Understanding Hair Pulling & Skin Picking | Trichotillomania & Excoriation
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- Опубликовано: 26 мар 2024
- Dr Syl explores Trichotillomania (hair pulling) and Excoriation disorder (skin picking). These behaviours are compulsive disorders and can cause significant distress and even functional impairment. Dr Syl explores why they happen and discusses the treatment options
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** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. If anything in this video was distressing please consider calling LifeLine 131114 **
Timestamps
00:00 - Introduction 
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What should I react to next?
Here's a link to my upcoming newsletter (use it to follow for updates for my CBT course!): eepurl.com/iMHJp6
My friend is hebephrenic,at first I thought he said herbephrenic,he visits often for an hour or so,Is about all I can deal with,he does fancy beer too much,8 /10 cans a day, is it a waiste of time trying to het him to stop,or slow,are the AA meetings for people with mental health problems?
I overcame hair pulling and skin picking by placing bandaids on my thumb and forefinger. It makes you aware you are doing it and takes away the pleasure in feeling your hair or skin.
I am autistic and have trichotillomania as a stim. I pull my eyebrows out as a relaxing comfort. For me, it has nothing to do with anxiety. In fact, when I am really anxious, I don’t pull. For me, it’s something I do as I relax in the evening, scrolling social media, watching videos, etc.
I’ve tried everything possible to stop because it’s so embarrassing to have bald eyebrows but I haven’t found anything that successfully replaces the comfort.
Lifelong I’ve picked/bitten my nails, picked my skin since puberty started, and am constantly finger-detangling my hair. As an adult I’ve been diagnosed with ADHD then discovered body-focussed repetitive behaviour disorder, so I thought I had BFRB disorder exacerbated my constant need to fidget. But now that I’m more recently also querying autism for myself, I can see my BFRBs as a stim with a sensory element too, because sensory-wise I can’t tolerate anything that’s not ‘smooth’ hence the constant nail and skin picking and detangling.
Autistic too and I chew the inside of my mouth, sides of my thumbs, and pull my hair. I have been trying so so hard to stop my whole life. Bad enough my dad went bald young and I'd like to keep my hair! If I reduce one then others just get worse. Infuriating.
@@ZosiaDabrowskithe smoothness is a thing for me too. As soon as the skin on my fingers grows back it's all bumpy and horrible and I just pull or bite it off without even noticing. Same for the inside of my mouth.
It's such a weird condition, at the same time that deteriorates my mental health, it also makes my anxiety almost go away, a literal feeling of calm before the storm.
i have had excoriation disorder for about 20 years! it causes a lot of shame for me, so it's so cool to see a video raising awareness in a neutral and non judgmental way :) thanks!!
I was in a really bad phase of unmanaged OCD and picking out “bad things” (ingrown hairs or white heads) from my skin was an obsession that was a part of it. Also pulled out my hair so much that I had bald spots and shaved my head for 8 years; I can now have long hair and mostly leave it alone. I’m still occasionally picking at things (usually hidden by clothes) but I use it as a warning sign I have something I need to deal with that’s stressing me out. Finding positive stims instead also helps (I have AuDHD). The worst was when I had no idea how my brain operated and had no idea how to manage anything; self knowledge is power.
I have OCD too and had excoriation habit that for most of my life, but got jolted out of it by a major life change, so glad it's gone. It made me look awful.
I suffer from Excoriation and I can tell you for sure when I pick scabs and get the scab to release from the skin it is an extreme rush of euphoria and a feeling of a release of anxiety and stress.
I believe I have this. I've skin picked and hair pulled since I was a little girl. I've fought hard to resist the compulsions, but recently my partner discovered a good size bald spot on the back of my head I had no idea I had. I'm not consciously pulling my hair but clearly I am doing it somehow. It's really frustrating and yes, embarrassing..
Is it the camera,my failing eye sight,or have you Dr Syl been picking your left eyebrow?
Noooo he’s got a scar there!
It is a scar from childhood but good catch! :)
@@london_liv5539 how did you know 🙃
@@DrSyl I’m an RN 😊
I’ve been biting the skin on my fingers for as long as I remember. 😮 Had no idea WHY until now. I’ll mention this to my doc. Thanks for the info Dr Syl!
I have dermotillomania. I don't see it as belonging under ocd. It's not fear driven. It's more akin to, say binge eating: I get the urge, and I know it won't stop (or will come back) unless I do it, so I give into the urge, because it takes too much willpower to resist indefinitely. It's like having a recurring, strong itch. You will drive yourself crazy if you try to get through it with willpower alone. You can't do it. And other strategies don't really work. Other than treating the underlying malaise that drives the intense desire.
I have the same but through therapy have now realised the ‘urge’ is actually feeling negative emotions and then using the food or skin picking as a distraction/coping mechanism.
I was so cut off from my own feelings that I only experienced the physical ‘urge’ and could barely even realise that there was an emotion or thought because the neural pathways to go from negative feeling -> binge/skin pick were so strong I’d skip straight to the action in a heart beat. I’ve been working with a therapist who has helped me to tune in to my own bodily feelings and what they’re trying to tell me, and then how to process this in a healthy way and it’s the only thing that has helped my binge eating (and I’ve tried ALL the things over ten years).
The suggestions of changing it for a stress ball etc are quite invalidating. They rarely work. The two things I've found helpful are 1) moisturise my skin so I don't get dry patches I will pick (and cut off hangnails asap), 2) treat my depression so I'm overall better.
Cutting off the hangnails is something I do too, as well as patches of bumpy dead skin. I will give the moisturising a go
Not really invalidating, just because it doesn’t work for you doesn’t mean it works for no one.
Lifelong BFRBer here! Also have comorbid OCD, GAD, and depression. Thank you thank you thank you for talking about body-focused repetitive behaviors!!! Talking openly helps end the stigma, shame, and connects people with help and support.
BPD, OCD And GAD diagnosed but do think I'm autistic like 3 of my kids.
Didn’t expect you to talk about something so personal for me, Dr. Syl! I have trich and have worked hard to overcome the deep shame that comes with it.
I didn’t even know what it was for years . I only learned the term when I was 18 and watched “My Strange Addiction.”
To say the least, I’m SO glad you’ve decided to talk about it. I hope some other young person learns more about themselves from your video. Couldn’t think of a better person to learn about this from. ❤
Im taking an exam right now (super anxious), and you made me get up and get my fidget cube instead of picking at my skin. I told my doctor about my skin pulling and she didn't take it seriously. She said something along the lines of "Oh everyone does that", which is NOT true.
GAH! I got so excited when I saw the thumbnail for this! I have both (& a lot of other comorbidities) and can answer a bunch of your questions.
[Due to ADHD, it’s taking longer to outline everything, so here’s just a few answers]
In terms of pets, I had a stray cat appear approximately 6 months after I started pulling. He was exactly what I needed at that time: helping with depression, anxiety, & dealing with bullying about TTM. I am ashamed to say that, at one point, I did pull a few of his whiskers out. He was beyond patient with me & I quickly stopped. However, it is the pulling out/actual removal of the hair that [supposedly] satisfies the compulsion. I have a long-haired cat now who requires a lot of brushing, but doing so does NOT satisfy that compulsion.
I have been picking and worrying wounds on my chest (caused by the picking) for the last 10 years because the NHS is refusing me chest surgery because of my weight (I’m ftm). I consider it sort of a harmful form of ‘grooming’ the problem area - I squeeze sebum from follicles and skin pores, open wounds repeatedly to ‘empty’ them, I often bleed and 50% of my chest is just lesions and scars. I lose sense of time and can’t stop once I’ve started.
I go through periods of scalp picking. If I feel a little bump I want to scrape it off to make the area smoother. The scraped spots will scab over them I pick the scab off and make a deeper score into my skin. I will continue the process and it will bleed. Having 3 or 4 places on my scalp like this will prevent me from GE my haircut. When I am really motivated to go to the salon I can coach myself to stop to have the reward of getting a good stylist
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I have a similar thing on my scalp, right at the back. Once it scabs it's scraped right off immediately.
First explanation I have for those compulsions. Thanks
I have trichotillimania and dermotillimania (scalp picking). I’m highly functioning so no-one would realise if I didn’t tell them. I also have a double-coated German Shepherd and can confirm that when she blows her coat pulling out the loose hair is the same for me. It’s effectively a concentrated distraction technique and I always wonder if it somehow goes back to ‘grooming’ behaviours. I have/had depression/cPTSD, anxiety, binge eating disorder and obviously it’s not a diagnosis but a ‘workaholic’. The latter two being two other maladaptive defence mechanisms. I’m currently working with a therapist and I’m learning to identify and deal with my negative emotions in a healthy way…
It’s definitely working, my diet has improved significantly and I’m no longer morbidly obese as of this week(!). I’m focusing on physical health first before I address the hair pulling because I feel like doing both at the same time would be too much change at once. I’m feeling very optimistic about the future 😊
Thanks for bringing awareness to this topic. It is often overlooked.
Had skin picking all my life from as early as I can remember, due to childhood abuse. There is even a school photo at age 5 and you can see me doing it on my thumbs. No one even questioned it.
Thank you for making this video, people don’t often understand why I do what I do, and I could now use this video. I appreciate the sensitivity in which you approach disorders
I have had trich since I was 10! I am 34!
I have excoriation and have scars all over my arms from it 😞 most of the time I do it subconsciously and I was actually doing while watching this video.
I have dealt with skin picking for around six years now. My fingers are a mess, to be honest. My thumbs are the worst. The scars are thick and purple, and my phone can struggle to pick up my thumbprint. I have reduced feeling on the tips of my thumbs now. I have never been able to stop and probably won't. I often only realise I'm picking my skin when blood is trickling down my fingers or thumbs. I have begun to pull my eyelashes out, too. Thank you for being so thorough and non judgemental about this subject.
Long live you doctor❤,,thank you for let me aware that i have a disease 😭😭😭😭😭😭😭😭😭😭😭😭
I started making pick mats (small beads, trinkets, chunky glitter, and other small things set into silicone molds) this has helped a bit with the skin picking that i didn't realize there was a name for lol
First time i have heard someone say it is wrong to pick at your skin. Your skin should NOT be picked like this. I have heard someone say dont pick the spot it will make it worse. Having a dozen places to pick seems ok if no one knows about it. I hear what you said and will try to stop picking. It is not going to be easy as years doing this. I seem to enjoy doing it.
Such an interesting subject, thank you Dr Syl. As you mentioned Adjustment Disorder, might you do a video on that subject in the future? Thank you ❤😊
I have a skin picking disorder and it’s OCD driven. At first they thought it was a bad habit, then they said that it’s intentional self harm, then they said it’s a disorder and I never truly got to understand what that meant because life did life shit and I couldn’t figure out coping. Now I realize what I’m doing but the hard part is stopping. Sometimes I count down, tell myself “alright, time to stop, gotta stop, get my hand away from my lips, move on, you have to wash your hands, this is dirty! What if someone saw you ripping apart your lip?” I can’t literally stop. Until someone else or something else pulls me out of it. But I tend to go into dissociation once I slip into the “skin picking time” and sometimes it lasts for the longest, two hours, sometimes ill even be late for work or late for events, or gatherings. I started when I was about 9 and I’m 24 now and I still do it. All over my body and especially my lips. (Sorry for the horrible grammar and spelling it’s 1 am and I’m so tired but so happy someone is talking about this I have to finish the video.) my therapist told me when I was able to see her that I do it (dissociate or skin pick and “get lost”) is when we talk about personal things, things that happen at home, being asked a lot of questions, and group events. It’s been a hard journey with this, my body is pretty scarred and have a lot of difference to my pigment because of it. (Dark marks scars, scabs.). Always recommend going to seek help and talk to someone and start realizing what’s going on and when you “get stuck”
Hey Dr. Syl! This video couldn't have come at a better time. I have trichotillomania, PTSD, and am about to be assessed for ASD.
I'm not sure how common my experience with trich is. I developed it after I got lice when I was a child. My grandmother would sift through my hair with a comb and pick the bugs out, which ended up being a very soothing sensory feeling for me.
My pulling is very centered around the feeling of plucking the bulbs/follicles out and relieving that "something is crawling on my skin" feeling. I can get very fixated and pluck for hours.
Thank you for making such a well thought out video and spreading awareness!
Hi Dr.Syl hope you’re doing well…thanks for taking time off from your busy schedule and educating us.Very much appreciated
Thanks!
I do both. I constantly play with my hair and will occasionally pull bits out, usually if the texture is funky to me. I also will tug on my eyebrows and eyelashes usually looking for lose hairs to remove. I've pulled arm hair out with my fingers too. I've picked at my nails as long as i can remember. I used to bite my fingernails but that has lessened. I've ripped off both finger nails and toe nails more than once as a child. My cuticles look awful due to over grooming and picking and my fingers are almost always sore. I also will pick at my face if there are pimples and pick at any scabs. Since I've started seeing a therapist its seemed to improve some but my poor nails and cuticles are still taking some abuse especially when i start to get overwhelmed.
I pull out my pubic hair when I'm on the verge of hypomania, but it's almost as if I try myself as to how much of that pain I can handle. 😑
I have OCD, have self-harmed, has tics, Tourettes, GAD and a BUNCH of other diagnoses.
I've been thinking about this for a while now, but it feels so stupid to tell my psychiatric doctor.
Any input?
I just wanted to ask you to make videos about OCD. Thanks
I'd love a video specifically focused on pica. When I talked about it with my psychiatrist first, he wasn't even sure what I was talking about right away, so it's always super awkward to bring it up to medical professionals. 😅
I know it can be connected to anemia, but can it also be connected to ADHD and autism? As some kind of a fidgeting cope?
I have trichotillomania but I only pull out my eyelashes, I've had it for about 30 years and my kids have watched me pull my eyelashes so much that they have offered to pull them out for me 😅
I pick the skin off my forefinger & thumb knuckles only superficially, to me it’s just a habit - nothing to do with alleviating anxiety.
I've picked at the skin around my fingers and thumbs since age 4-5 from anxiety. I also started picking at my scalp around age 7 (same time I developed OCD symptoms) and chewing at the inside of my mouth until I got ulcers.
By age 15, I began picking at my upper lip. I would only pick at my scalp in private but couldn't stop picking at my fingernails or lip in public. My fingers were always bleeding and embarrassing. In times of severe stress, the picking would get worse.
In my mid-teens my OCD expanded to include motor tics. I mostly hide them, but some of them are physically exhausting and I have 8 of them. I also developed BPD symptoms just after this too, from CPTSD that I had no idea I even had.
At age 25, I began gouging my nails under my thumb nails, so eventually that half moon you're supposed to have at the cuticle is very faint, and I have a very deep reverse half moon from the top of my nail down.
At 30, I picked at my lip so much that some of the skin actually died. It eventually went white, and then I kept picking at it, and it never grew back due to no blood flow. I also caused a bubble-type scar that had to be burnt off. I now get lip filler to help fill in the gap in my centre upper lip where the tissue is missing. When I close my mouth, the lips in the centre have a gap.
Around my late 30s I began picking at the inside of my ears. I used to only do it when alone, but after a few years I felt the urge to do it more than I felt the embarrassment from being seen doing it. It feels so good, I do it almost constantly and kind of go into a trance.
I have had inflammation and mild infections in my fingers and my ears due to this. I'm 45 now.
Thank you for this. I have had bouts (some lasting 2 years or more) of trichotillomania for decades. I've also bitten my nails (severely) all my life, and often wonder if the two might be related in some way...?
I'm pretty sure I have Excoriation as a result of my OCD and Autism. I have had unhealthy skin on my face all my life and it is made far worse by my picking at the spots. People often ask me if I am ill because of how my face looks. The only time my face looks good is during long periods of sunny weather when I am outdoors more than at other times. It does make me feel ashamed and I have experienced it for decades.
Thank you so much for making these videos. They are not only entertaining and informative but also genuinely helpful. Thx for your time :)
I have trichotillomania and excoriation. It's definitely a sensory thing for me. Luckily I don't pick sores into myself. I have had the compulsion to pick at my dog's skin but I never do because I don't want to hurt her. I pick at blackheads mostly, I get really frustrated when I see them because it feels like there is something in my skin that shouldn't be there. It's also kind of satisfying, and once I start it's hard to stop until I've picked over my whole body. I've started to be able to curb the tricho by just pulling up on the hair without actually yanking it out- it gives almost the same feeling, but sometimes I still do end up giving myself a bald spot on my leg lol
I do this. I have picked my skin bad enough that both of my arms or face were covered in scabs. Honestly I was doing this so unconsciously that I literally did not know I was doing it. Stupid doctors thought it was related to drugs or scabies. Wrong. Currently my face and arms look great because I replaced the picking with lots of skin care. I have a bunch of products that clean and heal a pick sore. Also, I do things to prevent what I might pick at. If I deal with pimples and dead skin with proper skin care I wont pick. I also pick my eyelashes. At times I have had almost none. Currently I have most of them but its really hard to keep a full set. It is very...satisfying...to feel that bit of pain and, for me, I think to myself that I have gotten rid of something 'rotten' or 'dirty' in myself.
The doctor thing is something that I have experienced too, but in a case when I had a skin infection.
I was in the ER, and understood how crazy I must have seemed, so I said;
"I have *not* taken amphetamine, I swear!"
...The doctors response is almost unreal;
*"-Are you SURE about that?"*
So sorry that you too have been to doctors that already have a diagnose ready the minute you walk through the door... It's disgusting behaviour on their side - one is really already fragile enough when seeking medicational care.
@@Foxiz It would have been nice if they had even said what they thought. but no, they just screamed at me, i mean it, screamed, and told me to go to the mental health and addictions centre
I def pick my skin (excoriation) even when I try to distract myself. Got a fidget type toys and doesn’t seem to help.
I’ve done it since I was a kid to prob deal with anxiety of being different.
It usually is my fingers, scabs and toes. I’ve scratched myself when I couldn’t grasp any skin to pick. I’ve also used tweezers.
It’s def a release, I physical manifestation of how I’m feeling on the inside.
I’ve seen a counseling who don’t seem to worried that I do it. My mom used to slap my hands.
I do draw blood but agree I’ve never gone deeper but have done it to the point I’ve gotten an infection.
My family knows I do it. It is what it is.
Yeah, I have a hair twirling compulsion that goes with my anxiety issues. I always have to remind myself not to do it in public! It might freak people out.
Dr Syl, im not sure if its psychiatric or neurological but can you do something about FND.
Im autistic and pull my hair, bite/pick my fingers and eat the inside of my mouth. For me it isnt even as extreme as you describe, I just do it without even noticing and then it actually really pisses me off that I have done it! It doesnt come from any anxiety or need, its just a stim, theres not really any thought about it. Theres nothing enjoyable about any of it, apart from biting the inside of my cheeks is sometimes a satisfying texture, but I absolutely hate it and want it gone! Ive been picking my thumbs a lot recently and theyre constantly stinging and bleed often. I almost wish I enjoyed it because I just want it gone!!
Hmm. I do, pick at my skin, though it started because i had dry flakes in my scalp, and then i started getting sores, that i hit when i brushed my hair, i picked the sores again and again.. I now have a rash on my hand, Psoriasis, i have had it for 3 years and no matter how much i leave it alone and put moisturizing creme on it, its stays, and it so hard not to pick some of the thick layers of skin..
Just one minute ago I was picking my pimples on my face I do it every day. I can’t stop it’s a stress reliever. I pull my eye lashes and eye brows. I pull my hair from the root
Thank you for this video I’ll try to speak to someone about it since I do quite a lot of them
Hi Doctor Syl. Please answer this comment. I always peel off the skin of my fingers especially my thumbs. Sometimes it bleeds and takes a horrible shape. Can this be Trichotillomania? I do this by biting and I feel relaxed while doing this. I do this when I am nervous for example when Iʼm happy, worried, stressed
I have Lichen disorder. I have an indentation on my left leg. Usually I stop after a few years, but this one has a lot of damage. I'm prescribed Triamcinolone Acetonide cream usp 0.1%. I was only getting the small tubes, but my last refill I requested a larger one. My new tube is 80 grams. I also have dry skin patches on both butt cheeks and a raised spot under my left knee. Very close to my knee replacement scar. It's like my hair is stuck under the hard scarring. I'm going on vacation in May and I need to STOP picking. I've been using my tanning bed and that helps with my butt cheeks. 🍑
I'm under the care of my psychiatrist.
I have a question. My son has asperger syndrome and does this. But, with his eyelashes only. Is this normal, for a small child?
I pick my skin since I was a child but not on my arms. I do it on my fingers often until there is blood. And it's pretty hard to stop, often people around me need to remind me two or three times that I need to stop. I hate the feeling of the rough edges and the only thing that helps is getting my nails done in a salon regularly. I have generalised anxiety disorder. Is this skin picking on the fingers the same as excoriation? I start a new job next month it makes me crazy because fingers are not able to hide :/
Hi! I did a short from this video. Where can I send it to you?
Oh thanks, Medico.syl@gmail.com :)
I have recently found myself biting my finger tips and I am in my 50s. I have never been much of a biter or picker, but I have developed significant neuropathy in my fingers of late. I think my subconscious is trying make my fingers feel a sensation, any sensation.... Its hard to stop sometimes. Maybe I should try to switch it to chewing my fingernails, its less damaging.
I have ocd and I spin and twist hair which can cause thinning .. but also skin picking. Except I thought it was called dermatillomania...I also have used tools like nail clippers. Very embarassing. When its bad I do it on the bottom of my feet and until I can barely walk. But no one can see it and the calluses build back quickly, and I can pull large chunks before it hurts. But it's really not good.
I also pick scabs badly...or blemishes. It's really really embarassing and it can hurt to walk when I have a bad go at it.
I have indeed been diagnosed with GAD and OCD. I also did stop for like 6 years but generally have done this on and off for a long time, over 20 years except that 6 year stretch wehre I stopped.
Im guilty. Mainly eyelashes, eyebrows and beard/moustache :,0
My hubby pulls out hairs in his beard? I don’t know how to help him……or should I leave it?
I'd say leave it. My ex did this too, and he just felt worse when I talked about it. Same for me (I have dermotillomania). People saying I should stop or warning me about infections aren't helpful. They just make me feel more alone. With trich, there are no health risks, fortunately. I'd just show him compassion if he feels shame and regret. That's healing.
My autistic nearly 6 year old used to pull at his lashes ALL the time when he was tired.
Due to anxiety I use to pick
Interesting...does cracking your knuckles count?
No but if you have a compulsion that leads to injury that counts as ‘body focused repetitive behaviour’ which is the wider umbrella that hair pulling and skin picking falls under
@@KayosHybrid thank you very much!
I wish I could have a doctor tell me what's wrong with me
.a bloody cough that's going away, pain around my chest area , sickness 24/7 , my food coming back up every time I eat anything , any amoxicillin isn't doing a damn thing for me
I'd say I'm screwed
You should either followup with your doctor to run more tests or try a new medication or see a new doctor. I hope you’re feeling better soon!
I pick my head till it bleeds...its awful and painful..but its relaxing...
I have a cousin that picks on her skin and eyelashes
👍🏻
Dear doctor...if ever you want to talk to me...i would share my thoughts and experiences 🎉DSM IV
I'm sorry it,'s out of topic, but why is he so handsome and adorable ??? why ?
Bezoars
I know a woman who is constantly pulling on her hair to the point of creating bald spots. She now wears wigs and pulls the wig hair.
That can't be as satisfying, though?
...To pull hair from the wig, that is.
@@Foxiz Good point!
P R O M O S M
SECOND
Not good enough ;)
@@DrSyl haha, I'm trying okay!
@@DrSyl I'm studying all day and trying my best😭😭😭
who is this guy and why is he on my recommended videos ? lol Also I doubt this guy is legit lol
He's legit. Look at his video history.
Long live you doctor❤,,thank you for let me aware that i have a disease 😭😭😭😭😭😭😭😭😭😭😭😭