I started picking my scalp as a kid. At first, I just picked dried skin and dandruff all over my head. I was enamored with the quantity and the texture of flakes of dried skin. During college, I managed to find a good medicated shampoo and cut my hair lower so the flakes stopped.
In 2001, during my senior year of college, I started to focus exclusively on one spot on my scalp that eventually turned into a hardened callous. I would go through a pattern of consistent scratching and picking and the callous would get hard enough that I could remove it with the tips of my fingernails. Sometimes, I would use a push pin to score around the edge of the callous so that I could get it off in one piece. I would keep the callous because I found it intriguing. It had the shape of a scab but a texture that was way thicker than any of the dried skin and dandruff flakes that I compulsively picked as a kid. At the time, I was under a lot of stress. My dad was struggling with an underperforming family business which contributed to family financial problems. I was also ending a 3 year relationship. And I was looking for a job and applying to grad school.
I ultimately landed a job, moved to a new city, and started grad school part time. I also started seeing a therapist and did therapy for depression and a social anxiety disorder. I was prescribed Paxil. I went to a dermatologist who surgically removed the callous on two separate occasions that spanned a period where I was able to stop picking and heal temporarily. I attribute the break in picking behavior to the medication and therapy. The surgical removal also helped because the dermatologist removed an area that was deeper than my push pin removal would go. The larger scaring area plus the healing ointment prescribed by the dermatologist managed to temporarily discourage picking. The dermatologist removed it because he could send it for biopsy even though we both knew that it was not skin cancer.
By 2006, I had started another cycle of picking. I had relocated within my company from a city in the Midwest to a city in the Northeast a year earlier. I was beginning to experience pain from what I would later find to be a bone tumor. Also, my family was struggling again due to my dad’s alcohol problems. The family business was also still doing poorly and he wasn’t working by this point. The family finances were in bad shape. I started seeing a new therapist and taking Wellbutrin. I ultimately was able to stop picking – this time without the dermatologist removing the callous.
Fast forward to today and I am back to my compulsive picking. I’m again under a lot of stress. The good news is that I’m getting married in just over a week but I think the stress of the wedding planning in combination with my job and work on another part time degree have brought me to my psychological limit again. I’ve been picking for about 2 months now. I’m also still compelled to keep the calluses even though I hate myself for it. I’ve had 3 sessions so far with a new therapist. I am attempting to stop the picking without medication this time. I thought the Paxil and Wellbutrin caused me to feel too desensitized even though they may have helped. I’ve instead opted for Cognitive Behavioral Therapy. The therapist also suggested I read two books by Dr. David Burns – “The Feel Good Handbook” and “When Anxiety Attacks”. I’ve managed to make a nice dent in the latter and I think I am really beginning to address some of the root causes of my depression and anxiety. Hopefully, I can break this picking thing once and for all this time.