There’s something about how shopping mall changing rooms make me want to pick my skin. Maybe it’s because they’re smothered in the same acidic white light you sit under in hospital waiting rooms. It’s the same light that shines in your face inside airports, grocery stores and classrooms. Under this unflinching brightness every red scab, blackhead, hair and lump is brought into focus. Suddenly, the clothes I planned to try on don’t matter. Instead, I focus on squeezing every bit of dirt, fake tan, makeup and dust off my face until my face is raw and ruined.

This might sound extreme, but for those who share my headache of an experience living with Dermatillomania, you know what it’s like. Dermatillomania is a skin-picking disorder (SPD) that causes individuals to constantly pick at their skin until they’ve carved out very obvious flesh wounds.

This repeated urge to pick at one’s skin to the point where psychological or physical damage is done is suffered that much more by perfectionists who cannot bear the thought of dirt on their skin. Other times skin picking is used as a means to release the tension built up through impatience, frustration, dissatisfaction and boredom.

Even though just 2% – 3% of the population suffers from this compulsive act, it’s just as terrible as the more commonly known obsessive-compulsive disorder (OCD).

SPD is a very serious and sometimes deadly act that causes some to dig into their skin using needles and tweezers to the point where it has become disfiguring. In some cases, SPD can be life-threatening, as studies suggest it can lead to Septicaemia. This blood poisoning infection happens when bacterial infections in the body enter the bloodstream.

“You can create an open wound and increase your risk of infections,” says Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital. “Bacterial infections are most common, and they can lead to what is called an acute paronychia, where bacteria enters the skin [around the nail] causing a red, painful finger that may fill up with pus.”

Skin picking is used as a means to release the tension built up through impatience, frustration, dissatisfaction and boredom

There are several coping strategies, like wearing gloves, getting acrylic nails, or using varying forms of distractions. Still, it’s difficult to stop, especially for the majority who don’t even realize they are doing it.

“And after having the acrylic on for three weeks, I realized that I hadn’t picked at my fingers and my skin was actually growing back,” wrote Thatiana Diaz on Refinery29. “The almond shape and the length of my acrylic nails made it impossible to get a grip to pick at my skin.”

I’ve found ways to cover up my scabs, like carefully dotting on high coverage concealer. There I am staring back at myself, seeing this smoothed over pinky-beige uniform of a look on my face. Sometimes, I wonder what my face would look like if I had never picked at it.

Time becomes murky and slow when I’m subconsciously pulling at the skin on my arms or face. I’ll lean over the bathroom sink until my lower back aches and the whole toilet is filled with bloodied tissue paper. I can be in there for hours before I snap out of this daze, only to see my skin broken with scabs weeping from pores that no longer close. It makes me hate myself, but a few minutes pass until I get restless, and without knowing it I’m scratching at myself again.

When I scrape at my arms in public, I get embarrassed when people begin to stare. So, I start premeditating the responses I would have if they asked me to stop like, “My skin was just itchy,” or “I just have a scab from when I fell over.”

“I often locked the bathroom door and sought release from an anxious day at school, heartbreak, or college application stress by hacking at my skin with my fingers until it bled,” wrote Laura Dorwart on SELF.

I’ve come to realize that much of my skin picking is brought on by boredom. It’s during moments where I stare at my laptop, feeling brain dead from endless email responses that I turn to skin picking. I feel trapped, unable to escape the soft purple walls of my brain. Suddenly the urge to do something physical, to feel something happen under my fingertips which doesn’t include typing or tapping away at my phone, arises.

I could be double tapping my screen to ‘like’ photos on Instagram, or scrolling down, down, down through opinions I’m barely reading, but all I want to do is peel back the layers of my skin–literally.

While most skin picking disorders are not directly caused by social media, but rather by physical compulsions, the lack of representation of bad skin on platforms like Instagram heightens the disorder. I used to think I had bad skin, but I just made it that way. People never comment on the spread of blackheads on my nose or the white bulges on my chin, but they notice when I attempt to get rid of these flaws.

Studies linking Instagram to body dysmorphia are not new and are not shocking. Social media makes anyone susceptible to seeing flaws where they don’t exist and fuelling the desire to expunge them from their own body.

Whenever I come across photos of women, their smooth, glassy and poreless skin irks me. The perfect undulations of their cheekbones have made mirrors the enemy, especially for someone with SPD. Perpetually looking into images of filtered perfection makes me want to dig further into my skin to rid myself of these impurities. Somehow, achieving a hard ceramic casing of a robot has become the feminine ideal.

I’ve thought about stopping more times than I’ve picked at my own skin. But, stopping this repetitive notion means accepting that my skin will always be imperfect. It’s an idea which runs wholly counter to the logic of mainstream beauty culture which constantly tells us to invent and reinvent ways of solving the minutest issues. It’s an idea I’m not sure I’m ready to accept.

I want to be better, beautiful and have my act of self-improvement concretized on the back of a pore strip. To do that, I’d have to admit that there will never be skin without dirt, and accepting that I’ll never be perfect. It’s difficult to digest, so much that I can’t see myself detaching myself from my SPD. Not until I stop scrolling through Instagram, but that’s just another habit which is even harder to kick.

Annie Lord is a contributing writer to Perfect Mag, i-D, Dazed, Vice and this is her personal experience living with Dermatillomania