Tom, 26

Honestly I think it started around fifteen or sixteen, spots and the inevitable picking at them, but it got significantly worse at university. The combination of stress, long hours alone at a computer, and no external structure was basically a perfect picking environment. I remember my first year in halls, there was a specific desk lamp that I'd adjust to illuminate my face in the laptop screen and I'd pick while I was supposed to be studying. That became a regular thing very quickly.

I was diagnosed with ADHD at twenty-four, which was two years ago. That reframed a lot. I'd always thought the picking was just a stress response, and stress was involved, but the ADHD dimension - the impulsivity, the seeking of stimulation, the difficulty sitting with discomfort without doing something to displace it - explained a lot of what I'd experienced as "just being bad at self-control."

For me it's very tied to being stuck. If I'm coding something and it isn't working, or if I'm procrastinating on starting something, my hands go to my face. It's like the frustration or the restlessness needs somewhere to go and picking is what's available. There's a tactile element - I'm looking for something to work at. Found it, working at it, making progress. It creates a false sense of task completion when the actual task isn't moving.

Remote work made this much worse. In the office there are people around, you're visible, you don't sit picking your face at your desk for three hours. At home alone there's nothing to interrupt it. Working from home is genuinely a risk factor that I don't think gets discussed enough in this context. The privacy that makes home comfortable for a lot of people makes it a picking trap for me.

Aftermath: I look at my face, I feel the familiar mix of shame and annoyance, and I've also usually not finished the work I was supposed to be doing. There's a practical failure alongside the skin damage. I find that specific combination particularly demoralising.

Being a guy with this. I found the dermatillomania community on Reddit about a year ago and most of the people posting were women. Which makes sense given the statistics, but it also created a bit of a "is this really what I have" moment, which is daft in retrospect. The content of what everyone was describing was exactly my experience - the episode structure, the shame, the failed attempts to stop - but the gender coding of the community made me hesitate.

I haven't told any of my friends. I've told one colleague, a woman, who actually mentioned she had something similar, which is how we got onto the topic. That conversation was a relief. But with my male friends I genuinely don't know how to bring it up. Skin picking isn't part of any vocabulary I've seen men use to talk about mental health stuff. I'd have to introduce the concept and the condition simultaneously and that feels like a lot.

Video calls. I've avoided having my camera on during work meetings on bad skin days. Which is a specific remote-work version of this problem that I don't think would have been relevant a decade ago. The default is cameras on at my company and I've made up technical reasons for mine being off more than once. That's embarrassing to admit.

I also wear a beard partly as cover. I'm not going to pretend that's the whole reason I have it, but it's a factor. A beard covers a lot of the area I pick most. That's a practical adaptation I made without ever acknowledging to myself that I was making it.

Not huge amounts of obvious avoidance otherwise. I'm young enough that the pattern hasn't calcified in the way it might after twenty years of this. But I'm also aware enough to know that if I don't address it properly now, I'll be James in fifteen years - carrying it invisibly and not talking about it and avoiding the swimming pool.

The ADHD diagnosis, and finding the overlap between ADHD and BFRBs in the literature. I found that the two things co-occur a lot - people with ADHD are much more likely to have something like this. And once I read that, it made immediate sense. The restlessness, the need for something to do with your hands when your brain isn't settled, the way you'll take any available input over sitting with discomfort - that's the ADHD piece, and picking fits straight into it. Reading that felt like someone had finally given me an accurate map.

Also finding the Reddit community, even though it felt slightly misaligned at first. Reading other people's descriptions of episodes that matched mine almost exactly - the getting lost in it, the coming back and realising how long you'd been doing it, the gap between intention and action - made me feel significantly less like an aberration.

I'm approaching it primarily through the ADHD lens, which means working on the underlying restlessness rather than just the picking in isolation. Medication has helped - not as a direct treatment for picking but because it reduces the restlessness and the difficulty sitting with discomfort that drives a lot of my episodes. That surprised me.

Environmental changes at home have been significant. I reorganised my desk so I'm not facing a reflective surface. I set a rule that I don't touch my face during work hours - which sounds simple and is not simple, but having it as a clear stated rule makes violation slightly more noticeable than just drifting into it. I keep a small ball at my desk to give my hands an alternative.

I'm working on the camera-off thing. I've been gradually using it more. Nobody has ever commented on my skin in a meeting, which shouldn't be surprising but is. The self-focus is much more intense than other people's attention. That's a cognitive distortion I'm actively working against.

If you have ADHD or suspect you might, look at the overlap. BFRBs and ADHD co-occur at higher rates than chance, and the ADHD dimension changes which interventions make most sense. Treating the impulsivity is relevant to treating the picking. Getting an ADHD assessment might be worth it if you haven't had one.

If you're a man who's found this and feels like it's a condition for other people: it isn't. The fact that the community is predominantly women reflects help-seeking patterns more than actual prevalence. Men have this. Men carry it silently. You don't have to be the first man to have it, and you don't have to be the last one to keep it secret. The community exists and you're not as out of place in it as you might feel at first.

And if you work from home: take the remote work picking trap seriously. Structure and visibility aren't just good for productivity. They're actually a useful environmental intervention for this. Consider working somewhere with other people some of the time. Not as a fix, but as a meaningful reduction in opportunity that accumulates over weeks and months.