It can be tempting to pick at scabs on the scalp if they are itchy or painful, but this can cause complications such as infections or skin damage.
Some people may pick at their scabs due to an underlying condition known as dermatillomania, while others may only pick at their scabs if they are causing itching or discomfort.
This article looks at the complications of and treatment options for scabs on the scalp.
Dermatillomania, or excoriation disorder, is a psychiatric condition wherein a person repeatedly picks, scratches, or rubs at their skin.
The International OCD Foundation says that common areas a person may pick at include the:
- head
- face
- hands
- arms
- legs
- back
A person with dermatillomania may pick at their scalp with their fingers, nails, or tools.
Diagnosing dermatillomania
According to Mental Health America, in order for a doctor to diagnose dermatillomania, a person must show:
- repeated attempts to stop their behavior
- clinical impairment or distress caused by the symptoms
- frequent skin picking that causes damage to the skin
- no evidence that another psychiatric or medical condition is causing the behavior
These are also the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
However, the International OCD Foundation also states that not everyone who picks at their skin has a skin picking disorder. Otherwise healthy people may pick at scabs, pimples, or other skin imperfections from time to time.
It is also possible that other conditions can lead to skin picking, so a person exhibiting this behavior may wish to contact a doctor for evaluation.
Picking at a scab on the scalp does not always cause hair loss. However, it could cause the scab to take longer to heal or lead to an infection.
If a person has a skin picking disorder, repeatedly picking at the scalp can cause scarring, discoloration, or disfigurement, according to the TLC Foundation for Body-Focused Repetitive Behaviors.
If a person repeatedly picks at scabs on their scalp, it may lead to an increased risk of complications.
According to the TLC Foundation for Body-Focused Repetitive Behaviors, some potential complications associated with this behavior may include:
- an increased risk of infections that require medical attention
- open wounds
- continued scabbing
- disfigurement
- scarring
- discoloration of the scalp
Additionally, if a person is compulsively picking at their scalp, they may become self-conscious about their appearance and try to cover up the damage using makeup or clothing.
A person may also use avoidance behaviors to conceal skin damage caused by picking. This may include avoiding social situations, avoiding intimacy with others, or wearing clothes that cover the areas they have picked.
These behaviors may lead to a person becoming isolated and developing strained relationships with their family and friends. Over time, this can cause mood disorders or anxiety.
If a person has a skin picking disorder, they may have other conditions alongside it. According to Mental Health America, conditions such as trichotillomania (hair pulling disorder), obsessive-compulsive disorder, or major depressive disorder may also be present with a skin picking disorder.
In most cases, scabs on the scalp will heal on their own with no need for medical intervention. A person should try to stop picking at their scabs to prevent them from getting worse and to help them heal.
The American Academy of Dermatology (AAD) recommends that people take the following steps for small wounds:
- Keep the area clean.
- Use petroleum jelly to help keep the scab or wound moisturized.
- If possible, cover the area with a bandage and change it daily.
- Use sunscreen or keep the scalp covered to prevent browning or reddening of the scab.
If the scabs occur due to an underlying condition, a person should work with a doctor to determine the cause of the scabs and help prevent new ones from forming.
According to Mental Health America, the two most common treatments for dermatillomania are cognitive behavioral therapy (CBT) and medication.
CBT teaches a person how their thoughts and behaviors are connected to help them stop picking at their skin.
Medications such as selective serotonin reuptake inhibitors may help prevent obsessive picking.
A person should contact a doctor if they feel as though their picking is negatively affecting their life. The doctor may be able to recommend a therapist who can diagnose and help treat the condition.
A person should contact a doctor if they have scabs on the scalp and the following symptoms develop:
- scabs that are inflamed or swollen
- a fever
- other symptoms of infection
- scabs that keep coming back or do not go away
- scabs that become very itchy or painful
- scabs that do not go away within a few days of not picking at them
The AAD recommends that a person contact a doctor as soon as possible if they have any symptoms of infection.
A person should also contact a doctor if they develop multiple scars on their scalp that they cannot identify. An underlying condition may be causing these to appear.
If a person suspects that they may have dermatillomania, they should discuss treatment options with a doctor. The doctor may be able to recommend a psychiatrist or other qualified healthcare professional to help with treating the condition.
Picking at the scalp can put a person at higher risk of infection, scarring, and discoloration of the skin.
A person who compulsively picks at their scalp may have a skin picking disorder.
Treatment for a skin picking disorder often involves therapy and medication. If the scalp is damaged, a person may need to apply topical medications to help the wounds heal.