People With Dermatillomania Are Spreading Awareness On TikTok

For months, Jaylin Scott had picked at her armpits. She would dig at her skin any time of the day — even in her sleep — until it bled and burned. These episodes would make her scream and cry in pain, drained by the compulsion to level out her skin.

“In my mind I’m screaming at myself to stop picking, stop picking, but I just couldn’t,” Scott said. “I had to have someone physically pull my arm away.”

The dry heat where she worked as a lifeguard in Las Vegas was intense, but she couldn’t wear deodorant because picking made her skin raw, so she constantly worried about body odor, too.

“It felt really shameful,” Scott said. “I became disgusted with myself.”

Then she found videos on TikTok about people struggling with the same thing, which made her feel seen. That was the first time she’d heard about skin picking disorder, a mental illness related to obsessive compulsive disorder that involves repeatedly picking at skin on the body, resulting in emotional and physical damage.

About six months ago, a dermatologist finally diagnosed her with the condition and prescribed an ointment called triamcinolone acetonide. The medication healed the scabs that formed in her armpits, which helped Scott avoid the urge to pick at her skin, a feeling many with the condition experience due to emotional and physical factors.

Receiving a diagnosis helped her immensely; now Scott is in recovery and has joined the many people with the illness who have posted about their journey on TikTok.

“Beyond proud of myself,” Scott wrote in a TikTok caption in August 2021. “I’ve kept this a secret for a long time and i feel it’s time to share my journey so others don’t feel alone!”

Why people pick their skin

Skin picking disorder affects as many as 1 in 20 people and is a form of self-soothing to handle emotional distress. It was informally called dermatillomania (a term still commonly used) or compulsive skin picking until 2013, when it was classified as excoriation disorder by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Research on the disorder is in its “infancy,” but awareness around the illness has grown, especially in the past five years, according to Karen Pickett, a licensed psychotherapist in California who has researched the condition for 20 years.

The disorder goes far beyond popping pimples or removing dry skin. It can cause conspicuous lesions on the body. People with the disorder often miss out on normal life or suffer emotional distress because of the compulsion.

Pickett said that someone with the disorder can simultaneously want to stop and seek the satisfaction of checking the skin for areas to work at. The behavior sets off synapses that produce dopamine and endorphin hits in the brain.

“Skin pickers can talk about the ‘reward’ as a feeling of accomplishment or relief or a way to self-soothe,” Pickett said.

According to Lauren McKeaney, CEO and founder of the Chicago-based Picking Me Foundation, triggers depend on the person but can be anything from a stressful day to a comment about your appearance.

The primary kinds of skin picking are scanning, a process of unconsciously searching the skin for something to smooth out, or focused picking, honing in on a perceived imperfection for an extended period of time before “coming to” and realizing what damage has been done, McKeaney said. She likened skin picking to an unavoidable “signal” from the body about an emotional state; to find a solution to picking, it’s important to recognize the emotion behind the behavior, she said.

Based on research about closely related disorders, Pickett said that about 80% of people with skin picking disorders have other psychological conditions, such as depression, because of its emotional regulation component.

Lauren Brown, 26, said she thinks her family’s history of addiction and depression, and her own “addictive personality,” set her up to potentially have dermatillomania.

For her, skin picking was a normal habit exacerbated to dangerous levels by a change in her environment. Brown, who wrote a memoir about anxiety and skin picking called Hands, said the behavior gave her solace after she moved to a new city and felt lonely. After a while, she couldn’t resist looking at herself in the mirror for extended periods of time, picking at her skin, and savoring the reward of clearing perceived irregularities. It’s hard to explain to someone who doesn’t have the disorder, she said, but she felt a sense of “achievement.”

“You think, It’s just a habit…