As a young girl, Kettlewell discovered that the only way to find relief from overpowering feelings of self-consciousness and alienation was to physically harm herself. She has become the first person to tell her own story in a book about living with and overcoming the disorder known as cutting.

Caroline Kettlewell's autobiography reveals a girl whose feelings of pain and alienation led her to seek relief in physically hurting herself, from age twelve into her twenties. Skin Game employs clear language and candid reflection to grant general readers as well as students an uncensored profile of a complex and unsettling disorder. [This] mesmeric memoir examines the obsession with cutting that is believed to afflict somewhere around two million Americans, nearly all of them female, Francine Prose noted in Elle. [Kettlewell's] language soars and its intensity deepens whenever she is recalling the lost joys and the thrilling sensation of sharp steel against her tender skin.