A woman looks up with concern at her hand, which is poised over her scalp.

Scalp Picking: Bad Habit or Disorder?

The top of your head, under your hair, can be one of the trickiest places to have skin cancer, pre-cancer, or patches of flaky skin that you can’t identify. With most other areas of your skin, you can take a photo, or have someone take a photo, and email to the dermatologist or post on Patient Gateway or another portal. Then you can at least get input on what it might be.

Is this spot on my scalp skin cancer?

So, what about something you feel has to wait for an appointment or be addressed in a phone call. My next appointment is only a few weeks away. It’s a good chance to show my dermatologist an area of my scalp where I feel something. But nooooooo...I just couldn’t leave it alone and investigated it on my own. Would it dislodge? Sorry if this is gross, but I stuck my fingernail under it and nudged it. I lifted a little piece of it off and pulled it out through my hair. As soon as I did it, it started to hurt. I was sorry I did it. I tried to apply Vaseline. But obviously, that is hard to do through your hair.

My doctor said that some of these are seborrheic dermatitis of the scalp. She prescribed ketoconazole shampoo. The shampoo was OK on my hair, but it didn’t calm the areas down enough. I wonder if I need to use it more consistently.

The issue with scalp picking

Picking can cause an infection and will not actually make a spot go away. It will just form a scab that can be a target again. I picked absentmindedly while stressing over the vote-counting in the Presidential election. I know other, more productive ways to relieve stress, but I did it before I even realized it. In searching the internet for a product that might help, I learned something: Scalp picking is a subcategory of skin picking disorder (excoriation disorder).1

Trudi Griffin, a psychotherapist, writes that determining the difference between a bad habit and a disorder depends on whether:1

  1. Picking results in repeated injury
  2. Attempts to stop failed multiple times
  3. Creates difficulties in other areas of life

A bad habit but not skin cancer

I’d say that mine is a bad habit and not technically a disorder. But that is a moot point because it’s still a problem. And it crisscrosses with my tendency to catastrophize. Another way of saying this: I am sometimes a hypochondriac. After touching the raised skin on my head, I thought, “Oh no, I’m getting a brain tumor!” It wasn’t actually a lump, so I don’t know what I was thinking. But as I said, I was stressed. When I dislodged it with my finger, I was relieved of that anxiety. But I could have found other ways to calm myself, starting with a realistic inquiry into what the problem could be. Or I could have put it on hold and gone and done the many positive things that relieve stress for me, such as doing yoga, going for a run, walking my dog, or calling a friend.

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