Masterpost: Dermatillomania and Trichotillomania

More than half the letters I get from my readers ask me for help with stimming—be it redirecting unsafe stims, ideas for healthy stimming, or developing sensory coping skills. I’ve decided to create a series of masterposts to serve as a kind of FAQ for these common issues! I’ll be adding onto these continuously over time, and this is only the first, so if you have any ideas to contribute, or any sensory needs I haven’t addressed yet, please comment here or contact me!


Dermatillomania & Trichotillomania

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Compulsive skin picking and compulsive hair pulling, respectively. Dermatillomania can include picking at scabs, skin bumps, acne, cuticles, etc. Trichotillomania can include plucking or ripping the eyelashes, eyebrows, head hair, body hair, etc.

The majority of the emails I get from autistic adults asking for help are for one or both of these conditions, so I felt it was worth it to start with these two big baddies!

Redirections:

  • Apply liquid bandage, then peel it off
  • Wear a spinner ring or some other type of stim jewelry
  • Carry around a stim toy to fidget with
  • Stitch, knit, or crochet (and carry your tools around everywhere)
  • Carry a nail file to smooth rough patches on your nails to keep your hands busy
  • Carry playdoh and rip it up into tiny shreds
  • Stretch silly putty
  • Rip paper or tissues into small pieces
  • Weave bracelets (Remember “friendship bracelets”? Great way to keep hands busy!)
  • Wear nail polish, and pick it off.

Barriers:

  • Wear gloves
  • Wear fake nails (can make it harder to pick/pull, but mostly helps to remind you not to)
  • Wear a hat or headscarf if you pick/pull at your scalp/hair (wear a sleep cap if you do it in your sleep!)
  • Apply lotion to problem pick areas regularly throughout the day (makes it harder to pick, and helps remove the rough areas that trigger picking; personally I recommend something like shea butter that won’t irritate even in large amounts)
  • Cover your fingertips with bandaids or medical tape

The “Competing Response” Method

  • Squeeze your fists for 60 seconds
  • Press down on your fingernails and squeeze your fingertips
  • Practice diaphragmatic (deep belly) breathing (breathe in and out for equal amounts of time to slow and even out your heart rate)
  • Completely wet your hair
  • Wash your hair (do a deep conditioning treatment that has to sit under a shower cap for a long time!)
  • Brush your hair instead of pulling it
  • Paint your nails
  • Stim with soft or weird textures
  • Pet an animal
  • Chew gum
  • Other miscellaneous stims: hold ice cubes, listen to loud music, hang upside down off your bed and wiggle around, punch a pillow.

The “Reducing Anxiety” Method

  • Practice deep breathing exercises
  • Meditate (I recommend the Headspace app for iOS)
  • Practice mindfulness (google “CBT mindfulness” and “DBT mindfulness” for ideas)
  • Practice grounding exercises
  • Take a shower or bath
  • Write about your feelings
  • Every time you want to pick/pull/bite/etc, write it down and put it in a jar. Imagine that intrusive thought being sealed in that jar.
  • Avoid caffeine after 12pm.
  • Go for a walk. Or at least stand outside and try a mindfulnes exercise (what are 5 things you see? 4 things you hear? 3 things you can touch? 2 things you can smell? 1 thing you taste?)
  • Distract yourself with your favorite TV show, video game, Disney movie, etc.

Community and Support

  • Join a support group
  • Check out the Derm/Trich tumblr community
  • Check out the Derm/Trich reddit community
  • Find a therapist
  • Google your issue and try to find any other communities
  • Help other people; reach out to anyone struggling on derm/trich forums, write your own blog
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8 thoughts on “Masterpost: Dermatillomania and Trichotillomania

  1. Best thing I ever found is Next Gen nails applied at a Salon. I have to get the earliest appointment because later in the day, the salon may have people asking for acrylics and I get headaches if I smell that. But the Next Gen doesn’t smell much and I have the lady put lots of layers and leave the tips very thick. I explained that it helps me if they are thick so I can’t use them to pick. Plus she nips off any snaggy cuticles and then puts oil to keep them from drying out. Then I also carry a nail kit to immediately smooth any rough places if they occur, and lotion. I finally don’t have bandaids on every finger!

    Like

  2. My son chews his fingers in his sleep – he’s 15 he won’t wear gloves to sleep and i can’t get tape or posters to stay on his fingers. Any ideas?

    Like

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