Annie Lord: Dermatillomania (aka skin-picking) and the triggers and solace of social mediaThe worst part about shopping is the changing rooms. The acidic white light flares up my skin so that every blackhead, flaking scab, hair or spot is presented with forensic precision. It never feels like a conscious choice, my nails just start squeezing and pressing into skin until my pores weep. I stand there until my lower back aches from leaning close to the mirror and scattered around my feet are bloodied tissues.

There are other places I hate: The hairdresser chair, the shopping centre lift mirror, washing my hands with strawberry scented foam in the train station toilets while reflected back at me are hundreds of imperfections speckling my nose. The car wing mirror, looking at an iPhone front camera on the tube.

I have a skin-picking disorder called dermatillomania. Dr Adam Friedmann from the Harley Street Dermatology Clinic explained the condition to me. “It’s characterised by the repeated urge or impulse to pick at one’s own skin until either psychological or physical damage is caused. Dermatillomania is related to hair picking or ‘trichotillomania’ where people injure themselves intentionally or unintentionally. These conditions are often exasperated by anxiety and depression. It can get to the point where people become convinced there’s something living in their skin.”

Social media makes us susceptible to seeing flaws where they don’t exist, fuelling a desire to expunge them from the body

In more severe cases, skin picking can actually make you physically ill. Dr Friedmann told me: “When people believe there’s a parasite living under their skin, they become more aggressive in their treatment of their skin and they sometimes start to use instruments to cut these imaginary beasties out of their bodies. These people will look much more aggressively injured because they have cut bits of themselves off.” In some extreme cases, obsessive picking can lead to septicemia.

I used to think that I acted this way because my body was imperfect. But the problem is not that my skin is dirty, but rather my belief that it shouldn’t be so. What gave me that idea in the first place?  

I blame the Instagram home feed. When I feel low I often find myself scrolling through images of flawless skin. Even under an HD lens, a woman’s cheeks show nothing but balmy undulations of cheekbones. Another glows make-up free on a pillow, her eyes still sticky from sleep. A model has skin so smooth it’s like the hard ceramic casing of a robot. I look at these women and I want to inhabit their skin like a costume. When I catch sight of myself in the mirror again, I lose control.

Studies linking Instagram to body dysmorphia are nothing new. Social media makes us susceptible to seeing flaws where they don’t exist, fuelling a desire to expunge them from the body. As Dr Freidmann said to me, “Anything that can raise levels of anxiety or self-loathing can trigger skin picking. Social media may be a means by which someone could find themselves stressed or anxious or irritated.”

But now when I feel stressed I sometimes scroll past a different type of face, one that’s a lot less smooth and a little less perfect

For some people skin-picking gets so bad they avoid birthdays, they call in sick, they cancel on people, hiding under duvets so that no-one can laugh at the holes in their face. It hasn’t got to that point for me yet. I am an expert with concealer, endlessly dotting beige blobs on scars until no one could see what I have done to myself. It doesn’t make me feel much better, I still know what’s underneath. The red flecks where I’ve hurt myself are now permanently pressed into my DNA. Now when my cells replace themselves they come back red. If you keep picking into your flaws you will find nothing but more flaws, more dirt, wetness, infection. The body isn’t clean and it’s not supposed to be.

There is hope; people do get better. Some women say acrylic nails stopped them picking, others wearing gloves, avoiding mirrors, practising mindfulness, 10 step K-Beauty routines.

One evening I was curled on my bed in a damp towel scrolling through Instagram until my phone overheated. I clicked on a face, I liked the way her nose curled up all cute at the end. Her skin wasn’t quite like other women’s, pinky patches were mottled over her forehead. I noticed that in the caption she’d spoken of her problematic history of skin picking. Of taking tweezers to her face until her complexion was broken. Of slathering acidic face masks onto open wounds. She looked like she was healing.

I still haven’t managed to stop picking, that would mean accepting that there will never be skin without dirt and at the moment that’s a thought which is too stressful to bear. But now when I feel stressed I sometimes scroll past a different type of face, one that’s a lot less smooth and a little less perfect and it makes me feel better about all the monsters living under my face.

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