Sarah Redzikowski tilted her head and leaned closer to her phone camera, examining the redness that spread from her cheekbones to her chin. She traced her fingers over her swollen skin and sobbed, placing her face in her hands.
“I hate that I do this to myself,” she said softly.
Ms. Redzikowski, 40, was talking to her TikTok followers about a secret she had kept hidden from even her closest friends and family for decades: Since age 12, she has compulsively picked her skin, often to the point that it bleeds and scars. As desperately as she wants to quit, Ms. Redzikowski, who has a mental health condition called dermatillomania, simply cannot stop.
She estimates that she spends at least two hours per week scraping at the skin on her face — and her scalp, arms, back, chest and legs. “I’ve spent at least 125 days of my life bent over a mirror,” she said in the video. “And that’s 125 days I’ll never get back.”
She wiped her eyes and squirted cleanser onto her palms, massaging it over her face until it started to foam. Then she began the familiar routine of trying to repair the damage she had done. She waved a high-frequency wand over the constellation of lesions on her cheeks, willing them to heal faster. She slathered her face in spot treatments and serums.
Still, her skin was angry, bleeding in some places. And she was angry with herself.
“It’s an internal battle, because I do know it’s not my fault, and I’m not wanting to do this,” she said in an interview. “But it is my hand. I did do the damage.”
People with dermatillomania or other conditions like it, such as uncontrollable hair pulling or nail biting — which are known as body-focused repetitive behaviors, or BFRBs — can feel a sense of shame so debilitating, they will not admit to the behaviors even in anonymous surveys, medical experts said. After all, it’s their fingers plucking strands of hair, their nails digging into their skin.
But the secrecy has made it difficult for many people with BFRBs, which affect at least 3 percent of the world’s population, to heal. “It’s hard to go forward if you’re so stuck in shame that you can’t talk about it to anyone,” said Suzanne Mouton-Odum, a psychologist who specializes in treating the issue and works with a nonprofit that supports people with BFRBs.
That’s what made it so radical for Ms. Redzikowski to bare her skin on social media. Accepting that talking about it was a way to heal was a painful lesson, one that took decades for her to learn.
A ‘Constant Cycle of Shame’
The bathroom was the only place in Ms. Redzikowski’s childhood home with a lock. She would retreat there when her mother and stepfather fought. It was in front of the mirror in that bathroom that she noticed a few pimples on her back, so she started squeezing and picking at them. Eventually her fingers migrated to the imperfections on her face, which stood out to her under the harsh overhead lights. She would pick her skin for hours, squatting in the sink to get as close to the mirror as possible. It brought her some comfort, a sense of control.
When she stopped, it was hard to remember why she started in the first place.
“I get in front of the mirror and then suddenly the time is gone,” she said. But then she would look at her reflection again, and see how much worse her skin now looked. “It was this constant cycle of shame,” she said.
As a teenager, Ms. Redzikowski did all she could to keep her skin picking secret. She curled her hair toward her face to conceal her raw cheeks, sometimes touching the hot iron to the spots she had picked so that the burns would attract more attention than the scabs. She wore shirts under her sleeveless cheerleading uniform to cover the scars on her back and chest. Once, panicked after a particularly severe bout of picking the night before school picture day, she cut herself bangs to shroud the swelling on her forehead.
It can be almost impossible to hide the signs of a BFRB — open cuts or sores on the skin, bald spots or bloody nail beds — from everyone, though.
When Saharra Dixon started pulling her pubic hair shortly after she hit puberty — a common trigger — her grandfather asked her why her hands were always in her pants. Embarrassed, she moved to the hair on her head. Her mother soon berated her for the bald spots on her scalp. “When I take you to the hairdresser, you’re not going to have any more hair to get done,” Ms. Dixon recalled her mother saying. The questions only made her feel worse about her hair pulling, or trichotillomania.
“It was the act of pointing it out constantly that kind of really started making me feel ashamed,” said Ms. Dixon, now a 29-year-old Ph.D. student.
Dr. Mouton-Odum said she had worked with parents who had blamed cancer for their children’s hair loss from hair pulling. “Talk about the level of shame,” she said, “if you would rather say, ‘My child has cancer’ than, ‘My child pulls her hair out.’”
Ms. Redzikowski learned to skillfully apply makeup as a way to hide her damaged skin from her family and friends, and to feel more confident. So she decided to pursue a career as a professional makeup artist.
“No matter what kinds of issues that somebody sits down in my chair with, I am known for making skin look impeccable,” she said.
But especially after bad picking episodes, Ms. Redzikowski felt mortified about showing up to a set, and worried her clients would look down on her. She felt the models’ eyes on her uneven skin when she leaned in close to draw a flick of eyeliner. “People lose respect for you because they think you can’t control yourself,” she said.
One night, Ms. Redzikowski picked her skin badly enough that she could not bear the idea of showing her face at work the next day. She swallowed a handful of painkillers. “My skin picking had created such a distressing situation for me that I felt that was my only way out,” she said. She woke up more than 24 hours later in her bedroom.
Suppressing the Urge to Pick
For most of her life, Ms. Redzikowski thought the picking was just a bad habit. She didn’t learn what dermatillomania was until she started seeing a psychiatrist for her depression in 2021. The year before, she had dug at her skin to the point of bleeding nearly every day during Covid-19 lockdowns.
Her psychiatrist started her on a regimen that included an amino acid called N-acetylcysteine (NAC), which can reduce the urge to pick or pull for some people. He suggested covering the mirrors in her home and buying fidget toys to keep her hands busy. But they were so focused on treating Ms. Redzikowski’s depression, however, that they never discussed the picking at length or tried to build awareness of what triggered it. It barely improved.
There is no cure for a BFRB, and physical interventions can do only so much without addressing “the underlying need that’s driving the behavior,” Dr. Mouton-Odom said.
In therapy recently, Ms. Redzikowski traced the root of the picking to her chaotic childhood. “That became my coping mechanism,” she said. Today, it remains a self-soothing behavior that she turns to in times of stress, like the recent wildfires near her Los Angeles home. But even when she isn’t overwhelmed, she feels compelled to squeeze or pick any blemish she sees. “I see an imperfection, I want it out,” she said.
Often, the goal of treatment is just to reduce the compulsion to pick or pull. That urge can feel like an unbearably itchy mosquito bite that just needs to be scratched, said Barbara Lally, who has documented her experience with trichotillomania on social media. Once Ms. Lally, 33, pulls out the “right” strand of hair — one that feels coarse or crinkly — she is flooded with relief. “It actually doesn’t hurt,” she said. “It feels good.”
She mimed this ritual in a video for her more than 10,000 Instagram followers, many of whom also experience the condition. “I can’t believe I understood this,” one follower wrote. “WHAT. OTHER PEOPLE EXPERIENCE THIS?” another commented.
To help people learn how to tolerate that urge without acting on it, providers often suggest certain types of therapy, as well as peer support groups.
Just talking about the behavior openly was a revelation for Jason Yu, 31. He had spent a decade trying everything to stop picking the skin on his hands, like wearing gloves and tying them around his wrists to make them more difficult to remove, or coating his hands in lotion. But it wasn’t until he joined a support group that he truly started to find relief. He eventually started a podcast on BFRBs with a friend from that group.
Now, when he catches himself scraping at his knuckles, he views it as a signal from his body that he is anxious and may need something — a snack, a phone call with a friend, fresh air. Accepting the behavior helped to reduce it, Mr. Yu said. “I’m not 100 percent pick-free,” he said. “But I’m a rock-solid 95, and that’s good enough for me.”
Sharing Her Scars
One day, Ms. Redzikowski decided she was tired of hiding.
She slipped on a puffy pink headband, pushed her hair back to reveal her bare face and looked at her phone camera. “Today I’m showing you how I’m going to cover this picked skin that I destroyed over the weekend,” she said, and began to unfurl her decades-long struggle as she dabbed on concealer.
That video garnered nearly 400,000 views on TikTok and hundreds of comments from people with BFRBs. “Thank you for telling this story. I thought I was alone,” one commenter said. “I’ve never felt so seen,” another read.
Ms. Redzikowski has not stopped picking and doubts she ever will completely. She frequently reminds herself: “This is a disorder — it’s not a choice.”
That mentality has helped her to become a beauty influencer in her own way. Having long sworn off social media filters, she has secured brand partnerships by caring for and doing makeup on her own imperfect skin. The response to these videos has “helped me heal so much,” she said through tears.
Sometimes, her fiancé, Kimoon Kim, joins in her evening skin care routine. When they started dating, she made excuses about her skin — blaming the redness on an allergic reaction, or a bad breakout — before finally opening up. They now try to go to bed at the same time, so that she doesn’t get sidetracked in front of the mirror. If he notices her picking, he doesn’t tell her to stop. Instead, he points out the behavior and asks what she’s feeling — an approach he learned when he spoke with her therapist. And he comments on nearly every one of her TikTok videos to support her.
Seeing her own unfiltered face on her feed can sometimes trigger more picking or bring up negative thoughts, Ms. Redzikowski acknowledged. But she feels compelled to keep posting anyway. “I can’t imagine if I had seen the content that I create when I was younger — how that would impact my life,” she said.
She recently noticed a comment on one of her videos from a familiar face: a model she had worked with a few years ago. Ms. Redzikowski recalled the model as having a flawless complexion. But she wrote beneath the video that she picked her skin, too. “I will pick my skin until it looks like I was stung by 1,000 wasps, then fully regret it,” she wrote.
Ms. Redzikowski replied, “You’re definitely not alone!!!”
If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.
Chloe W. Shakin is a social media editor for The Times, based in London.
The post She Kept Her Condition Secret for Decades, Then Bared It All Online. appeared first on New York Times.
