Marcus, 45

I was about fifteen. I had dandruff and I'd scratch at my scalp. That's how it started, practically, as a response to something real. But it kept going long after the dandruff was sorted. By the time I was in my twenties it was just part of what I did. Watching the telly, driving, sitting in a meeting. My hand would go to my head and I'd be at it.

I didn't think of it as a problem exactly. More like a tic. An annoying one, because it made a mess, because my wife would notice and pull a face, because I'd sometimes make the scalp sore. But not a problem in the sense of something to address. It was just me being restless. I'm a restless person. I always have been.

There isn't much of an urge that I'd recognise. It just happens. I'll be thinking about something, or not thinking about anything in particular, and I'll become aware that my fingers are in my hair, working at a rough patch on my scalp. I often don't know how long it's been going on. There's no trigger I notice. It's more like a background process that runs without me logging in.

The scalp is something I can mostly do without anyone seeing, which I think is part of why it's been so invisible to me. If I picked my face it would be more obvious. But a hand in the hair looks like you're just running a hand through your hair. I can pick at work, in the car, watching the kids' football. It doesn't look like what it is. That invisibility meant I never had a reason to look at it properly.

I had a bad patch last year where I'd picked a spot on my scalp that kept getting infected. That was what took me to the GP. Not thirty years of this being a problem, but one infected site that wouldn't clear up. That's how I found out what it was.

That it's not just a nervous habit I could stop if I tried hard enough. My wife has said versions of that over the years, not unkindly, just as a reasonable person's reaction to watching someone do the same thing over and over. "Just don't." And I've said "I know, I will," and then carried on doing it. She's not wrong that it looks like something you could just not do. From the outside that's what it looks like.

I've found it genuinely hard to talk about this. I work in a trade, I'm around men all day, and the kind of conversation where you say "I have a mental health condition that involves compulsively picking my scalp" doesn't have a natural home in my working life. I'm not complaining about that. It's just a fact about my context. The information is in my head and I haven't put it anywhere else yet.

Less than some people, I think. The scalp means it's hidden most of the time. I haven't avoided swimming or beach things or anything like that. What I've avoided is having the conversation, which is its own kind of isolation. My wife knows something is wrong with my scalp but she doesn't know the full picture. My GP knows now, because of the infection visit, and that was actually a relief, to say it to someone medical who treated it as a medical thing and not as evidence of some personal failure.

The impact on my wife has been something I've not wanted to look at directly. Years of me scratching at my head on the sofa next to her, of her making a face and me saying sorry, of it not changing. I don't think she's connected it to anything diagnosable. I probably should tell her. I'm getting there.

The GP appointment. She looked at my scalp, said it looked like it had been picked repeatedly over a long period, and asked if I knew about excoriation disorder. I said no. She explained it briefly, mentioned there were specific treatments, gave me a leaflet. And that was it. Fifteen minutes. Thirty years of something, and fifteen minutes in a surgery changed how I understood it entirely.

I went home and read the leaflet properly, then read more online. Found that it was a recognised condition, that it had specific features I recognised in myself, that there were people in communities talking about exactly what I'd experienced. The main feeling was that I'd been carrying a very heavy object for a very long time and someone had finally told me what it was. Not taken it away from me. Just told me what it was. That mattered more than I expected.

Practical. I'm a practical person. I've been trying to approach this practically. What I've done so far: I keep a small comb in my pocket now, because running a comb through my hair when the urge comes gives my hands something to do in the same location. It interrupts enough episodes that it matters. I've started keeping my nails shorter, which reduces the damage in the episodes that do happen.

I've told one person other than the GP - my brother, who I'm close to. I told him about it in a fairly matter-of-fact way, same way I'd tell him about a physical health thing. He took it the same way. Asked a couple of questions, said fair enough, moved on. That was the right conversation to have first. I'm going to tell my wife next, probably soon. I've been working out how to say it.

I'm aware this is all very early days. I haven't actually reduced the picking very much yet. But I understand what I'm dealing with now, which I didn't before. That feels like a prerequisite for anything else.

Go to a GP if you haven't. I found out by accident through a medical appointment, which is a roundabout way to get there, but the point is that going to a GP with this is legitimate. It is a medical thing. You don't have to wait until something gets infected. You can just go and say "I pick at my skin and I can't stop and I'd like some help with it." That is a completely valid thing to bring to a doctor.

Tell one person. It doesn't have to be everyone. It doesn't have to be your partner first if that's too daunting. Tell someone you trust with the practical facts of your life. For me that was my brother. That one conversation took something that had been entirely inside my head and put it somewhere slightly outside, and that changed how it felt to carry it.

And if you're a man who's never seen this talked about in a context that felt relevant to you: the condition doesn't care what gender you are. I know it's mostly discussed in ways that seem to be aimed at women. But this has been part of my life for thirty years. It's real and it's mine and I'm dealing with it now. Better late than not at all.