I Have a Skin Picking Disorder – Dermatillomania (Excoriation) Story

“Where did you learn to do that?” my mother asked.

“Do what?” I answered, biting the nail on my pinky finger.

She pointed at the finger between my teeth.

Ever since I can remember, I’ve picked and bit my nails. Growing up, I didn’t know how to cope with the stress I faced in a healthy way. Nail biting was the only thing I knew to do — but over the years, my anxious habit spiraled out of control.

I’ve tried all the tricks in the book to combat my nail biting and picking. When I briefly stopped gnawing at my nails in middle school, using anti-nail biting polish to deter myself, my habit transferred to my scalp. I dug my claws into where my hair grew and left fresh flesh under my newly long nails. I also began picking at dry skin around my cuticles. Although I wasn’t tearing away at my fingernails, the urge to pick was still there.

And the urge didn’t go away. In high school, I developed a new obsession with popping blemishes all over my face and body in front of the bathroom mirror, which later evolved to picking at my face in general. During stressful periods in college, I’d wake myself up to find I was picking callus from the bottoms of my heels.

For most of my life, I thought nail biting and picking was just a gross habit, like sneezing inside your shirt or picking your nose. After all, everyone has some kind of bad habit that would gross someone else out, right? And I knew other people were grossed out by mine — but no one was as disgusted as I was with myself.

I’d wake myself up to find I was picking callus from the bottoms of my

However, I now see this habit as more than just a gross one. For me, it crossed over into a compulsive and intentionally self-harming one.

In therapy, I identified my urge to pick at my skin as dermatillomania, or skin-picking disorder. Mental Health America describes the disorder as a chronic, body-focused, repetitive behavior; sufferers “spend significant amounts of time, sometimes even several hours a day, on their picking behavior.”

Now that I recognize that I’m a trauma survivor dealing with anxiety, it’s easier to see how I developed the behavior. The realization came in a therapy session earlier this year, when my therapist noticed I couldn’t stop twisting my ankle to the side against the leg of the lounge chair in her office.

“When I was younger, my parents sometimes fought while we all ate dinner,” I explained when she pointed it out. “I’d twist my ankle inwards against the spindle of a dining chair.”

I twisted my ankle, I realized, to give myself something else to focus on, to escape a distressing moment. I wanted to feel pain. Growing up, I thought it was my fault when my parents fought. I reasoned that they wouldn’t have a reason to stay together if I didn’t exist. They may not have been punishing me, but somewhere inside, I decided I needed to be hurt anyway. And unlike the pain I experienced through childhood trauma, I could be in control of this pain — like when I picked at my skin till it bled.

Dermatillomania and self-harm are not at all the same, but understanding my behavior meant understanding the place where they overlapped for me.

Young woman picking her nails
Getty Images

“In dermatillomania, there is distress and inner tension, which results in a strong need to relieve the self from these feelings,” Michaela Chatzimanoli, a counseling expert at SkinPick.com, explained to me. “Touching oneself biologically, can bring relief, as part of grooming behaviors.” The National Alliance of Mental Health defines (NAMI) self-harm, meanwhile, as “hurting yourself on purpose.” According to NAMI, those most at risk for self-harm are people who have experienced some type of trauma, neglect, or abuse, and it’s more common in adolescents and young adults.

Intent is the operative characteristic here; not everyone who struggles with dermatillomania means to inflict pain on themselves. “Someone can be riding the subway and picking at their forearm and not be conscious necessarily of what they’re doing,” Brittany Sherwood, psychiatric-mental health nurse practitioner with Mental Calm, a telepsychiatry service, pointed out to me. “They don’t have the thought that ‘oh, if I bite my nails, I am going to be less anxious,’ but then, if they do bite their nails, they do become a little less anxious through that habit. It’s self-soothing.”

While many of those who engage in skin- and nail-picking aren’t mindful of their behaviors, often, I was — and I was trying to hurt myself with them. During low periods in my high school and college years, when I was overwhelmed with self-doubt and hatred, I’d pick and bite with bleeding as the end goal. Bleeding gave me an adrenaline rush like nothing else could; I consciously craved it. The pain felt like an escape. Once I started bleeding, I didn’t know how to stop until all of the skin was picked or bitten away. People who self-harm using objects such as razor blades or scissors may struggle with an urge to keep going, much as I feel compelled to keep picking and biting.

The dominant narrative of self-harm often revolves around cutting, but once I saw nail biting and picking through the lens of self-harm, it opened to my eyes to other ways in which people can harm themselves. The College of Human Ecology at Cornell University says carving of the skin, subdermal tissue scratching, burning oneself, banging or punching objects or oneself with the intention of hurting oneself, and embedding objects such as safety pins under the skin can all be considered non-suicidal self-harming behaviors.

Once I saw nail biting and picking through the lens of self-harm, it
opened to my eyes to other ways in which people can harm themselves

I know I’m not alone: According to the American Federation for Suicide Prevention, in 2015, 494,169 people visited hospitals for injuries caused by self-harm, and that some one people in the U.S. engage in self-harming behaviors every year. To this day, I still struggle not to revert to self-harm habits, even though I now rarely intend to hurt myself. I know that there is hope, and that those who self-harm can heal. Mental Health America recommends medication, cognitive behavioral therapy, and interpersonal therapy as possible treatments for self-harm. I’ve found all three to be extremely helpful, but understand that no single one of them is an end-all cure.

Understanding dermatillomania through the lens of self-harm has helped me become more conscious of my body and mind, as well as how I take care of both. When I feel the urge to pick or bite, I ask myself, Why am I doing this? Is something bothering me? This awareness is the first step toward choosing to do something else.

If you struggle with dermatillomania, self-harming behaviors, or both, help is available. In an emergency situation, call the National Suicide Prevention Hotline at 1-800-273-8255 or text “HOME” to the Crisis Text Line at 741741.

Additionally, Sherwood stresses that those who pick and bite their skin are more prone to infections since they are more likely to have open wounds. See your primary care doctor if you are concerned about any possible infections. Additionally, be sure to keep your wounds cared for and covered using basic first aid techniques.


  • How Knitting Broke Me Out of an Anxiety Prison
  • How to Tell If You’re Having a Panic Attack
  • I Didn’t Believe Hypnosis Could Work — Until It Changed My Life

Now for a very different form of self-care: