Hiiii, I’m Sara 💖 and I have Severe OCD 🧠, Severe Excoriation Disorder ✋, ADHD ⚡, GAD 😰, and Major Depressive Disorder 🌧️. I love using emojis if you haven’t noticed lol.
To keep this as straightforward as possible I want to focus on the OCD and dermatillomania part today. I hope this can help some people 💬 and maybe give others a better understanding of what it’s like to live with these two issues! ☺️
I have always struggled with skin picking, especially on my face 😔, and it has made my acne worse and caused scarring. 🤕 I did not realize until my therapist told me that it can be connected to OCD. Sometimes I do not even notice I am doing it, and other times I am aware but cannot stop. 😓
For me, the OCD side is often tied to perfectionism or needing that just right feeling. 🫠 From thoroughly washing my face and hands, overusing or meticulously applying products to make sure the “ritual” is done perfectly takes both time and money. To having picking episodes which causes scars to heal slower⏳ and to also leave me with a “pepperoni face” 🍕 from all the red and raw wounds or with widespread hyperpigmentation that lingers for months. Oof 😅
ERP IS A LIFE SAVER!!! 🛟
Addressing that OCD pattern is a big part of ERP, Exposure and Response Prevention 🚪. ERP helps you face the discomfort without picking or fixing, so over time your brain learns the urge does not need to be acted on. 😤
Behold~ another technique, HRT!
Habit Reversal Training can still be part of treatment, but timing matters ⏰. If OCD is the main driver, starting HRT too early, especially if it leans on avoiding triggers, can unintentionally strengthen the OCD cycle 🔄. That is why ERP often comes first, and HRT is added later once the compulsion has weakened. 🤗
Skincare time! Oooo la la la 🤭
For wound care 🩹, I keep it simple. When the skin is still open, I use a gentle cleanser 🫧, a moisturizer 💧, and Aquaphor directly on the wound, then keep it covered to protect it from bacteria 🦠 and UV exposure 🌞. Once the wound has closed and turned pink 🌸, I use a gentle cleanser, a moisturizer, a scar cream, and SPF daily to prevent discoloration and help the scar fade.
Fidget toys 🪀 do not work for everyone (Ik people who love it 😍), but ERP paired with steady skin care has made the biggest difference for me ✨. If possible, I recommend seeing a dermatologist 🩺 to help heal your skin and give you tools for long term care, and ask directly if they understand skin picking and OCD and will keep that diagnosis in mind while treating you.
Progress is absolutely not linear 📉📈. You will have times when you pick or have an episode, even when your skin has been looking great. 😥 That does not mean failure ❌. In OCD, compulsions are rewarded in the moment because anxiety drops after you do them, so the brain learns that the behavior works 🤥. ERP builds new learning that competes with the old habit rather than erasing it, which means stress, hormones, sleep loss, or strong cues can still light up the old pathway at times ⚡. The goal of therapy and strategies is not to create a life with zero urges 🚫, but to help you navigate 🧭 life with OCD by reducing how often urges show up, how intense they feel, and how quickly you recover when they happen.
Most important part EVERR 😮💨🥰
The most important part of this process is practicing self compassion 💕 and remembering that no one is perfect 🌼. Every lapse is information you can use for the next step forward! 🫂
Thanks for listening to my Ted talk! 😄 (edited) (edited)
