Obsessive Scalp Scab Picking

[sarahgugels]

I wasn't sure where this would fit in. Lately I have found myself obsessively picking scabs on my scalp. I do it when I am bored and even in situations when I am not aware. It is driving everyone around me CRAZY. I act like I can stop but I am not sure how. I won't even give the scabs time to heal. My mother said she used to have this condition when she was younger but grew out of it. I was just wondering if there is anyone else out there like me? If so, what did you do to stop picking? Please let me know...I am DESPERATE!

Added:

I have noticed since I posted there have been no replies. I wasn't sure if this was because no one can relate or if people think it is a joke. It isn't a joke. I am seriously looking for some suggestions. If you can help, please let me know. Thanks so much!

 

[Daniel E.]

While you wait for others to respond...

From what I have read online, a fancy term for this compulsive behavior may be "dermatillomania," more commonly referred to as "compulsive skin picking." Antidepressants (SSRIs) are used to help treat the disorder. I would think that therapy would help too, maybe even more so since cognitive behavioral therapy is often more helpful for compulsive behaviors than medication. The ideal with OCD, at least, is therapy with meds.

 

[sarahgugels]

Thank you for replying. I actually do take an anti-depressant. I take Effexor XR and have for some time now. But I understand that it would be good to unlearn this behavior through a change in thought patterns.

 

[Daniel E.]

Along with therapy, keeping a journal that includes each occurrence may help:

Case studies, open trials and small double-blind studies have demonstrated the efficacy of selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors in psychogenic excoriation...

Treatments found to be effective in case reports include a behavioural technique called 'habit reversal'; a multicomponent programme consisting of self-monitoring, recording of episodes of scratching, and procedures that produce alternative responses to scratching; and an 'eclectic' psychotherapy programme with insight-oriented and behavioural components.

Psychogenic excoriation. Clinical features, proposed diagnostic criteria, epidemiology and approaches to treatment (2001)

Maybe keeping the hands busy by writing, drawing, or using a stress ball may help a little since this seems to help some people with nail-biting and hair pulling:

Try substituting another activity, such as drawing or writing or squeezing a stress ball or silly putty, when you find yourself biting your nails. If you keep a record of nail-biting, you will become more aware of the times when you bite your nails and be able to stop the habit.

Nail-Biting - Yahoo Health

Also, the standard treatment of compulsive hair pulling (trichotillomania) seems very similar to that of compulsive skin pulling:

Treatment of trichotillomania usually involves a combination of:

- Antidepressants
- Behavior therapy, using a treatment called habit reversal

Hair-pulling disorder (trichotillomania) - MayoClinic.com

 

[Daniel E.]

Some info on "habit reversal therapy":

Many people believe that if they stop one bad habit it will be replaced with another bad habit. However, one of the key ideas of habit reversal is to replace the harmful habit with another harmless habit that makes the bad habit impossible. This new behaviour is known as a competing response.

A suitable competing response for skin-picking might be clenching one's fist, as this is incompatible with skin-picking. Another important part of habit reversal training is practising a suitable method of relaxation such as meditation, abdominal breathing or progressive muscle relaxation.

excerpted from Habit Reversal Therapy (HRT) - OCD Action

BTW, I would think using a stress ball would be less boring than clenching one's fist.

 

[David Baxter PhD]

I don't think anyone was ignoring you intentionally. Sarah, and I certainly don't think it was interpreted as a joke -- I for one simply missed it, probably because there were a lot of new threads that day.

Generally, this sort of behavior is associated with some sort of anxiety disorder. You indicate that you have been taking Effexor XR for some time -- how long and what dose?

Also, are you seeing a psychologist or other therapist as well?

 

[sarahgugels]

I have been taking Effexor for about 5 years now. I take 150 mg a day. I really think I do it because of stress. I find myself doing it when I am bored or have nothing to do. I went to a site about it and it described me perfect. It is hard to explain to someone who is an outsider because they think you are consciously doing it when in turn it is really unconscious. I also didn't mean to sound mean when no one replied to my post. I just noticed so many views and wondered why no one said anything. Oh, I am not seeing a psychologist. As a college student, I have access to a psychologist during the school year and saw her a couple times my freshman year.

 

[David Baxter PhD]

The medication will help to reduce your physiological and psychological response to stress and anxiety... however, it won't necessarily give you other ways of coping. That's where a psychologist could be helpful.

 

[Daniel E.]

It is hard to explain to someone who is an outsider because they think you are consciously doing it when in turn it is really unconscious.

That is also the case with trichotillomania:

"Trichotillomania isn't an intentional or voluntary behavior."

Hair-pulling disorder (trichotillomania) - MayoClinic.com

I think it is also sometimes the case with biting on pens, pencils, nails, etc. I don't consciously start biting on a pen. I just notice myself doing it after I already started, which is when I will usually put the pen away. (This is why I don't keep pens lying on my desk.)

 

[HA]

Welcome Sarah,

Something else to consider is your hair care routine and products. I have had a few small pimples that are itchy and very hard not to touch when using certain products. These products are used to give you a more smooth looking hair if your hair tends to be frizzy from dryness or the curly hair type.

They have more "oil" ingredients in them. One example is the Pantene shampoo to give you "smooth" hair. Another is the "KmS SILKER, style and condition in one step" which is applied on clean wet hair and again is meant to help with dry hair. These oil products may stimulate the subaceous glands (oil producing gland) or block the hair shaft resulting in pimples which will be itchy and do crust over.

Maybe your hair is naturally oily and could also contribute to itching, scratching and picking crusted areas.

Have you tried washing your hair once per day with a shampoo thats suitable to your hair type and not an oily product?

 

[David Baxter PhD]

That's a possibility, too... I am allergic to various perfumes so as much as possible I use unscented altermnatives -- with shampoos, I find that I'm okay if I stick to "dandruff" shampoos, not because I have dandruff but because anything else tends to irritate my scalp.

 

[HA]

Allergies are another possibility. I had an ithcy exzema like rask on the backs of my knees and legs at one time. I was dealing with this for a couple of years and thought I had to learn to live with it when a nurse had mentioned trying a different laundry detergent. Within a couple of weeks the rash disappeared so I now only use the one laundry detergent.

Anything thats itchy or irritating is hard not to scratch or pick at.

 

[just mary]

Welcome Sarah,

Just to let you know, I find myself doing the same thing, I always have and I have tended to assume that everyone else does it too. But apparently not. I have always picked scabs, pimples, whatever. I noticed my Dad does it too, I've watched him do it during conversations with other people and it's quite noticeable. Is this behaviour hard coded? Or is it something we learn from watching others?

Anyway, I know I'm not offering advice, probably just raising more questions. But I think I know how you feel and you're definitely not alone in your habit. And I wish you all the best.

Btw, thanks to Daniel for his suggestions, I'm definitely going to try some of them.

And HeartArt, thanks for the tips on the shampoos, I had no idea but they make sense. I've been using Pantene Smooth and Sleek for the last year or so and I've been getting these little pimples on my scalp, someone told me it was just old age but you're information makes much more sense.

Take care.

 

[David Baxter PhD]

Try switching to Head and Shoulders and see if that helps, Mary...

 

[Daniel E.]

For dermatological scalp problems, I personally recommened Neutrogena T-Gel or its cheaper, generic equivalent sold at Walmart. Neutrogena T-Gel treats a variety of scalp problems, including dandruff, very effectively. BTW, some dog shampoos for dermatitis include the same active ingredient as T-Gel (coal tar).

 

[David Baxter PhD]

I wonder if that's available in Canada... I must look. I used to use another coal-tar product and it was the best but I can't find anyone who sells it around here any more.

 

[ThatLady]

Ish. I missed this post entirely. You say you're picking at "scabs" on your scalp. I'm wondering why you have "scabs" on your scalp in the first place. Are they from scratching your scalp, or do they just appear?

It sounds to me like you might have some dermatological condition that's causing the problem. Picking at the scabs is a separate issue. I'd see a dermatologist to determine what's causing the breakout on your scalp, then go from there.

 

[Daniel E.]

ThatLady's suggestion of seeing a dermatologist to examine your scalp seems to be the most logical thing to do at this point. If you continue to have problems with the picking, I read elsewhere that wearing articificial nails or gloves can help mitigate the effects of picking.

 

[krcaddis]

Picking at scabs

I don't know if you've had any success yet, but I'm also looking for a solution. I, too, compulsively pick at scabs in my scalp. And I take prescribed anti-depressents, Wellbutrin XR(300mg) and Lexapro in combination. This combination finially works after many of the usual drugs and only short term or no apparent effect.

I don't consider myself under stress although my picking may had become my habit during a period of my life when I was under significant stress at work.

My MD suggested a keeping a rubber band on one wrist and snapping it every time I catch myself scratching. I tried it for a few days but it didn't help - I couldn't remember to snap it usually.

A baseball cap helps in some instances as it reminds me every time I touch it. Unfortunately it is not appropriate to wear where I work. IT only means I scratch fewer times however and the result is the same.

I have also applied a triple antibiotic a couplr times a day and that seems to promote healing but doesn't stop the behaviour. A hair salon recommended applying a little olive oil - and perhaps any sterile oil that softened the scabs might take away "the reward" that I must get from the behaviour. Now it's getting into psycology and OCB treatment as seems to be the jist of the recomendations from others.

My cousin, who does not share the compulsion, got a serious staph infection from scratching a small skin injury on his scalp that required an emergency room visit and some serious medications. He said it was apprently life threatening and developed in a very short period - hours as I recall.

I'd appreeciate an effective cure if anyone hase one. (This is my first "hit" on my internet search.)

 

[HA]

Welcome krcaddis!

Other people may offer some suggestions but I think that the link that Daniel provided about Habit Reversal Training when combined with a therapist to help this would be your next best step.

I can imagine the risk for infection on the scalp would be there to. Wonder if the oils from the hair would increase that risk compared to other skin areas?

Neutrogena hair and skin products are the best on the market outside of dermatologist presciptions. They are available in any drug store and don't use perfumes or other products so agree with sensitive or allergic skin types. They are more expensive then your regular brands but far less expensive and better than your commercial high end products.

Let us know how things work out for you because it can help others who are struggling with this too.