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I have been compulsively picking at my scalp for years. It started when I was in sixth or seventh grade and now I'm a junior in college and continue the habit. I think the habit started when I noticed a scab or two on my scalp. I picked at those scabs, and then they came back, and I created new sores in the process. Once I start picking my scalp, it is very hard for me to stop.


I have never told anyone about this habit because I am aware that it's gross and I don't think anyone will understand. It wasn't until today that I read about skin picking being added to the new Diagnostic and Statistical Manual and thought it sounded similar to my problem, so I looked around on the Internet and found out other people have the same problem.


I want to get help for my condition but I don't know how. I do not want to form permanent bald spots on my head but I do not think that I can stop picking on my own. I am already taking Paxil for depression and anxiety but like I said, no one knows that I have this problem. I guess I also have a bit of trichotillomania because I compulsively pull out my pubic hairs at night.


How can I stop these habits?

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How much Paxil do you take? For OCD the required dose sometimes exceeds that needed for depression by far. My package insert recommends up to 60mg/d - talk to your doc prior to raising the dose. Another option are anti psychotics, but I do not have experience with them so far.

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Hey Chloe,


I had posted a reply to this topic before, but it was unfortunately lost yesterday when the site was reset. I'll try to summarize my reply in case you didn't get to see it.


I think it's important first to recognize that though OCD and derma/trichotillomania are often comorbid, they are separate conditions.  Unless you display symptoms of OCD, I would not take  simon_I's suggestion of raising your Paxil dose.  Medication is not usually successful in treating derma/trichotillomania, and curing your OCD will not by default cure your derma/trichotillomania.


I had also previously stated that stopping picking/pulling will probably be one of the most difficult things you do in your life. And it's true.  Whether you succeed will be totally dependent on the drive you have to quit.  There isn't a magic drug or supplement that will do the work for you.  But there are some techniques that can help.


First, you need to identify your triggers.


Where do you pick/pull?  You mentioned you pull your pubic hairs before bed. When do you find yourself picking at your scalp? On the computer? In the bathroom?


And why do you pick/pull? Does it happen when you're stressed? Angry? Sad?  Bored?  Is it just so you have something to do with your hands?


When you identify your triggers, you can devise a plan on how to eliminate these triggers.  When a trigger can't be eliminated, you can prepare ahead of time by having ways to prohibit yourself from picking/pulling or by having alternatives to keep your hands busy.


Paperclips, rubber bands, tangle toys, and other fidgets are good to keep around the house.  If you find yourself picking/pulling, grab a fidget to keep your hands away from your scalp/pubic area.  Redirecting the urge to pick to something less destructive will be the single most effective way to prevent picking in the future. It will be difficult at first, but you'll eventually find fiddling with a fidget to be just as addicting as picking at your scalp. Wearing gloves and hats may also help to prevent you from picking/pulling.


Take this one week at a time.  If you mess up, it's not the end of the world.


And it won't always be this hard. It DOES get easier.  Once you hit the one month mark, it's smooth sailing. I promise.


Good luck!

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