6 Photos That Perfectly Explain This Heartbreaking Skin Disorder

Liz Atkin is 40 years old and only recently starting wearing T-shirts. The idea of showing her arms, and the scars on them, was frightening, shameful, hard to explain, and so much more. Since childhood, Liz has lived with a disorder called dermatillomania, a skin-picking disorder in the same family as obsessive compulsive disorder. 

“It’s not about self harm,” she says. “It’s about trying to perfect the skin and make it smooth and make it feel and look perfect, but the process of it causes wounds and scars and marks, so it constantly perpetuates this cycle of wounds and scars.” 

The disorder only affects about 1 to 5 percent of people, according to U.S. News and World Report, but women are more likely to seek treatment. For Liz, it developed as a way to rid her skin of imperfections but became something she was unconsciously doing. 

“Sometimes I’d look down at my hands and I was picking all the way down to my knuckles, and on some fingers I didn’t have fingerprints because I was picking all of the skin off,” she says.

The disorder was easy to hide, too, as Liz would have a lie ready to explain any picks or scars. When she was 8 years old, she told a schoolmate’s parent it was chicken pox. When she was older, she avoided swimming parties, covered her face in foundation, and dressed in what she calls gothic clothing in order to keep her disorder a secret. 

“I was adapting my behavior to fit this disorder around my life,” she says, explaining that the shame also comes from it being something that one theoretically should be able to stop. “There’s not a way to switch your fingers off, so what do you do if the tool you’re using to attack your body is attached to you?”

Liz saw her skin picking get worse than ever in 2013 when she went through a depressive breakdown that led her to take 10 months of sick leave. During that time, she took antidepressants and saw a therapist for cognitive behavioral therapy that helped her manage her anxiety, depression, and skin picking. But something else that worked as an antidote to her frustrating mental state was her work.

This is what it’s really like to suffer from depression:

As a visual artist in London, Liz had previously captured her disorder in artwork featured in the Museum of the Mind at the Bethlem Royal Hospital, England’s first mental health hospital, which features artwork specifically focused on mental health. 

During her 10-month leave from working regularly, Liz received a call from the museum asking for a commissioned set of artwork explaining skin-picking disorder. While she initially turned it down, feeling too unwell to deal with it, her therapist pushed her to try. 

The commission, which featured images of Liz that she took herself mostly in a bathtub where she felt safe and comfortable, was so well received that she earned a solo exhibition in Los Angeles at the David Geffen School of Medicine at UCLA, where students and professors learned to look at the disorder through her artwork. 

“It went from the very worst thing of my life to something that led me on a very different journey and I was able to translate this awful thing in my life with an image,” she says. 

Now Liz is able to work as a freelance artist, teacher, and mental-health advocate. Here, she explains some of her pieces that best illustrate what it’s like to live with dermatillomania.