Compulsive Scalp Picking

[Christi797]

I am 28 years old and have picked scabs on my scalp since I was about 12 years old.  Normally I find little imperfections, possibly dandruff or dry scalp, and I pick at it until it becomes a scab.  Once a scab develops, I find myself uncontrollably picking at it, so it usually never heals or takes an extremely long time or another scab to develop to stop.  Right now, I have a total of six scabs that I have created on my scalp.  When I am picking I can't necessarily say that it relieves stress like I have found on some of the other web sites, but more of an obsession that I can't control.  I have been treated for depression and PTSD, but have never mentioned my compulsive picking.  I have been prescribed both Zoloft and Prozac with Klonopin for the symptoms of anxiety and depression, but I still seem to pick at me head.  The kicker is that I also do this in my sleep.  I will literally wake up with blood under my nails.  What treatment options are there other than medication?  Should I tell my primary care physician or should I talk to a psychiatrist?  What are some of the causes of this, could it be OCD?  I don't really have any sort of rituals like you see or read about or extreme fears, but I can not seem to stop picking at my scalp, and although I am not pulling at my hair, I am noticing hair loss.  Any feedback would be appreciated.

[DumbHick]

I just want to mention that is an OCD related behavior. Many folks that have your condition are diagnosed with OCD as well. You should mention it to a psychiatrist if you're not already seeing one.

[Mark1988]

Definately speak to your psychiatrist. A psychologist would help you overcome your constant picking by getting to the route cause of the problem, why did you start doing it? when was it and what happened around the time you first did it? Questions like this would be asked and it's possible you do it as a coping mechanism of some kind. It could be an OCD or it could be described as a simple habit. We're all creatures of habit, drawn towards the comfort of the familiar, it may be the fact that if you found picking your scalp as a coping mechanism in the past then you may have just learnt to do it as you know it relieves you of stress or any imbalance of emotion. There could be some underlying cognitive or behavioral faults that could be sorted by a psychologist that could break the habit. Like you said, it may not relieve stress but it may be as a result of the stressor and this is how your mind attempts to cope with it.

[aggie68]

Hi, My daughter was just diagnosed with trichotillomania.  an impulse disorder in which she pulls her hair out.  In my research, skin picking is in the same catagory.  The treatment for this type of disorder is therapy and medications such as Zoloft and Klonopin.  These disorders are closely related to OCD. Good luck to you.

[DizzyDolly]

Scientific evidence has supposedly found that OCD is a result of a chemical imbalance. Thus medication is usually prescribed to help with the compulsive side, whilst therapy, usually cognative behavioural therapy is used in combination with this to treat the obsession/reason for your compulsion. Prozac can be used to treat OCD, but usually needs to be at a much higher dose before it can take effect. I was told by my doctor 20ml for depression and 60ml for OCD, but it will vary depending upon patient. It's best for you to talk to your doctor about this compulsion, so they can start you on the best treatment option for you, Its very unlikely your doctor will judge you, but if you don't get on with your doctor, I'd go see another one. A doctor that judges you shouldn't be a doctor at all.

[littlemarla]

I am 51 years old and have the same problem as you.  I find it relieves my anxiety and stress level.  It is very strange that something that hurts me also makes me feel better.  I take prozac and a low dose of xanax, but it isn't helping much.  My head it covered with scabs.  I hope you and I find an answer to our problem.  There are many people with this problem.  We are not alone.  God bless and good luck.

[DizzyDolly]

I was searching online the other day about scalp problems cos my scalp looks white and there arn't flakes, but seems like build up. It sounds like you may have scalp problems/build up too. It seems like in picking the build up, you are causing your scalp to bleed. One way you could break the picking is to remove anything there to pick. Have you tried a tar/medicated shampoo? You can find them on shelf and they're used to things like scalp periosis (spelling?) serbaceous dermatitis and dandruff. It wont get rid of the scabs you keep picking, but it may help with the imperfections you refer to.

[brooke1968]

i have had this problem for a year. I thought I had scalp problelms.  I realize that I have created it my self. I can't stop.I hate it. My scalp hurts
so bad. I cant stand if someone touches my head. I dont know what to do. it sounds like a freak telling someone that you can't stop picking. But, I think after I pick I do feel better.

[bp819]

Your description sounds exactly like my scalp picking problem. I am 26 years old but I only started this 3 years ago. To be honest, I can't recall how this all started. it's as if I'm trying to clean/smoothen my scalp from dandruff/scabs with my nails..but it just creates more. I'm embarrased to go to the salon because of the scattered bald patches and newly formed scabs. How do I explain if asked what the scabs are from???

But i understand the frustration and embarassment of it all. My family can't stand it because they think it looks disgusting, which adds to the guilt of the behavior. They don't understand and say "Just stop" but that's easier said than done.  I was diagnosed 4 years ago with severe depression, Bipolar II and PTSD, although I've been suffering from the 3 with symptoms since I was 16 but did not get help until later.

When I told my doctor about my compulsive scalp picking, first she said to "cut my nails" but that does not help. Or wear mittens and a beanie =).....but that does not solve the underlying cause of the behavior itself. It's under "trictillomania" which is compulsive hair pulling even though I don't directly sit there and pull my hair out. The deep picking/bleeding/scab cycle eventually results in a small bald spot.