I first recall episodes of skin picking, or dermatillomania, at the age of 13. I went straight for the little bumps on my arms, above the elbows. Especially on the right side. Search and destroy. 

The skin picking got worse over time, and I moved onto other parts of my body including my legs, but the compulsion to skin pick would come and go. I’d turn to skin picking as an escape, especially when bored or anxious. I believe it gives me a dopamine release, like scrolling through Facebook. According to LumenLearning.com, “Studies have shown a linkage between dopamine and the urge to pick.” You know the feeling when you feel like you’re sucked in, and you can’t seem to look away? That’s what it’s like for me. It’s hard to stop once I’ve started. 

I have used make-up to cover up the redness, but I’ve given up on that now. I only bother with makeup on my face. It’s otherwise too much effort, and it gets on my clothes. So I leave it be. But it’s still embarrassing. I wear long sleeves and pants that are difficult to roll up when I just can’t stop myself from picking, which helps to a marginal degree.

I’ve looked for answers on the cause of my skin picking. According to Medical News Today, “People with ADHD may develop skin picking disorder in response to their hyperactivity or low impulse control.” However, it wasn’t my ADHD medication that helped me to get the skin picking under control. I believe it was the antipsychotics that helped me, and not until my mid-thirties, when I was diagnosed with delusional disorder, a psychotic disorder on the schizophrenia spectrum. 

While I was still ignorant of my psychotic disorder, I had concluded that my skin picking was a manifestation of Obsessive Compulsive Disorder. But that didn’t seem to be accurate, and despite being under the care of psychiatrists going back to age 18, I’d never received an OCD diagnosis. According to the International OCD Foundation, “Skin picking is not considered a disorder unless it is often and/or bad enough to cause significant distress or problems in other areas of life.” And it wasn’t that bad. But it was no doubt problematic. The scars on my arms say so. 

A few years ago, my psychiatrist prescribed me antipsychotics. He knew that I didn’t believe that I was psychotic yet, so he mentioned that the medication may help with my skin picking. Nevertheless, I didn’t take the medication, mostly because I didn’t believe I was psychotic. Boy, was I wrong. Of course, it can be hard to understand that you’re psychotic when you’re psychotic. 

Eventually, during a major episode of delusional disorder (complete with every subtype of delusion and including audio, visual, and somatic hallucinations), I started taking Seroquel because my primary care doctor prescribed it for what appeared to be post-traumatic stress disorder (PTSD). It only took about two days on Seroquel for most of my persecutory delusions to be debunked. And before I knew it, my skin picking habit changed. Since then, I’ve been taking Abilify to treat delusional disorder, and only taking Seroquel occasionally at nighttime to help with sleep. Both medications are antipsychotics, and I believe they both help with controlling my urge to skinpick. 

I still skin pick every now and then. Old habits die hard. But it’s under control now that I’m on antipsychotics. I can stop myself much faster than before. When I realize I’m doing it, I tell myself “one, two, three, STOP.”