When Picking at Your Skin Becomes a Disorder

This piece originally appeared on VICE France.

Chloé is obsessed with her phone and her skin. The 19-year-old’s worst nightmare is a hormonal acne outbreak or waking up to a huge, red spot. 

When it happens she heads straight to the bathroom. Standing in front of a magnifying mirror, eyes fixed on the offending pimple, she tugs, scratches and fiddles with her face. After half an hour or so, the spot has been replaced big a seeping wound. Dates and parties go out of the window. The only place Chloé visits is the pharmacist.

She has dermatillomania, otherwise known as skin picking disorder. As the name suggests, those with the condition obsessively pick at their skin. It can stem from stress, anxiety, and even acute boredom, or be triggered by other skin conditions. 

The more that people pick at their skin in the hope of attaining some kind of “perfection”, the more likely they are to find themselves covered in scars and wounds. It’s a hallucinogenically bad trip that plays out in front of the bathroom mirror and it can lead to strong feelings of shame, guilt, and isolation. 

“My skin is more important to me than seeing my friends or studying,” Chloé says. She’s been obsessed with her skin throughout her teens. “I can’t keep myself from touching it. I have this fantasy that after I finish fiddling with my skin, it’ll be perfect. Instead, my skin gets ruined — I bleed, I get big scabs, and I can’t bear to go out.” 

Psychotherapist Karine Blondeau created the Instagram account Psy Dermatillomanie hoping to offer social media users tips that might help them live with the condition. “Dermatillomania causes so much pain,” says Blondeau, “and, unfortunately, there’s very little help available for it.” She describes the average person with skin picking disorder as a young, hypersensitive woman with low-self esteem. Crucially, Blondeau goes on to say that the problem doesn’t lie with skin itself. “It’s the fact that it’s obsessing you, which is often masking other problems.”

Instagram helped Chloé develop an awareness of the disorder. The platform presented her with content from both flawlessly-skinned influencers and specialists like Blondeau. She got a smartphone when she was 15, around the same time that her skin began to break out. “I saw lots of girls posting these super gorgeous photos of themselves.” Peer-group comparisons gave her a complex. “They all had skin like babies, and I was this pimply teenager.”

Like Karine Blondeau, dermatologist Dr. Audrey Perret-Court spreads the word about skin problems online. Somewhat ironically, she believes that social media can feed the flames of conditions like skin picking disorder. In part she puts this down to the way that platforms encourage users to post selfie after selfie. “If you don’t feel comfortable with your face, you can’t communicate,” she says. 

But Instagram and Snapchat didn’t invent the idea of perfect skin. Acne expert and qualified naturopath Kelly Jastszebski has made it her mission to hunt down retouched photos from various French women’s magazines, pointing out that when it comes to media representation the sexes are still treated differently – and still unfairly. “You see women with two centimetres of makeup on their face, whereas with men you see the wrinkles.”

Camille Montaz, a 31-year-old author, felt for years like the negative things she thought about her skin were her own fault. Photoshoots in glossy magazines weren’t the only place that Camille felt subjected to unrealistic standards. Even the textbooks she was given as a high school student were problematic. “You saw people in the photos who were our age with perfect skin,” she recalls.

Hoping to insulate herself from unpleasant comments thrown her way by peers, she took to wearing make up, only to receive similarly barbed comments about doing that. “I was ashamed of myself.”

A decade on from her schooldays, Montaz found a skin picking forum where users shared advice. She eventually she decided to embark on a course of therapy and found someone who introduced her to mindfulness, something that has ultimately helped her reshape her skin picking habits. 

In 2019 Montaz published "My Dermatillomania Story”, an account of the 15 years she spent struggling with day to day life as someone who compulsively picked at their skin. Opening up to people about the realities of skin picking disorder has had a liberating effect on her. “For years I made up scenarios where people would judge me. I finally realised that people appreciate me for who I am and look past my skin. I fixated on something that other people didn’t."

How exactly does someone recover from the condition? For Perret-Court the first step is understanding and accepting the fact there really is no such thing as “perfect” skin.  Then, obviously, you need to treat the source problem — which might be something like acne, although for some, a single mosquito bite could be enough to set off the unhealthy habits. And one more bit of advice from the doctor: throw away your magnifying mirror.