"Pick one scab and leave the others alone. Make the one your friend" As bizarre as these words may seem to some people, others will find a great deal of relief, camaraderie, even wisdom in them. They are, in fact, the advice one sister gave to another when discussing their mutual compulsions to pick obsessively at the scabs that form on their bodies. Scab picking is a form of excoriation, just as picking at the skin is. When picking scabs, however, the picker will pick at scabs that have been caused from any trauma, be it accident or result of earlier picking episodes.
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Picking scabs is a remarkably self-perpetuating way to act out obsessive-compulsive tendencies that often signal an underlying, often as-yet-undiagnosed mood or anxiety disorder. Patients often describe the experience as comforting even though painful. And very unsightly. A common symptom of scab picking is eating the scabs after picking. This form of skin picking disorder can be difficult to spot from the observer’s perspective. The person experiencing the scab picking behavior knows the results are unsightly and repulsive to others. For this reason, he or, usually, she will limit picking scabs to just the areas of the body that are most often hidden under clothing. Repeated infections at the scab picking sites become problems that can have significant consequences. Permanent scarring is almost always a result of the behavior and sometimes the scarring can be profound and disfiguring. There seems to be a great deal of shame associated with this obsessive behavior, even more so than in other types of skin picking. Many people who suffer with this compulsion know they are doing something that is considered undesirable, even disgusting (to others), but they find it almost impossible to stop nevertheless.
Habitual picking of scabs is classified in the group of psychological disorders associated with self-harm, such as deliberate skin cutting, head banging, and burning oneself. These actions are more often associated with girls than with boys and scab picking often starts when the subject is age 13 or 14. Psychological symptoms that are often associated with picking scabs are depression, low self-esteem, addiction, eating disorders, and anxiety. A history of trauma or some sort of abuse is almost always involved. Quite often the habit gets started as a way to relieve the pent-up frustrations or fears when other ways of dealing with conflict are not effective. Feeling that verbal communications are ineffective leave the scab picker feeling there is no other way to express the emotional turmoil going on inside. Most people will pick a scab from time to time with no significant harm done. It’s when the act of picking the scab brings on emotional relief, desired pain, or pleasure that medical intervention is advised.