Facing the mirror in her bathroom, Camille Montaz inspects the skin of her face. She starts fiddling with a button and goes after him until she manages to pierce it. Then she focuses on another. Then another. And continues methodically until tearing the slightest imperfection that is on his skin, in a state of trance. After two hours of crisis, she stares at herself and sees the devastation inflicted on her skin. The young woman is disfigured. She has just had yet another crisis of dermatillomania.
“This disorder consists of crushing and scratching the skin excessively and repeatedly, which can induce self-induced lesions”, defines Alexandra Lecart, psychologist specializing in dermatillomania. This psychiatric illness has been recognized as an OCD, an obsessive-compulsive disorder, since 2013 by the Diagnostic and Statistical Manual of Mental Disorders. It is listed in the family of body-focused repetitive behaviors (CRCC), in the same way as trichotillomania, compulsive hair pulling. Although now identified, this pathology remains very little known and therefore very little treated. We sought to understand why, thanks to the testimonies of Camille, Bruce and Léa, who suffer from it or have suffered from it, and the analyzes of health professionals.
Patients who are unaware of suffering from a psychiatric disorder
Camille took 15 years to realize that she was suffering from a mental illness. “For years, I thought I just had a problem with willpower, that it was my fault. » Each time she promises herself to stop fiddling with her skin, she starts again, in spite of herself. “I thought I was a monster and that I was the only one with this obsession. I scared myself,” admits Léa, 25, whose dermatillomania damages not only her face but also her chest, legs, armpits and pubis.
The young woman consulted several dermatologists but none diagnosed her dermatillomania. However, it is taught in the course of dermatology, under the name of “neurotic excoriations” or “psychogenic excoriations”. The dermatologist consulted by Bruce, who has suffered from OCD for 20 years, advises him to stop touching his skin. “He thought I had acne so he prescribed me too strong products which only made my skin problems worse. If patients take years to put a word on their pathology, it is also because they do not talk about it. “Patients don’t even dare to have scans or go to the gynecologist, they are so ashamed of their bodies. So talk about it to professionals or relatives…”, analyzes Alexandra Lecart.
Professionals uncomfortable with this pathology
However, some dermatologists manage to detect dermatillomania in their patients. This is the case of Laurent Misery, a follower of psychodermatology, an approach dealing with the relationship between dermatology and psychiatry. He regularly sees patients suffering from OCD for consultation. “The diagnosis is quite easy because we see self-induced lesions, by scratching, rubbing, pinching or using small instruments. For him, in a relationship of trust, it is enough to ask patients how the lesions were created. “Then we try to help them understand that it’s a pathological problem, if they haven’t been able to walk that path themselves, and then put a name to that problem. »
For Laurent Misery, it is less a question of ignorance than of embarrassment vis-à-vis the disease. “Dermatillomania is avoided by health professionals because dermatologists, psychiatrists or psychologists feel uncomfortable with a pathology that they only half know how to manage. According to him, the diagnosis is easy on the dermatological side but the treatment is more laborious. For shrinks, it’s the opposite because it is complicated to make a dermatological diagnosis.
Social networks to talk about it
Undiagnosed patients are turning to the Internet to find answers to their questions. It was thanks to an American Facebook group on “skin picking” that Camille understood that she suffered from dermatillomania. As no group on the subject existed in France, she decided to create an Instagram account dedicated to this disorder. It is on this account that Léa falls after having searched “I can’t stop crushing my skin” on Google. “I was like, ‘No, I’m not crazy or monstrous.’ I had renewed hope by telling myself that if it was a problem, I was legitimate to ask for help”.
For his part, Bruce has created a Discord group bringing together 600 dermatillomaniacs. A bubble in which the sick, who often isolate themselves because of this misunderstood pathology, can empty their bags, listen to each other and help each other. “This disease has ruined my life. If I had consulted a psychologist at 20, I would have healed faster. Today, I speak to prevent young people who have it from closing in on themselves and becoming like me. Because as with all OCDs, recovery is possible. Whether it is related to simple stress or heavy trauma, it is possible to work on the disorder once its origin is known. Not easy but possible. Camille is proof of that.
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And to learn more about dermatillomania, you can go to Instagram account by Camilla Montaz.