I have dermatillomania. I have been searching the internet for a few years seeking a support group - and am glad I finally have....
I have thought a lot about why I do this, and I have come up with a few things that I believe are related to this behaviour.
When I was very small, my father would allow me to "play with him" by brushing his hair, or, by removing any pimples on his face or shoulders. I know this may seem a little strange, but, I have seen primates engaged in very similar rituals that seem to bond them-and I have often heard from friends that they too, ritually "pick at" their boyfriends pimples/blackheads.
I know that to some extent, pretty much everyone who gets pimples and blemishes picks at the odd one.
When I was 12, my very devoted mother, in a move that stunned everyone, walked out on us and into the home of one of our neighbors. (They're still married, all these years later).
Interestingly, both my mother and father promptly went bonkers. My father was abusive, neglected us, was extremely immature about the whole thing, became paranoid, a germaphobe, and overall - just extremely bizarre.
My mom became suicidal. I witnessed long, violent tirade of behaviour, and she had long stays in the hospital.
I could also mention at this point that ever prior to this, being a smart but shy child, I was severely bullied by my older sister and I was severely bullied in school, and had few friends.
After the divorce, I was subjected to ongoing, severe psychological and emotional (sometimes physical) abuse from not one - but all three of my parents. My new stepfather delighted in degrading my in any conceivable manner, from calling me fat, ugly, pimpleface to inviting me into the violent fights he would have with my mother, forcing me to "mediate".
When I was 14, my parents told me I would be "better off" with my 17 year old sister. A perfect student who had never been in trouble, I left as requested.
My obsessive skin picking began when I started to get pimples around the age of 12. To this day, over 20 years later, I continue to pick at every fragment of skin, pimple, possible pimple, and blemish - to the point where I will employe a pin if necessary. I have to wear heavy makeup due to the scarring and constant presence of flaky scabs.
I cannot even stop myself from doing it in my office - when I am lost deep in thought at my desk, I'll unconciously seek a scab with my fingernail, and start to pick. My goal is to pick it off and make it disappear. It takes months, sometimes, because I won't leave it alone.
I have some sense of why I do it - the calm daze that comes over me, the weird gratification I get from popping a pimple, the urge to smooth out every surface of skin...I just feel that this behaviour is so ingrained, that I cannot stop it. It's as habitual as breathing.
FYI - I am an attractive, intelligent women in my mid thirties. I do suffer bouts of depression sometimes, and in particular, I am extremely sensitive to stress. I have also had a few bouts with bulimia.
I hope someone reading this recognizes some of themselves, and is not shy about saying hello. I am ready to at least try to understand this behaviour that is really interfering with my life.