Theres no single way a doctor may approach treating someone for skin picking disorder. Awareness of the condition is still growing, and the solution is different for every person. Some medical providers may prescribe an ointment like Scott received, while others may send a patient to a therapist for a mental health evaluation. McKeaney of the Picking Me Foundation said she creates information packets to send to physicians who are often the first point of contact with someone with dermatillomania and a directory of informed medical providers.

Hollander, the nurse practitioner, gives patients the foundations fiddle packs, which include tools to keep the hands busy and deter someone from touching their body. She said she cant speak for the whole medical community but noted that her nursing background gives her a holistic approach to skin picking disorder that focuses on the emotional factors behind a skin problem; she also refers patients with skin picking disorder to a therapist for cognitive behavioral therapy, which provides people with ways to approach specific behaviors in the moment.

Many skin pickers feel like theyre the only people doing it. But the Picking Me Foundation has run a virtual support group since March 2020 that has grown from three attendees to about 40 per meeting. The foundation now has over 800 members, and its email list has doubled in size since the start of the pandemic.

Mills said she had trouble finding useful forums or treatments on her own when she started her recovery three years ago, prompting her to make social media content as Kim on Skin to help others feel seen and learn more about skin picking disorder herself. She started her recovery by tracking her triggers, writing down when she was picking, how long the episodes were, and how these might be connected to other events that day. Theres even an app she used for this purpose called SkinPick, which provides a self-monitoring tool and a four-week course to help people understand and reduce their skin picking.

After gathering this data, Mills noticed that job stresses were often behind her picking, so she pivoted from a career in finance to one in social media. She now has a full-time job but hopes to eventually focus full time on Kim on Skin.

Mills reiterated how important it is to not downplay someones skin picking as only a habit. Then theyre back to square one, she said, feeling embarrassed and even more alone.

Investing time in recovery is also not something that may come naturally to people with dermatillomania, Mills said.

A large majority are struggling with providing self-care, she said. Because of that, a big investment into themselves, that's really hard for people to justify.

Self-managed treatment depends on the person and their triggers. For McKeaney, avoiding mirrors is important. She splashes water on the sink in her bathroom so she wont bring her face close to the mirror. She also leaves the lights off, keeps the door open, puts a tape boundary on the floor, uses acrylic nails (which are less sharp on skin), and wears pimple patches to hide areas she would be tempted to pick.

Scarlett, the personal coach in England, manages her picking by going on walks, keeping a stress ball in the bathroom, and covering up mirrors with towels. She spoke out on TikTok about skin picking and connects via DMs with others who do it, which makes her feel less alone. She said her skin picking has become less intense with each little change. In July 2020, she decided to enter a bodybuilding competition; knowing the event was coming up served as a reminder to hold back from skin picking.

Picketts advice for anyone who encounters a friend or relative with skin picking disorder is to cite the definition, treatment options, and other resources from the TLC Foundation for Body-Focused Repetitive Behaviors, and then ask them if theyve heard of the disorder and if they think it might be something they have. This avoids any sense of blame or shame, as if theyve done something they should be embarrassed about.

For anyone who is struggling, I ask them to be as gentle with themselves, McKeaney said. This disorder already tears us apart and doesn't deserve another minute of our time.

This story is part of our Body Week series. To read more, click here.

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People With Dermatillomania Are Turning To TikTok To Spread Awareness - BuzzFeed News