Ask Sam letter


To Sam

My hands.

Dear Sam,

I have dermatophagia, which includes me chewing, eating, peeling, and picking the skin all over my hands and palms.

They are very ugly and grotesque, in my opinion and in others I think, as they're sore and raw and painful. I consistently get asked what's wrong with me and what have I done to my hands, have I been in a fire accident? The questions go on.

I never admit to it because I'm ashamed, and I hate my hands a lot. I wish I could cover them up forever because they're so ugly in my eyes, and they look strange and disfigured to others.

How do I come to terms with embracing myself and how will I feel comfortable showing my hands around others, and being comfortable in my own skin for once?

Ask Sam


H there,

Mental and psychological health problems can often have physical effects too. Habits and urges are often temporary and happen when people are nervous or anxious, or are struggling with something in their life. For others it can be more long term and be part of a larger mental health problem. There is help and ways to cope for anyone who is struggling with compulsive habits.

Dermatophagia is an impulse-control disorder where a person is unable to stop themselves picking or chewing at their skin. Habits like this can become something people do without realising it - it can cause negative feelings, such as guilt, shame and embarrassment.

If someone has a habit or a compulsive behaviour, it can help to think about what the cause behind this could be. Try to think about the reasons that you are picking at your hands, and also what your feelings are at the time of doing this. Try to decide if you are consciously doing this to help cope with difficult thoughts, or is this something you do subconsciously without realising.

If there are times when you suddenly realise you are picking without even thinking, then it might have become an addiction and paying more attention to when it happens could help. Have a think about whether there is a particular time that you are more likely to do this habit and if there is a pattern to it. For some people there may not be any patterns and could be happening because of other mental health issues, like obsessive compulsive disorder (OCD).

Only a doctor or trained medical expert can diagnose mental health issues, so it’s important to talk to your doctor about it if you’d like to get some help.

Coming to terms with a condition like this is difficult and if we hear negative comments about our appearance, it can leave us feeling self-conscious and anxious. To be confident you’ll first need to accept yourself as you are and know that it’s okay to be you.

It might be a scary thought for you being honest about your dermatophagia, and unfortunately sometimes people can be judgemental. If people do ask question, you don't have to tell people personal information about yourself unless you feel comfortable with them knowing. It's up to you who you share it with. It's okay to let people know that this is something private, but it's also okay to tell people if you want to.

Self-acceptance is an ongoing process and sometimes it can take time for people to accept the things they might dislike about themselves. There are some things you can do to build your confidence. Try listing some things that you like about yourself. Once you start, you're more likely to notice all of the other positive things about who you are. If you start to feel more confident within yourself, you might start to less self-conscious about your hands - remember there is more to you as a person than this condition.

It takes a lot of courage to share your feelings and it is great that you have been able to write this.

Take care,


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