[20F] With chronic scalp picking and anxiety

Patient Description

A 20-year-old female reports a lifelong habit of picking at her scalp, which is painful but provides relief. She experiences chronic anxiety and stress, particularly exacerbated by situations involving drinking, yelling, or fighting. This anxiety leads to freezing, panic attacks, and self-isolation, which negatively impacts her well-being. She uses marijuana 1-2 times daily to cope with anxiety. There are no changes in sleep patterns or appetite. The patient has a known allergy to grass since childhood and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on what you've shared, you might be experiencing a condition known as Dermatillomania or Excoriation Disorder. This is a mental health condition where individuals repeatedly pick at their skin, often as a way to cope with anxiety or stress. It can be related to anxiety disorders and may provide temporary relief or a sense of control.

  • Anxiety and Stress: Your anxiety and stress, especially in certain situations, might be contributing to this behavior. It's common for people with anxiety to develop habits that provide temporary relief.

  • Treatment: Treatment often involves therapy, such as cognitive-behavioral therapy (CBT), which can help you develop healthier coping mechanisms. Sometimes, medications for anxiety or depression may also be helpful.

What you can do

  1. Seek Professional Help: Consider reaching out to a mental health professional who can provide therapy and support tailored to your needs.

  2. Mindfulness and Relaxation: Practice mindfulness or relaxation techniques to help manage anxiety. This could include deep breathing exercises, meditation, or yoga.

  3. Healthy Coping Strategies: Try to identify triggers and develop alternative coping strategies, such as squeezing a stress ball or engaging in a hobby.

  4. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, and share insights with your healthcare provider.

What you should look out for

  • Worsening Symptoms: If you notice an increase in anxiety, depression, or skin picking, it’s important to seek help.

  • Physical Symptoms: Watch for any signs of infection or significant skin damage from picking.

  • Emotional Distress: If feelings of isolation or distress become overwhelming, reach out to a mental health professional.

Remember, it's important to consult with a healthcare provider for a formal diagnosis and personalized treatment plan.

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2 mo ago


People Also Ask


What is Dermatillomania and how is it related to anxiety?

Dermatillomania, also known as Excoriation Disorder, is a mental health condition characterized by repetitive skin picking, often as a way to cope with anxiety or stress. It can provide temporary relief or a sense of control but may lead to skin damage and emotional distress.


How can cognitive-behavioral therapy (CBT) help with skin picking and anxiety?

Cognitive-behavioral therapy (CBT) can help by identifying and changing negative thought patterns and behaviors. It teaches healthier coping mechanisms and strategies to manage anxiety, which can reduce the urge to pick at the skin.


Are there any risks associated with using marijuana to cope with anxiety?

Using marijuana to cope with anxiety can have risks, including dependency, increased anxiety over time, and potential negative effects on mental health. It's important to discuss these risks with a healthcare provider and explore other coping strategies.


What are some effective mindfulness techniques for managing anxiety?

Effective mindfulness techniques for managing anxiety include deep breathing exercises, meditation, progressive muscle relaxation, and yoga. These practices can help calm the mind, reduce stress, and improve overall well-being.


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