Nearly all people will pick at a pimple or scab their skin periodically. But for some people, skin picking causes them significant distress, anxiety, and even health problems. This can be the case when a person routinely picks and eats their scabs.
Picking and eating scabs can have multiple underlying causes. Sometimes, a person may pick at their skin and not even notice they’re doing it. Other times, a person may pick at their skin:
- as a coping mechanism to deal with anxiety, anger, or sadness
- as a response to serious episodes of stress or tension
- from boredom or habit
- because of a family history of the condition
Sometimes a person may feel relief when they pick and eat their scabs. However, these feelings are often followed by shame and guilt.
Doctors refer to repetitive skin picking disorders as body-focused repetitive behaviors (BFRBs). They occur when a person picks their skin repeatedly and often has urges and thoughts of picking at the skin, including picking scabs. Other examples include repetitive hair pulling and eating or picking one’s nails.
This disorder is often considered an obsessive-compulsive disorder (OCD). A person with OCD has obsessive thoughts, urges, and behaviors that may interfere with their daily lives. BFRBs can also occur with body image disorders and hoarding.
Currently, skin picking (including eating scabs) is listed under “obsessive compulsive and related disorders” in the Diagnostic and Statistical Manual-5 (DSM-V). This is the manual that psychiatrists use to diagnose medical disorders.
According to The TLC Foundation for Body-Focused Repetitive Behaviors, most people typically begin a BFRB between the ages of 11 and 15 years old. Skin picking typically begins at the ages of 14 to 15. However, a person can experience the condition at any age.
A disorder that involves picking and eating scabs can affect you physically and emotionally. Some people pick at their skin because of feelings of anxiety and depression, or this habit may lead them to experience these feelings. They may avoid social situations and activities that involve exposing areas of their body that they’ve picked at. This includes refraining from going to places like a beach, pool, or gym. This can cause a person to feel isolated.
In addition to its effects on mental health, picking and eating scabs can cause:
- skin infections
- nonhealing sores
In rare instances, a person may pick at scabs so much that their skin wounds become deep and infected. This can require surgical treatment to reduce the risk of the infection spreading.
If you can’t stop picking and eating scabs on your own, you should seek medical treatment. You can start with your primary care physician or psychiatrist if you have one.
Therapists can utilize approaches, such as cognitive behavioral therapy (CBT), which can include acceptance and commitment therapy (ACT).
Another treatment option is dialectical behavior therapy (DBT). This treatment method has four modules designed to help a person who has a skin picking disorder:
- emotion regulation
- distress tolerance
- interpersonal effectiveness
The concept of mindfulness involves being aware of possible scab picking triggers and accepting when the urges to pick or eat scabs occur.
Emotion regulation involves helping a person identify their emotions so they can then try to change their outlook or feelings of action.
Distress tolerance is when a person learns to tolerate their emotions and accept their urges without giving in and returning to picking and eating scabs.
Interpersonal effectiveness can include family therapies that may also help a person who is picking and eating scabs. Participating in group therapy can help educate family members on how they can support their loved one.
In addition to therapeutic approaches, a doctor may prescribe medications to relieve the anxiety and depression that may trigger skin picking.
No one medication has been shown to reduce the incidence of scab eating. Sometimes you may have to try several different medications or medication combinations to determine what will be most effective. Examples include:
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- sertraline (Zoloft)
- paroxetine (Paxil)
These medicines are selective serotonin reuptake inhibitors (SSRIs), which help to make more of the neurotransmitter serotonin available. Sometimes doctors will prescribe the antiseizure medication lamotrigine (Lamictal) to reduce the incidence of skin picking.
Some triggers for picking and eating scabs are tingling or burning sensations of the skin. As a result, a doctor may recommend applying topical treatments to reduce these sensations.
Antihistamine creams or topical steroids can reduce itching sensations. Topical anesthetic creams (like lidocaine) or astringents may also help to reduce sensations that could lead to picking scabs.
You may find that you can stop skin picking for a while (remission), but then resume the behavior later (relapse). Because of this, it’s important that you’re aware of the therapeutic and medical treatments available to treat skin picking. If relapse does occur, see a doctor. Help is available.
Mental health conditions such as BFRB are considered chronic conditions. This means that there are treatments to manage them, but the condition can last for a long time — even lifelong.
Educating yourself about what triggers your symptoms as well as the current treatments available can help you begin addressing the problem.
You can visit The TLC Foundation for Body-Focused Repetitive Behaviors for the latest information and research regarding skin picking behaviors.