Dealing with habitual face-scratching

YunoGasaiFan asks: Hi Shirelle, I have another question. And it’s very serious. So basically I scratch my face and I don’t know why, I want to stop but I can never resist not to. My face is full of “scabs” and scars. My parents think it’s some kind of mental issue but I looked it up and I think I have a skin picking disorder also known as dermatillomania. I kept on begging my mom to take me to the dermatologist but she either says, “okay tomorrow” or “you don’t have to go, just stop scratching your face, it’s that easy” But my dad reacts much worse he either reacts about how students at my school will see my face or he will say “that face is getting bad,” with a disgusted look. Sometimes I just lock myself in my room and cry about why I did this to my face and cry that I don’t know how to get rid of these “scabs” and scars. It started off in 6th grade and it’s still happening (I’m in 7th grade). I tell people at my school it’s a “skin condition” because I don’t want to scare them of knowing that I pick my face. But only one friend knows I scratch my face. When I looked up what I have probably had, I told my mom about this months ago, but after those months she did nothing about it, she probably forgot, that’s why she always asks me now “why do you scratch your face?” Out this very long story I have 2 questions: I’m really scared about how they will react but should I tell them the full story about how and why I got my “skin picking disorder” and keep pursuing to ask them to take me to a dermatologist? Or should I just not tell my parents and not “worry” them and ask my sister to take me? I’m sorry, I’m just really scared about how my parents will react if I choose the first one, especially my dad.

Hi YunoGasaiFan –


Sometimes people write me questions and I really wonder why.  I’m a dog – I have a huge heart and a fairly good brain, but when I get questions about academic issues, I just think, “What in the world made you ask me?!”  But your question isn’t in that category at all, YunoGasaiFan.  Your sending this to me makes total sense.  Because when it comes to scratching yourself, no one understands better than a dog!


Oh I love scratching!  I love to get the nails of my rear paws right into my neck, especially where my collar rubs.  I love to roll around on rugs or grass and scratch those areas of my back where my paws can’t reach.  And of course I especially love scratching at fleas and getting them off of me!


But this can go too far.  For example, I knew a dog – his name was actually Dog, would you believe? – who died from scratching too much.  He was pretty old, and he had fleas that just wouldn’t go away.  And he scratched so much that his body’s immunity just burned out – he literally got the same condition as a person with AIDS, the lack of a working immune system – and so went from being a beautiful vibrant pup to a withered weak shell of himself.


Now you’re a long way from this happening to you, but I will say, your letter does concern me a lot.  Your condition could be one of many things.  At your age, it’s very normal to get highly self-conscious about your face – you want to look good, and you might be breaking out in painful and itchy patches of dryness or too much oil, which could all get you scratching and picking.  Or you could have an obsessive repetitive tendency that comes from stress.  Or you could even have something more like an addiction to the feeling you get from picking and scratching – a condition called “Excoriation Disorder” or, as you said, “Dermatillomania.”


And the bad news is… I have no way of knowing which is true.  And it looks to me like no one else does either.  Yet.


Your parents sound perfectly well-meaning to me, but when your mother says you just need to stop scratching, she might be missing the point, just as Dog’s humans telling him to stop scratching were.  You might need some medication for your face, or some for your obsessive action, or some sort of therapy to help with your stress, or with your actual addiction to these actions.  But it’ll take an expert to find out.


So I like your idea of going to a dermatologist, but they are doctors who specialize in skin, and might only treat your face, and not your actions.  What I’d like would be a dermatologist who also knows something about the possible psychological issues behind your action.    One who could refer you to be tested, to see if you also need some other help dealing with this.


But here’s the tough part – you’re going to have to get your parents involved.  I doubt your sister would be able to pay for whatever services you get, and you might also have to have your parents there legally.  So here’s my best thought – go online, as you already have done, and find information about Excoriation Disorder, and present it to your parents.  You’re right that they won’t like it, but I can tell you Dog’s humans sure didn’t like watching him die away from those fleas either!  Your dad is unhappy about how you look, but I’m hoping that when he finds out about your concerns, he changes from being angry to being a little scared – the way I am.


If we’re lucky, the doctors will find that you’re just anxious, and need to find ways to relax, and can give you some medicine to help your face heal.  But just in case you have this very rare condition that requires more, I’d like you to seek out some really good help.


The reason humans look at each other’s faces so much is that that’s where you tend to express your truth the most.  And I want your face to be as lovely as your heart (Especially for when you find your own Yukiteru!).  So let’s get this messiness cleared up, whatever it is.  Deal?!


Best of Luck,



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