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I began picking at my face around puberty and the compulsion has only gotten worse since. It always starts with the feeling that I have to remove something from under my skin and then follows with an euphoric feeling if I succeed. Eventually I discovered that if I used a needle I could pick out the whole follicle of my armpit and pubic hairs and ever since I've been addicted to the feeling I get when I "surgically" remove the follicle and the fatty tissue attached at its base. I started picking with a needle when I was 16 and now have 11 years of scar tissue. What I didn't realize when I began, but I'm not sure if it would have dissuaded me anyways, was that once the follicle is removed, the hair does not grow back. Even though I initially tried to convince myself that the damage was only going to be temporary and the scabs would heal like they did on my face, eventually it became clear that I had done permanent and noticeable damage. There is almost no pubic hair on the front of my body and where each hair grew is now a small raised scar. I hate it. I know that there are many women who choose to shave their pubic hairs and if it weren't for the scars maybe I could pretend that was the case for me also. But I hate that self-mutilation has taken away my choice. I have no idea how to ever possibly explain what I've done to a potential partner and the feeling that I'm permanently damaged has kept me too ashamed to risk intimacy. Logically I know that I'm attractive; usually I can conceal what I do to my face and the people around me (aside from my therapist, psychiatrist, mother, and sister) will never know how broken I feel. I spent 3 + hours last night first picking with a needle at what I had convinced myself was an ingrown hair an inch below my belly button, and then I just kept going until I'd picked beneath the first two layers of skin and was pulling out the fatty tissue underneath. It left a centimeter sized hole and a large cavity underneath. Usually the picking gets painful enough to snap me out of it but there were too few nerves underneath the skin to shock me into stopping. I was terrified about what I was doing but so fixated on the rush I was getting that I kept going. This is worst I've ever done and the depth of the hole it left was horrible, and yet as scared as it made me, I can't stop from feeling disturbingly proud of myself. It was clearly going to need stitches but the last thing I wanted to do was try and explain myself to a doctor. I seriously considered attempting to stitch it closed myself. I had a therapy appointment that day to which I walked in shaking and my therapist convinced me to go to urgent care. I explained that I had a variation of OCD The doctor had no idea what I was talking about but seemed genuinely interested in trying to understand and concerned about the welfare of a person who would do this to themselves, without making me feel judged. In the end he needed to use dissolvable stitches underneath the skin to close the empty space left by the tissue I had removed and four regular stitches on the surface to close the wound. I didn't start out planning to write all of this. But I'm glad I did even if no one else ever reads it. I can breathe a little bit better and maybe feel a little less crazy.