ZocdocAnswersI pick at my scalp. Could this be anxiety related?

Question

I pick at my scalp. Could this be anxiety related?

I've been picking at my scalp since I was younger. I'm now almost 25, and I still pick at my scalp. I can't control it, my hand just goes up to my head and I start feeling around for "bumps" on my head and start to pick and scratch. Sometimes, they bleed and it can be a little painful, and I've noticed these little red sores whenever I look at my scalp in the mirror. I sometimes do this for an hour or two a day, sometimes I don't even notice it, it just feels "natural" to me. Whenever I shampoo, my scalp burns terribly, but I've gotten used to that feeling now. Sometimes for months at a time, I would stop, but then I would just randomly start back up again. I feel really relaxed after I'm done with it, so could it be a way to cope with anxiety? I haven't told my doctor that I think I may have Depression or Anxiety, but I think this picking is compulsive. How do I approach this situation without causing more anxiety or embarrassment?

Answer

I would definitely suggest talking with your primary care doctor about this issue. The way you describe the issue - especially how you feel that you cannot "stop it" and that you feel less stressed after picking - would be consistent with an anxiety disorder or obsessive compulsive disorder. At the same time, I think it is important to make sure that there is no underlying skin problem on your scalp that might be driving you to pick, such as seborrheic dermatitis of the scalp. If there is underlying itching or inflammation of the scalp that is driving your picking, then this might be a treatable medical problem that could relieve the picking behavior. However, if this is ruled out, then it would be worth a formal evaluation by a psychiatrist. Some primary care doctors are also comfortable treating mild obsessive compulsive disorder, so my recommendation would still be to start there. Your doctor has your well being and your confidentiality as their first priority, so I do not think you need to feel worried or embarrassed to discuss this issue with them. Fortunately, if you end up being diagnosed with this condition, there are excellent counseling and therapy options, as well as medications that can be very effective.

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