Wedding Woes

How to get help?

Dear Prudence,

About a year ago, my best friend told me that a towel of hers had caused microfibers to be buried deep in her skin and that she needed to remove them. I know from spending time at her house that she spends hours every day picking at her skin, using harsh chemicals, and cutting at her face with razors to get these microfibers out. I have never seen the fibers, and every time I see her, she tells me she’s almost done getting all of them out, but it continues.

It seems implausible to me that she would have fibers buried in her skin for over a year since she first noticed them. I did some cursory internet research, and it’s my understanding that there is a type of delusion that people get sometimes, where they think that they have worms or strings in their skin that need to be removed. I don’t want to discount her experience, but I am extremely concerned about her. Her face is covered with wounds all the time, and she is leaving the house less often because she doesn’t want to be seen. I encourage her to go to the dermatologist whenever she brings up the fibers, but she says that they can’t do as good a job as she can at removing the fibers. Is there anything else I can do to help her? I’m worried that if I push too hard, she’ll react very badly, and it’ll have the opposite effect of helping her.

Re: How to get help?

  • levioosalevioosa member
    Knottie Warrior 5000 Comments 500 Love Its 5 Answers
    This is literally one of the hardest delusions to treat. I've had patients with Delusional Parasitosis before and there is nothing you can do to convince them. They will bring in bags with "parasites" and the bag will be empty, they take pictures of their skin, and aside from the excoriation from picking nothing is there. They seek out horrible over the counter treatments and take pills from Feed Stores. It's horrible, sad, and frustrating for the patient and the provider. I had a patient try to run me over in the clinic parking lot once because they were upset I told them we could not send an empty bag to the lab (this was time #3). They get bounced around to infectious disease, dermatology, and it usually only reinforces the idea that they must have something exceptionally rare that no one else can find. LW can be supportive and suggest they speak to their doctor, but it may not lead any where. This is something where psychiatric medications are needed, and when people feel they are experiencing physical symptoms that are being ignored, they are much more resistant to starting those medications. 


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  • This sounds awful.  Thank you for the insight @levioosa
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