I Have Dermatillomania, You’re Not Alone

***This was written for my Health Reporting Class: May 26, 2025***

I’ve had acne for over ten years. You wouldn’t know it, and many dermatologists don’t believe it. One time, the doctor gasped as I took off my Lancome foundation. 

“Oh there it is!” she exclaimed as if she had never seen acne before, as if she wasn’t medically trained to treat this very condition.

But it’s there, alright, if not physically with scabs and pepto-pink scars then mentally with the feeling of invisible bumps. 

My face is a battleground. It will never look curated like a before-and-after photo in an advertisement or like a filtered Instagram model. No, my face carries with it the kind of damage that never quite scabs over. Raised pink ridges scatter my cheeks and jawline. And beneath that, a more silent wreckage: the itch of obsession and compulsion to pick, to flatten, to smooth. 

This isn’t just acne. This is dermatillomania.

Societal conventions gear acne as a condition often attributed to greasy teenagers going through puberty and eating a diet of red-40-filled candy and French fries. The reality is harsher, it’s painful, especially as an adult woman, and no amount of drinking water and washing one’s face gets rid of it. Most people think acne is the whole story. It’s not. Acne was only the beginning, something misprescribed from an OBGYN trying to help. It was the start of something darker. 

I live with dermatillomania, a form of obsessive-compulsive disorder (OCD) where I compulsively touch, squeeze, or dig at my own skin. A lot of the time, I don’t realize I’m doing it. I’ve done it half-asleep. I’ve done it in bathrooms, in Ubers, in classrooms. I’ve done it in the rare weeks of summer where my skin manages to stay clear and there’s nothing to pick. The urge isn’t rational. 

When I was 13, I stood pressed up to the mirror scanning for any unevenness, when my fingers danced across a bump on my jawline. My fingers dug in, temporarily flattening it. Once. Twice. Before I knew it there was blood caked under my fingernails and shame in my chest. 

No one noticed at first. Not even the professionals, the doctors trained to prescribe a myriad of creams and lasers, and prescription pills. I was good at hiding it. By 14, I could apply tinted moisturizer that was a little too orange and concealer with the precision of a paleontologist putting fossils back together. Green for redness and inflammation, foundation to smooth, powder to finish it off. I could draw a flawless face over the raw, freshly picked bumps. Powder first to dry it out, then layer after layer of concealer. I fooled dermatologists. I fooled my parents. I even fooled myself for a while. 

The mask always comes off, and my fingers always knew. 

They hovered at the base of my jawline during lectures. They drifted to my cheekbones, waiting in lines with friends. Sometimes I’d catch myself halfway with my finger starting to dig into a fresh pimple and press my palms together in my lap. Other times, I’d zone out and snap back with blood under my nails once more. My heart would palpitate, and I’d start to sweat if I stopped for too long.

Once, I wore grape-purple colored gloves to keep myself from picking in my sleep. I woke up with the covers kicked off and the gloves balled up somewhere in the sheets. Anything to get at a blemish I thought was coming, even while unconscious. 

That is what people don’t understand: it’s not about what’s there. It’s about what might be. It’s about the feeling of unevenness and not being able to flatten it out. The wrong texture under my fingers. 

The language of dermatillomania is mostly invisible. There were no support groups in high school. No neatly labeled Instagram advice on a Canva-designed infographic. When I finally found the term, thanks to Reddit sleuthing and specialized cognitive behavioral therapy for OCD, it felt like hearing the air whoosh out of a popped balloon. 

But a diagnosis isn’t a cure. I tried habit trackers and made it to seven days, meditation, and a bright yellow apple-shaped stress ball. I tried keeping my hands in my pockets, fidgeting with jewelry. 

There is no quick fix. No miracle cream. No miracle pill. No miracle diet. No amount of water. No amount of pestering–” just stop touching your face.” If I could, I would. Dermatillomania is not about discipline. If this were about discipline, maybe I’d have Instagram-worthy skin. Maybe I would have beaten it years ago.   

It’s a fight with the voice that whispers that I can make it better, but being taunted when I try. There’s a profound loneliness to this disorder that’s hard to explain. Friends, family, and medical professionals don’t get it. They see the makeup, now pared down to sunscreen, concealer, and a lot of blush; they don’t see the bottles of nearly empty concealer in my purse or not wanting to look in the mirror. 

It’s difficult to celebrate the good days when my skin is clear, when I manage to fight the urge for a few hours to not dig and twist into the bumps. I brace myself because I know I’ll ruin it. The worst part is the shame, the raw marks, the phantom staring, and knowing how my face looks. Of knowing I did this to myself. Of not knowing how to stop. 

I’m learning to live with the scars and with the skin. I treat it like a living being. Like it’s my friend instead of an enemy. A friend who deserves to heal. A friend who deserves grace when a bump pops up. I keep my nails short. I’m gentle when I take off my makeup. I keep the lights off in front of the bathroom mirror when possible. I force myself to focus on other things when the urge to pick becomes too much. 

Some days I win. Some days I don’t. Healing means taking one day at a time. My skin is a living reminder of everything I’ve done to it. Every wound, every scab, every scar. But it is resilient and remembers how to repair itself. Slowly. 

So maybe I can, too.