[Editor’s Note: I’m a skin picker. I pick and scratch at my skin, especially around my fingernails. I’ve always thought of it as a manifestation of my OCD. When I start getting nervous, I’ll start picking at my cuticles or scratching my shoulder. I don’t do it much, but when my anxiety picks up I do. So when I saw Adrienne Jones, who blogs at No Points for Style, talking about trichotillomania on Facebook, I jumped at the chance to invite her to write about it, and dermatillomania, here in case any of our moms are dealing hair pulling and skin picking as symptoms of depression or anxiety. -Katherine
For more than twelve years after I started pulling out my eyebrows and eyelashes, I thought I was the only person in the world who did this strange and frightening thing. I don’t remember how it started, or what I was thinking, or how I felt about it. My first memory about pulling is a memory of exposure—a classroom, an open book, a tiny heap of lashes on the page.
“Ewww, gross! Mrs. Polson, Adrienne is pulling out her eyelashes! Oh God, that is so disgusting! Why would you do that? You’ll have a bald face!”
I swept my hand across the page, sending the lashes into the air, and spoke low. “It’s no big deal. You don’t have to tell everyone. It’s no big deal!”
That was in 1980 when I was nine years old, and for the next dozen plus years I made excuses for the hair that was missing from my face. I faked vision problems in hopes that glasses would offer some camouflage, and turned my face away or down, hoping that people wouldn’t notice. Eventually, I learned to use makeup to make the missing hair less noticeable, though no one who looked carefully could fail to see. I wanted very badly to be invisible.
I tried everything I could think of to stop, and since I pulled mostly when I was reading (and I read a great deal), my efforts usually centered on somehow keeping both of my hands busy (one holding the book, the other occupied with something else) or incapacitated. I wore gloves; held a lump of silly putty; put substances on my fingers that would sting my eyes; wore wrist weights; kept my fingernails trimmed brutally short; and punished myself relentlessly.
I’ve always been possessed of this irrational belief that self-flagellation could somehow cure all that ailed me.
Nothing worked, least of all the perpetual shame and guilt. I would pull a little less for awhile, or even manage not to pull at all for a brief time, but eventually I would succumb to compulsion. Shame over my situation morphed, at some point, into a belief that I was ugly and, worse, that I deserved to be ugly. I thought I could live with ugliness as long as I could camouflage my bald face enough so that people would not stare.
I was 21 when my mom handed me a magazine folded open to an article. I don’t remember what it was called or the name of the magazine, but I remember how I felt when I read it. Not only was I not the only person in the world who pulled her hair, but there was a name for it: Trichotillomania.
I was overwhelmed by relief.
tricho – hair
till(ein) – to pluck or pull out
mania – madness
Trichotillomania (TTM) is one of several body-focused repetitive disorders, the two most common of which are TTM and dermatillomania (compulsive skin picking). Little is known about the mechanisms and causes of trichotillomania, and even less was known 20 years ago when that first article I read was written. I have watched for two decades as the research has generated more and more understanding about TTM, but we still don’t know what causes it. Genetic, hormonal, emotional, and environmental causes likely all play a role.
Recently, researchers have linked some cases of TTM to a mutation on gene SLITRK1, the same gene that seems to be associated with Tourette syndrome. TTM was for many years considered a form of obsessive-compulsive disorder or self-injurious behavior, but it was re-classified in the DSM-IV under the umbrella of impulse control disorders.
What we do know is that both hair pulling and skin picking are attempts to self-soothe. The pulling itself is not painful, and is in fact experienced as satisfying or even pleasurable. My own experience is that pulling from my usual sites (brows and lashes) is not painful, while pulling from elsewhere on my body is. People with TTM may pull from any part of the body, but the most common pulling sites are scalp, brows, lashes, beard, and pubic area. Average age of onset is eleven, but TTM has been documented in children as young as one year.
When I “came out” about my experience with trichotillomania on my blog, I was inundated with messages from people who have the disorder, and 100% of them spoke of the shame they felt. They hated themselves for not being able to control a behavior that most people never experience and can’t understand. They wrote about how hair pulling and skin picking made them feel weird, crazy, and weak.
Here is what I know: TTM is not my fault. It is a quirk of biology and wiring and circuit mis-fires. I don’t know if we’ll ever find a cure or a universally successful treatment for hair pulling and skin picking, but I do know that those of us who pull and pluck and pick have nothing to be ashamed of.
My story doesn’t have a happy ending in the sense that I have not so far been able to stop pulling. I have taken every pill, done every treatment, and tried every self-help cure I’ve ever heard of. While I remain open to new possible solutions, I have given up on the frantic search for a way to stop pulling.
But the story continues happily in any case. My parents gave me permanent makeup for my birthday: tattooed eyebrows to replace the ones I pulled out. As recently as a year ago, I wouldn’t have gone to the appointment, believing that my bare face was a punishment I deserved. But yesterday, I went. Finally, I know that it’s okay for me to do what I need to do to feel good about myself and I don’t have to apologize or try to disappear or punish myself.
Trichotillomania is just a crappy thing that happened to me. If hair pulling and skin picking have happened (or are happening) to you, too, know this: Your worth is immeasurable, whether you pull or not. You have nothing to be ashamed of.
Sources and resources for hair pulling and skin picking:
- The Trichotillomania Learning Center
- Trich World
- Stop Picking
- Naked Eyes and Angst (the blog post in which I first shared my struggle with TTM)
- Life With Dermatillomania, Psychology Today
I don’t pick, I scratch. When I’m bored, when I’m anxious, when I’m tired, when I’m overwhelmed. I scratch and it feels good and I make scabs. THEN I pick at the scabs. Like Adrienne, I’ve tried unsuccessfully to stop myself. I’ve stopped trying at this point in my life. I’ve accepted it. I think that acceptance of yourself is the key. You can be ashamed or you can own it. I don’t shout it to the world, but if asked I own it.
This sounds very similar to what my son does on his arms. You’re so right; we can sit in the shame or we can own it and begin the process of accepting ourselves.
I don’t pull my hair but i do other things to myself. It’s frightening when you start because it does get addicting. Thank you so much for sharing this story.
It IS frightening. I think I was maybe 11 or 12 when I started to realize that I couldn’t stop and I was almost unbearably ashamed. Thank you.
I get this. I have been pulling out eyelashes and eyebrow hair for as long as I can remember and biting nails and picking at cuticles, scabs etc. I have always felt like a freak thank you 🙂
I totally bite at my cuticles and pick at them. Thankfully I’m careful about it so you wouldn’t really notice if you looked at my hands. Anxiety! Gah!
It’s so much more common than most of us know! I was stunned, the first time I wrote about this, to see how many people shared my struggle.
Thank you for posting this!
I have been picking at skin on my shoulders for many years. It’s worse during times of stress, but it never stops completely, and, because I manage to keep most of my OCD issues in check, I have beat myself up over this one compulsion. I think it’s harder to accept because of its beauty implications.
This piece helps me to put this in its place, to see it as a little less monstrous.
I know exactly what you mean. I care about beauty, and I’m the first person to admit it. I doesn’t sound pretty to admit that you pick at your shoulders. But if I’m nervous you’ll see my scratching at my shoulders. It’s an immediate response to anxiety. It’s what I do. I’ve never understood it, but it’s what I do. And well, I guess I just don’t care whether people know it. Because whatever. I’m not the only one.
Now if you see me scratching my shoulders you’ll know why. 😉
Yeah, exactly. We all have our idiosyncrasies and anxieties, but I don’t want people to be able to SEE mine. I’m thrilled to hear you’re starting to put it where it belongs – just a crappy thing that happens to some of us.
Thanks for your article. Trich can very much happen even earlier than 1, though most doctors will say they will grow out of it. DD is almost 5 and started at 4-6 months of age. She had very good fine motor skills to pull hair. Thanks for your article and for bringing educational attention to the topic.
I think the research says that most very young kids who develop TTM will outgrow the behavior (because it’s more of a habit and less of a disorder most of the time), but not all of them. I saw one family punish their toddler for his hair pulling and it just broke my heart.
I sat in my therapy appointment compulsively picking at the skin around my nails this morning. And now I’m sitting in a coffee shop, my ‘alone’ time during the hellish week that is April break for my older two kids, and stumble on this. Thank you for sharing this. I never knew it was a ‘thing’, always thought it was just one of my quirks.
I noticed when I was pregnant with my youngest, I did not pick my skin around my nails. I found that to be really interesting and it does make me wonder if part of the picture for me is hormonal.
It’s so fascinating how giving something a name, knowing other people deal with it, makes it feel so much less stigmatize. Again, thank you.
Glad you saw the story and it was helpful!
Knowing we’re not alone is enormously healing. I’m so glad (more like thrilled) you got to have that experience today.
I had no idea it had a name, I pick at my acne, and yet I can’t seem to help it. So enlightening to hear i’m not alone in this too!
Nope, you’re not alone, and I hope you feel some comfort from that.
Thank you for this very frank article. My niece, she is only 11, suffers from pulling her hair and started very young – toddler – with pulling her eyelashes. Her parents were dumbfounded. It has been on again, off again for her. Mostly on, and my brother and his wife have spent the past year with therapists and therapies. The one that seems to work for now is a low dose of an anti-depressant. She is like a different person. Please let me know if there are any support groups out there. I will forward the sources. You are right about taking away the shame. So important.
I’m so pleased to hear they’ve found something that’s working for now! Definitely check out trich.org. They have support areas for adults, kids, and parents.
I could have written this article. My experience mimics yours, even the article in some magazine that my mother handed to me in my early teens. I am a mother of three now (never in a million years thought I would be where I am today) still a puller but with confidence about who I am now. I don’t tell people, feel protective of it. However, it has shaped who I have become, that being a postive thing. My oldest son was diagnosed with Tourettes recently and as I mourned the ease that his childhood may no longer have I hope to rejoice at who he will become because of this syndrome. Thank you for your article
Yes, I started pulling out my eyelashes and eyebrows when I was about 8 years old and I am 34 now and still struggling with it at 34. I was literally tormented growing up by this. My parents took me to specialists because I would lie and tell them that I was not pulling them out. I was Extremely ashamed and could not tell them that I had been doing it. I was picked on in school because I always wore my bangs super long over my eyes to hide the fact that I had no eye lashes or eyebrows. I have tried to stop all of these years. I am so glad that I am not alone and that there is a name for this. It has gotten a little better over the years…but It is still a struggle. I also pick at my skin : (
Two of my four kids have special needs (one mild, one more serious), and accepting myself and healing my own shame has helped me give my kids more love and compassion than my parents were able to give me. What a huge side bonus to healing ourselves!
I am 45 and have Tourette’s and ASD and dermatillomania. I decided in my 20’s to stop letting any of that be a barrier to my education or career. That meant no longer allowing ‘professionals’ or others act like there’s something wrong with me. My picking is mainly on my chest and cuticles and my lips if they get too dry. Most people aren’t aware I do it, possibly because my tics are more obvious. I’m not upset about it and it doesn’t gross me out. I accept that I do it and use balms etc daily to avoid infection.
Reading this I felt such a head-rush of recognition and relief. Thank you for writing it.
I’m so happy you had that because I love that feeling.
I’m so glad, Swistle!
I pull hair & skin pick. Have since I was a child. Fortunate enough that my compulsion NOW allows me to control where, so I can camouflage it fairly well. The compulsion for both is definitely much stronger when I’m stressed or anxious, so I can see where they say it’s self-soothing.
Yes, it’s absolutely an anxiety disorder (even researchers who are arguing about exactly how to classify TTM/DTM agree on that piece). But wow, I wish my anxiety disorder didn’t cause more anxiety!
yeah, I’m a puller/picker too. I still open my academic books I haven’t read in years and find piles of eyelashes tumbling out. Luckily I have very, very thick eyebrows so even if I pick incessantly they still look “normal” and I’ve never really gotten comments about it. My nails OTOH are misshapen from years of continuous picking. I have a lot of OCD/anxiety and autism in my family–I have not been diagnosed with OCD but do have bipolar and anxiety. I didn’t recognize it as stimming until pretty recently when I was watching my son (w/autism and OCD) pick at his lip and realized it’s the same thing. It feels comforting and satisfying. I also chew on the lashes between my front teeth.
My eldest son has DTM and somehow, it helps me have some compassion for myself. I guess it’s because I can’t condemn him, so maybe I shouldn’t condemn myself. And I almost always rub the hairs across my lips.
I love you for writing this here and Katherine for letting you. My eldest has trichotillomania which presented when she was 9 years old, right before I was about to give birth to my 3rd (lashes & brows). You can imagine how that affected & exacerbated my PPD (along with other situational factors). I appropriated so much guilt and shame over my precious daughter’s ailment. Wow. I’m happy to report we’ve come a looooong way, baby. Still, crazy cool how this has come together in my world once again, years later, here on these pages. Thank you again and much love to you! PS I’ve written on the subject several times in the past, if you’re interested: http://tinyurl.com/84udt6x (click “hide advanced search options” for a list of posts)
me too, always played with my eyebrows, always, as long as I can remember, and when very stressed the urge is much more frequent and much harder to stop. I really try not to stress about it, just to notice it as a symptom of my stress levels and try to make it manageable. I have OCD too and anxiety and depression and have wondered at the link. My Dr also says there is a strong link with low zinc, which as there is also a link with zinc and stress I am not surprised about. Why isnt it just considered a part of OCD; its a compulsion to relieve stress, to self soothe?
It’s not considered a form of OCD anymore, though it was for many years. However, both OCD and TTM/DTM are classified under the anxiety umbrella of disorders and have lots in common. Its closest relative is probably Tourette syndrome which was partly determined by brain imaging studies. My theory is that the disorder varies dramatically among sufferers and some people have a form that more closely resembles OCD than others.
I came across this via Brain, Child Magazine’s FB feed. I am a picker. It seems to be worst just before and during my period, but I always thought that was just when my skin would break out more, and create the seed for picking. The funny thing is that I don’t really see myself as an anxious person at all. I do it when I’m bored, I think. Is boredom a kind of anxiety?
But mostly, it’s interesting that I found this article this week because my daughter (9yo) has just started pulling her eyebrows and eyelashes. Because I recognized my own fidgetiness in her, I immediately realized that I needed to be gentle (not shaming) in drawing her attention to it, and suggest that she try redirecting her fidgets to another less destructive fidget. Initial feedback from her has been good; she says she caught herself doing it and redirected eyelash pulling to hair pulling. I don’t know if that’s better, but it’s less obvious for now. I think I may talk to her doctor and see about getting some effective behavioral therapies. I’m hoping that it makes a difference to catch this early. Does it?
I don’t know that boredom is necessarily a form of anxiety, but I know for sure that boredom is a trigger for many people with TTM and DTM. I’m SO glad to hear that you offered your daughter gentle feedback and not shaming! From my perspective there is nothing more important. Yes, catching it early and getting therapy early improves the prognosis significantly. I would definitely speak to her doctor and talk about accessing some treatment for her. Best of luck to you both!
I feel so relieved! I’ve been pulling my hair out for a long time, and since the baby was born (a year ago), I’ve been pulling it out twice as much. I’ve had to hide bald spots, and give excuses to my hairstylist, doctor, friends, family and my husband (unfortunately, he figured it out, and shakes his head when he finds me lint-rolling the carpet). I feel so ashamed and nutty and I wish I could stop. But, it’s become my “thumb sucking” and it makes me feel better when I have a bad anxiety attack. I’m just glad I’m not alone.
Please don’t feel ashamed. Just reach out and have a chat with your doctor about it.
~ K
You are absolutely not alone. I hope you’ll spend some time at the listed resource sites and talk to your doctor. There is absolutely nothing to be ashamed of. Nothing at all.
Another skin picking mum here! In hindsight as a teenager, young adult, I used to pick the skin on my face a lot. I think it is linked to perfectionism, anxiety, a focussed/obsessive personality trait, self soothing – perhaps just coping strategies? Somehow as I got older this morphed into scalp picking …like one of the other posters here I found that this problem completely disappeared during my last pregnancy and while I breastfed – so for over a year – but it has now returned. I used to beat myself up over it (and still do at times) but I guess I am a bit more accepting of it as one of my quirks…my eldest daughter also has a repetitive self soothing thing she does with her legs so it is interesting…Keeping hands occupied is definitely helpful. It is nice to know that I am not alone. I told one of my friends about it once and she thought I was rather odd so don’t share this piece of information with too many people!
This is exactly what I am going through. And it all started out in 6th grade in class and I just started picking my eyelashes out and gathering them up in a pile on my desk. I didn’t even know what I was doing. And when I’ve started having acne, I was picking at my pimples and the skin around them. I cannot stop. And I don’t think I ever will. I am 16 years old. 🙁
Hi,
i have been research this topic for a while trying to get a better “understanding” of it. My lovely wife pulls her hair often, and she also believed it was a form of OCD, but now there’s a name for this urge. Point being, I would like any advice or direction on how to “help” her. I know i cant stop it, nor change her. But, I want her to know I care and will always love and support her as she trys to help herself.
If there is anything I could/should do or even not do, please let me know.
Thanks!,
Michael
There are support groups she might find helpful Michael. You can find them here: http://www.trich.org/treatment/support-groups-1.html
In terms of how you might best support her, try reading these:
http://blog.trich-free.com/7-ways-support-loved-one-trichotillomania-pt/
http://www.trich.org/treatment/AdviceforSignificantOthers.html
I was going to direct you to Trich.org as well. There is a wealth of information and support on the site including a comprehensive listing of counselors and therapists who specialize in this condition. It’s so important to talk to someone who is well versed in it as not all therapists are. As with any behavioral disorder, there is no cure but it can be managed successfully. I think it’s awesome that you’re educating yourself and want to love and support your wife. She is lucky to have you!
I started by twirling and chewing my hair around 5:5yrs old. Then turned it up a notch to pulling my hair out ,then my eyelashes. I now do both without knowing im doing it.
I also skin pick , my head was first but because I was a bottle platinum blonde it was very noticeable ,well big holes in my head would be as I used anything I could find, tweezers,needles sharp knives. Then stopped doing it in my head. I started on my tummy to the.point of bleeding. I also now.do it in my pubic area. I am 50 in 2days.
And I have just opened up to my GP
Who has said he will help.. But in order for that to happen I have to write all the traumatic things down . Jeez hope hes got a spare hour or so..