Rebecca

Age at interview: 18

Age at diagnosis: 12

Brief Outline:

Rebecca developed acne at the age of 12/13. She began picking at her spots and this developed into a condition called dermatillomania. Her acne cleared up with a GP prescribed cream to dry out the spots, but she continues to have dermatillomania.

Background:

Rebecca is 18 years old and a sixth form student. Her ethnic background is White English.

More about me...

Rebecca developed acne at the age of 12/13. Not many of her peers had acne then and she felt very self-conscious, although her parents reassured her that most teenagers get some spots. Rebecca began picking at her acne which she says developed into a condition called dermatillomania. This is when a person compulsively picks at things which they think of as blemishes on their skin. For Rebecca, it became a cycle when skin picking led to scabs which then became the focus of attention for further picking. Rebecca’s acne is now gone but she continues to have dermatillomania, something which she’s very involved in awareness raising for.

When she first started to develop acne, Rebecca went to the GP with her mum. She was given a cream to use to dry out the spots. However, the cream made her skin extremely dry and went back for a prescribed moisturiser. In an effort to get rid of her blemishes, Rebecca began picking at her skin. Although she had had acne mostly on her face, back and arms – she began picking at other parts of her body too, such as her legs. She would pick at her skin, sometimes several times a day, as a response to feeling anxious about her appearance. Rebecca realised it was a problem when she found that she couldn’t stop and she would wake up to find blood on her bedding. Rebecca looked online about her behaviour and learnt about dermatillomania. She went to her GP for help but feels that the doctor didn’t understand. She was referred to her local Children and Adolescents Mental Health Services (CAMHS) who then suggested she should be treated under dermatology. Rebecca thinks it’s important to emphasise the links between skin and mind involved in the condition, but her experience of medical care did not seem to link these together.

Rebecca struggled a great deal with bullying at school about her acne, scabs from skin picking and because Rebecca was seen to act differently too. She stopped taking PE classes as she felt embarrassed about the other students seeing her skin. She remembers being asked what the marks were and she tried to brush off the questions. Rebecca experienced verbal and physical bullying at her school, and ended up moving schools when she was in Year 9 for a fresh start. Rebecca had a good experience at her new school and, once she knew more about the condition herself, she became more confident explaining about her dermatillomania. Although she still feels self-conscious sometimes, preferring to wear make-up and long sleeved shirts, Rebecca’s becoming more confident. For example, she recently wore a swimming costume on holiday – something which she had avoided doing for many years because of her scars.

Rebecca continued researching online about dermatillomania and looked for a charity or support group based in the UK. Unable to find one, Rebecca decided to set up her own webpage for sharing experiences and giving support. She finds that most people haven’t heard of the condition before. In her experience, this includes medical professionals and she’s set up a campaign to include dermatillomania in medical training.

Rebecca picked and squeezed her spots, which she says later linked to a psychological condition called dermatillomania.

But then like when I was about 14, 15, like I started like picking at my skin as well and became obsessed about like getting rid of everything that I saw was an imperfection. And when my acne had like started to calm down a bit, I was still picking at my skin, even though there was nothing really there. And it developed into dermatillomania, which is what I suffer with now and continue to suffer with, even though the acne isn’t always there any more.

Could you say a bit about what dermatillomania is?

Dermatillomania is like an obsessive condition where you pick at your skin basically. And like I know for me it’s just anything I feel shouldn’t be on my skin, like I just start picking at my skin. And then it just turns into scabs and then I’ll pick my scabs because they’re also imperfections and things that I see on my skin. So-

Could you tell me a bit about that time when you first started picking and when you then got the diagnosis of dermatillomania?

Well, a lot of people that I know didn’t really know what dermatillomania was. And for me I started doing a lot of research because I thought ‘this can’t be normal, like what I’m doing’. And in the end I did go to my local Children and Adolescent Mental Health Services to basically say, “Look, I’m suffering with this.” And to start with, they actually didn’t know what it was. And they decided that they wanted to try and transfer me to see a dermatologist because it weren’t anything that they could deal with. But then I had to basically educate them on what it was because I’d done my research. And then they kind of realised that obviously it’s not just a skin condition, it is something to do with your mind as well. 

Rebecca went back to her GP to be prescribed a moisturiser to help with the dry skin caused by the topical cream for acne.

It was like a cream that I would put on my face to basically dry out like the spots and stuff. And then because it obviously dries your skin out, it did dry my skin out too much. So I did need to go back to the doctor’s to basically get some sort of oil-free moisturiser. Because if I was to use oil moisturiser, it would just make things worse again. So then I was prescribed some moisturiser to help with the dry skin.

And is that the sort of combination of things that then cleared up your acne with a bit of time, or-?

Yeah.

Yeah. How long do you think that the treatment maybe lasted for?

It lasted for about two years and then I stopped for a while. I don’t use the dry, the stuff that dries the skin out any more. I use-, I still use the moisturiser though because my skin’s still really dry. So-

Did your doctor suggest any different kinds of treatments that you might have tried for acne?

They did suggest a type of tablet. But I weren’t too keen on that because I would prefer to just do something externally rather than internally.

Yeah.

So-

Yeah, that’s interesting. Could you say maybe a bit more about why you prefer external treatment over an internal tablet?

Because like when you’re taking tablets – you-, I didn’t feel at the time that it was necessary. Because I just thought like ‘it’s just on my skin. I can sort it out externally’. And I didn’t really want to take medication. So the creams were a better option for me.

Could you say a bit about the side effects? You’ve mentioned the dry skin. The side effects that you got from the cream that the doctor prescribed you.

Well, initially I would put a lot of the cream on my skin. But then I realised that it was drying my skin out too much, so I only used a little tiny bit. And then I used a lot of moisturiser. But I would space out using the moisturiser and the skin that dries your skin out. So I would use the moisturiser in the morning and the stuff to dry your skin out at night.

Rebecca started to feel more self-conscious about her skin during secondary school.

I know like when I’m going to school and stuff a lot of people really care about what they look like. And for me to start with, when I first started school, I didn’t really care. I was just there for education. But then I got made fun of and people made fun of like my acne and my bad skin. So I got really nervous and I wanted to be able to be normal and kind of look good like everyone else did. So that’s when I did start wearing make-up. Because I thought-, I felt more empowered when I was kind of covered from basically my insecurities.

Rebecca picked her acne. It became an obsessive behaviour, even after her spots had cleared up. She would like her GP and local Child and Adolescent Mental Health Services (CAMHS) to know more about the psychological condition dermatillomania.

And how about when you went back and wanted some support and some help with dermatillomania?

Well, originally the doctor that I saw for dermatillomania, he just thought I was a bit weird. He just like, he asked me to show him what I was picking at and he just looked at me kind of dazed out like, “There’s nothing there.” And so he kind of just referred me to the mental health services cos he didn’t know what to do. He didn’t know what it was.

And what happened after you were referred to the mental health services?

Well, the person that I saw wanted to kind of, not see me sort of thing. Because she just thought it were like a skin condition, even though the GP previously said it’s not really relevant to the skin condition, but-, because I didn’t really have one at the time when I went to see the GP. So they kind of wanted to send me somewhere else.

And is it mostly since then mental health services rather than dermatology that you have seen? Or have you seen both?

I actually haven’t seen a dermatologist at all. Because I was adamant that it was something that I knew wasn’t related to my acne anymore, because my acne wasn’t always there. 

But they wanted me to go to see a dermatologist. But like I knew that it weren’t related to that.