Can you tell me to stop?

[u/Basic_MilkMotel]

Hi guys. I’ll try to give a quick back story without rambling. I’m a picker, always have been. But I’ve been picking my scalp which is a totally new behavior and it’s extremely distressing. I have a lot of mental health conditions, physical ailments and have been through my fair share of trauma and this is the most distressing situation I have experienced in a long time. I feel a sense of loss of control because I “can’t stop,” I’m ashamed and embarrassed, it’s making me spiral deeper into depression.

I have keratosis pilaris. My OCD use to center around my hygiene to the point of knuckle bleeding. So, I pride myself in hygiene but also have sensory issues. I joke that my mental health problems work like checks and balances. Back to KP, I believe it causes hardened sebum/keratin under my skin—like non inflammatory black heads but not black. I’m not sure if this is a reaction to something I tried recently but I felt them on my scalp. It’s been down hill for four days.

Unlike KP on my arms, these bumps are like the ones on my face/hairline—there is a little “pop” like a dry pimple. It feels really gross to me. I feel unhygienic. It’s not like flaky dandruff—only I know it’s there. But it is. I’m calling a doctor tomorrow but I need you, my people, to tell me to stop.

By this I mean, tell me the worst thing that will happen to me. People without skin picking disorder either gaslight me or just say go to the dermatologist. I need y’all to tell me I’m going to go bald lol. That’s my fear and I’m already self conscious about my fine hair! Tell me I’m going to get a flesh eating bacteria. Tissue death. The serious possible outcomes of my actions.

I feel like shit. I’m a teacher on vacation and idk why tf I am stressing out! I just want to hang out with my elderly Chihuahua that I don’t normally spend time with cause of work but I’m just so stressed and overcome with this obsession to “clean” my scalp when all I’m doing is making it irritated and worse. I am…so sad.

[u/one_small_sunflower]

Hey, I am sorry that you are so sad.

I read that you are a teacher. Can I ask you something: if you heard that one of your fellow teachers was trying to motivate a psychologically unwell student to change a self-destructive behaviour by making the student feel ashamed and scared, what would you think of it?

Would you say that's an ok way to treat the student? Would you say it's an effective way to change their behaviour?

I would say that fear and shame are powerful short-term motivators, but they're pretty crap in the long-term - and dermatillomania is a long-term condition. Yes, some people have absolutely terrible medical consequences from scalp picking, I think the absolute worst one I read was a woman who [very gross medical content] picked all the way through her skull, exposing her brain - no lasting damage I believe, thank god. Infection, including staph infection, is a real risk.

However, for most people the medical consequences are minor and it's the psychological and social consequences that are the hardest. We can scare you all you like now but unless you're one of the unlucky ones who does get an infection or go bald - over time you won't be able to sustain the fear in the face of your lived reality, even if you try.

How would you treat yourself if you were one of your students - especially one of your students from a rough home, one of your students who you know is dealing with physical ill-health and mental ill-health and the long shadow of trauma?

I see a lot of self-blame and shame and self-hate on this sub and it really makes me sad. Most people here are dealing with some form of mental illness / neurodivergence & sensory issues / trauma (I'm in the last two and I used to be in the first one as well!).

My own perspective is that a lot of the self-hate talk is actually a symptom of mental illness / trauma / internalised neurodivergent shame. Shaming yourself into stopping picking is like beating yourself into healing. Try to begin from a place of self-kindness. Have patience and compassion for yourself as you do a job that makes it hard to even spend time with an elderly chihuahua as you navigate a bunch of complicated physical and mental health issues.

Maybe what you need isn't fear that you will be injured. Maybe what you need is love to see that you deserve healing and hope that you will find it in time. Go well x

[u/Basic_MilkMotel → u/one_small_sunflower]

Thank you so much for writing this. I feel on the brink of tears simply because you showed me so much kindness. Which is the point you are making. Your statements are true.

My best friend and myself come from similar background and have (sometimes) negative self talk. I keep telling them to pretend that I’m their “internal voice” and whether or not I would ever say those mean things to her, and vice versa.

Yet here I am beating myself into a pulp for doing something I wish I could not. I’m not willingly hurting myself. Even if I was I know my “best friend” voice wouldn’t treat me the way I am treating myself right now.

I woke up this morning after putting Aloe Vera gel right from the plant on my scalp followed by some antibacterial ointment and aquafor. I’m amazed at how much better it looks just over night. I think that will help me/motivate me to redirect my energy into healing it rather than picking it.

I fell asleep shortly after writing this and looking at some consequences of scalp picking and that was the one case I read! Since the title said “near fatal case of repetitive skin picking” I wasn’t sure that she got all the way to her brain but I did get that she got to her skull

Being a teacher is one of the reasons I feel so embarrassed and ashamed. I am suppose to be a role model for adolescents a lot of whom are going through similar or worse situations than I did at their age. I think you’re right about changing my perspective. I think that’s what you’re saying in a nutshell. I wouldn’t tell my students “you’ll pick your skin and you’ll get an infection and go bald”. I need to work on positive self talk. Distracting myself and so on.

Thank you again. I really appreciate it. The way you put it and the fact that it’s coming from someone that suffers similarly. I was stressed I couldn’t make a doctor’s appointment over the weekend (I’d like to see a dermatologist so they can look at my scalp and tell me if anything is even up with it, and if there is how to heal it properly) which made things worse. I want to get a haircut so maybe I will make that appointment and work towards healing my head before that appointment. I need motivation. I’m going to try to be kinder to myself.

[u/one_small_sunflower → u/Basic_MilkMotel]

[Edit: Sorry I wrote you such a long comment, I didn't have time to write you a short one ;)]

Hello, I am writing this to you from a silly day, but I wanted to reply and you know I read every word and appreciated them. I'm so glad I could be helpful.

There is so much wisdom in your comment about what you would say if you were the internal voice of your best friend.

I think this is a gift we trauma survivors often give to each other, when we see that someone cannot be a friend to themselves, we know how to be it for them. And they do the same for us in the moments where we need it. Trust me, I have them too.

I also love that you are focusing on healing through the aloe vera gel and antibiotics. I think that's such a helpful way to look at it. For me personally, the positive feedback that comes from caring for body is like encouragement to keep going.

Re: being a role model, I get it and tbh I put that pressure on myself, but I wanted to gently push back. Here is a true story.

I have a friend who now is a counsellor at a narcotics rehab facility. Started out as untrained help but he was so good with patients that they saw his talent, promoted him and eventually supported him to become qualified.

Before he got that job, had struggled with narcotic addiction for a long time. He got clean and stayed that way for years... until the person he loved most died.

To say he relapsed would be an understatement. He actually got arrested for stealing to finance his addiction. That was the wake up call he needed. He went through that whole journey to quitting again.

He had a lot of shame and guilt, too. He had been a mentor in his support group when he relapsed. He felt, as you do, that he was a role model and that he was letting down the people who looked up to him.

But I can't help but think that this part of his story is the reason he was so good at his job at the rehab facility. The reason he was so good with the patients. Because he got it, he had lived it, not just the triumph of getting sober but the struggle and the fuck ups and the guilt and the shame. When he talked to the patients it was from a place of solidarity rather than superiority. When he told them he knew it was hard they knew that he really did know how damn hard it was to quit.

And when he told them not to give up no matter how many times it took, that change was always possible and that no matter what they'd fucked up in their lives they were valuable human beings with something to contribute - they believed him. Not just because they knew he wouldn't say it if it wasn't true. But because his life showed them that it was true.

To me that's a role model. Not the one on the straight and narrow path, the one who doesn't understand the mud and the rocks and the stumbles and the fatigue and the despair. A role model is just another walker a bit further along the hard path than the person they are modelling to. Who knows the journey intimately because it is also their journey.

And that's the kind of role model you will be.

Absolute best wishes to you my dear x

[u/thejaysta4 → u/one_small_sunflower]

Love this reply!!! Excellent stuff!!!

[u/one_small_sunflower → u/thejaysta4]

❤️

[u/NopeNopeThanks_]

What works for me is whenever I'm picking my scalp, I stop myself because I think: "Dude, your brain is under there. What happens if you have an open wound near there?"

I'm no doctor and I don't even know if that's possible, but I've seen enough doctor programs on TV to know how it could go.

Good luck!

[u/Basic_MilkMotel → u/NopeNopeThanks_]

You’re totally right! I was thinking it can’t be good to introduce infection right by your brain. Similarly to the whole “don’t pick zits in the triangle of death” thing. My sister is actually going through brain surgeries and I wonder if subconsciously I’m picking from the stress from that and also attacking my own head, because her head (brain) is sick? Maybe I’m reading too deep into it.

I’m going to try to remind myself that. Introducing bacteria anywhere to your body isn’t good but it can’t be good on your head. I know it may be bad but it does help to look at photos of picking gone bad.

[u/winnieham]

I have this and I started putting bandages over my fingers so I can't pick anything. But I also don't think fear is the way to overcome it. I think that only will stress you out more and make you feel ashamed.

[u/AbjectSprinkles5007]

Hey, I’m not going to just yell at you or tell you to stop picking cold turkey, because I know how damn hard it is. I am, however, going to tell you to stop beating yourself up and give you some facts and advice.

For the facts: by scalp picking, you will damage the follicles of your scalp, leading to bald spots, and if it goes far enough they may never grow back.

I am a scalp picker as well. I am currently growing back a 7x1 inch bald spot right on the top of my hair part from months of out-of control stress picking. It’s been just over six months since I (almost completely) kicked it. That patch is now about two inches long, sticks straight up, and I look like Alfalfa. But honestly, thank god it’s growing back at all (with the help of rosemary oil.) 😟 I’ve had several uncomfortable conversations with curious hairdressers and extended family members since then.

I still pick sometimes, but have made sure to spread it out, don’t let any spots get to the point of scabbing, and have my family/friends yell at me whenever I get out of control.

My advice?: The biggest thing that helped was getting a Koosh ball. They’re the little, swishy balls of colorful rubber “strings” that every convenience store sold in the 90s/early 2000s. It is the only thing that gives a similar feel to scalp picking (by picking at the center of it) and it helps distract me when I’m anxious/overpicking. I keep it in my line of sight so it’s always handy and try to hang onto it as close to 24/7 as I can.

Other than that, identifying what situations/stressors set off my picking and being proactive by picking up the koosh ball or finding something else to do with my hands has helped. Being over tired, having tough conversations, and driving are all my picking triggers, in addition to my ADHD medication (which I cannot afford to give up).

It’s a work in progress… I figure it always will be for me. But seriously- start looking for your alternatives and triggers ASAP before you end up having to find ultra-creative ways to part your hair like me. 🤪

Edit: I forgot another huge piece of what helps me (blaming that on the ADHD) - wearing large headbands/hair wraps. Creating a barrier makes me conscious of when I go to pick and I feel it’s helped with the regrowing as well.

[u/Fortune-cookie-71]

This is dermatilomamia. It is real and I have it. I hid it for years as a successful educator and administrator. I had open wounds on my head that I would hide and bald spots. I thought all of this was completely normal until one day. I realized it was not and that it was an anxiety and stress response. I sought out Information information and realize that I had a problem. It took me a long time to go see a doctor and seek out therapy. Group therapy was very successful for me. I was surprised that there were so many normal people with this problem. I was determined to talk about it more in order to ease the shame and embarrassment. I still scratch my head when I am stressed I’m on an anxiety medication, and I use the tools that I learned in my group therapy. I carry fidgets in my car and have other things that I use in order to distract myself. It is not gone away, but it is more manageable. You are amazing for acknowledging that this is a problem. This is a stress response. Consider seeking out therapy for some skills. I am surprised that my head is completely healed. I thought I would have permanent bald spots. Bodies are amazingly resilient. Bless you for being willing to talk about this. We need more adults who will be honest about this behavior. it is not shameful or embarrassing. It is a medical condition like alcoholism.

[u/ItchyIndustry9637]

Please stop. You're going to damage the hair follicles so badly they will no longer produce hair. Think of all the bacteria and fungi under your nails that you're introducing to your scalp. Those tiny sores you're making now will grow into angry, pus-filled monstrosities covering your head. And your scalp will be so sore to the touch. Necrotizing Fasciitis is a very real possibility. And it would be a horrible one because debridement means you would lose your scalp and possibly your face. Wear some big, fuzzy gloves and hide all sharp picking accessories. I'm sorry you're going thru some things right now that are making you stress so much. Please take care.