A person may occasionally pick at their scabs. These might itch, which may cause the person to scratch and remove the scab. Sometimes, however, a person may pick at their scabs compulsively.
Compulsive scab picking may be a symptom of a health condition known as dermatillomania.
Although picking a scab might seem harmless, in some cases, it can lead to more serious health complications that require medical treatment.
This article discusses the complications a person may have when picking a scab, when to contact a doctor, some treatment options, and more.
If possible, a person should avoid picking at their scabs, pimples, or other skin irregularities or conditions. Picking at a scab can lead to issues such as scarring or infection.
Any injury that causes a break in the skin can put someone at greater risk of developing the infection. Other risk factors include obesity and swelling of the limbs.
Picking at scabs, pimples, or other parts of the skin can also be a symptom of an underlying health condition called dermatillomania.
According to one recent study, dermatillomania — also known as skin picking disorder, excoriation disorder, neurotic picking, or psychogenic excoriation — can cause a person to pick at their skin excessively.
People with dermatillomania can damage large areas of their skin, which can lead to the development of local infections and other complications.
However, picking at a scab, pimple, bug bite, or other area of skin does necessarily mean that a person has dermatillomania.
The International OCD Foundation identify dermatillomania as a person experiencing all three of the following symptoms:
- repeatedly picking at their skin
- severe skin picking to the point of causing tissue damage
- issues at school or work or during other social situations due to skin picking
People who pick at their scabs from time to time likely do not have dermatillomania.
Dermatillomania has several signs and symptoms.
The most common symptom is that a person will continuously and habitually pick at a portion of their skin. The picking can result in damage to the skin tissue.
According to the International OCD Foundation, a person may pick at one or more areas of their skin at a time. Some common areas for this include the:
They add that a person often picks with their fingernails or fingers but that they may also use other methods, such as biting or tools such as scissors or tweezers.
Without treatment, dermatillomania can lead to several potential complications. The Picking Me Foundation indicate that complications can include:
- skin infections
- muscle fatigue
- blood loss or iron deficiency
- loss of sleep
- general illness
- bacterial infections
In one review of studies, researchers found similar potential complications, including abscess, paralysis, blood loss, and bacterial infections.
They also indicate that living with the condition can become life threatening due to blood loss, though it is important to note that this is rare.
The treatment approach for dermatillomania often involves therapy and medication.
Specifically, treatments may include:
- selective serotonin reuptake inhibitors (SSRIs), which are medications for treating depression and obsessive-compulsive behaviors
- cognitive behavioral therapy, which is a therapeutic approach that teaches a person how to better control their thoughts and actions
- other medications, such as N-acetylcysteine or naltrexone
According to Mental Health America, a person needs to display the following signs and symptoms for a doctor to diagnose dermatillomania:
- symptoms that are not the result of a dermatological issue, substance use, or a medical condition
- attempting to stop the behavior several times
- skin picking that comes and goes and results in tissue damage
- symptoms that are not due to other psychiatric disorders
- symptoms that create significant distress or impairment at work or school or in other social settings
The organization add that many cases start during adolescence. Symptoms may come and go.
There are several different potential scar treatments that a person can talk with their doctor about.
According to the American Academy of Dermatology Association, potential scar treatments may include:
- radiation therapies
- silicone gels or ointments
- pressure therapy
- corticosteroid injections
- surgeries or cryosurgery
- polyurethane dressing
- laser or light treatments
If a person is looking to treat a scar, they should talk with a healthcare provider.
In severe cases, a person may require a skin graft. According to one review of studies, a person may need skin grafting when the picking has damaged large areas of their skin.
A person may wish to talk with their doctor if they constantly feel a need to pick their skin. This could indicate that they are living with dermatillomania.
If a person suspects that an area of skin around a scab may be infected, they should contact their healthcare provider. They can help determine how to treat the infection.
Occasional picking at skin irregularities, such as scabs or pimples, does not mean that a person is living with dermatillomania.
However, if the picking becomes compulsive, causes damage to the skin, and creates issues with work, school, or other social situations, a person may wish to talk with their doctor. It is possible that they have dermatillomania.
Cognitive therapies and certain medications can help treat this condition. Without treatment, possible complications include infections, damage to the skin, and other related issues.