. It can be triggered by boredom, negative feelings, and skin conditions such as acne or eczema. My toxic relationship with dermatillomania began with squeezing zits on my forehead before bed. I found it oddly comforting and addictive; perhaps for the same reason YouTube channels such as Dr. Sandra Lee (aka Dr. Pimple Popper) have gained millions of subscribers.
By the age of twelve, my acne and skin-picking had become unmanageable. Despite countless dermatologist visits, facial treatments, and prescribed medication, my skin would not significantly improve. Simultaneously, I was constantly told by family members and friends to “just stop picking at my pimples”. However, skin-picking had become an act of self-punishment, reward, and distraction from stress for me.
I would also frequently find myself scanning for bumps to attack with fingernails, tweezers or pins whenever I looked at myself in the mirror or touched my face. I found it impossible to stop. The consequences of this ritual exposed my skin to infections leading to more breakouts, permanent scarring, and embarrassment. My permanently scarred, swollen and bleeding skin on my face lead to low self-esteem. This contributed to, but was also triggered by my deteriorating mental health. Throughout most of my teenage years I felt ugly, trapped and worthless due to this vicious cycle.
Fortunately, at the age of twenty, my face seemed to clear up, and I began to stop picking at my skin. This turning point occurred after my acne was so severe it was too painful to move my eyebrows. I would cry for hours before leaving my flat and customers at work would give me unsolicited advice. My face was covered with pus-filled craters that I would try to puncture, and it hurt when I applied concealer. I was annoyed by how much my appearance bothered me and wondered whether I was just vain. One day, I felt so distressed that I stormed into the doctor’s office, and demanded that they prescribe me Accutane, an oral retinoid with severe side-effects. The GP reluctantly placed me on the waiting list to visit a clinic for it, prescribed antibiotics—which I had tried in the past— and hormonal contraceptives. However, within six months my skin steadily cleared up without Accutane. As a result, I became less triggered to pick at my face. Extensive professional treatments for Generalised Anxiety Disorder, Major Depressive Disorder and Obsessive Compulsive Disorder have also helped me cope with dermatillomania.
Although my skin is not perfect, I am able to care for it and avoid my dermatillomania triggers. Limiting animal products in my diet, using the contraceptive patch and following a strict skin care have been keeping my face clear. I occasionally get a few pimples, but I am able to accept them. Through therapy I have been able cope with mental illness and fight my skin-picking compulsions. Learning how to reduce low mood, anxiety, and stress levels has decreased any skin-picking urges. I have also become more aware of my thought processes and actions. I am now able to successfully talk myself out of destructive behavior. I can forgive myself if I relapse, which occurs very rarely. To actively prevent myself from picking, I still keep my nails short and dab bentonite clay mask, tea tree oil or some Differin—a prescribed topical retinoid gel—on areas that I am tempted to pick.
I am incredibly thankful for the help I have received in the past, and will never take clear skin or stable mental health for granted. It has taken me over a decade of trying many different treatments, and unlearning damaging habits to feel like I am finally overcoming dermatillomania for good at the age of twenty-two. Although I still have my bad days, and have a fear of severe breakouts, I have higher levels of self-worth now. I am more accepting of my appearance and emotional needs. If my skin worsens again in the future—which could happen when I stop using hormonal contraception—I am confident that I will cope with it better than I have in the past.
If you think you may be struggling with acne and dermatillomania, I want you to know there are others who can relate to your obstacles. You deserve to feel confident, attractive, and loved, regardless of the condition of your skin. I highly encourage you to not give up, and to seek advice from your local GP or counselling service.