Scalp picking and hair loss?

Question

Hello Doctor, I am a 30 year old male and for maybe 10 years i have been picking at my scalp... i get scabs that come and go and i had a habit of removing them with my fingers often leading to the hair coming out with it. I started using Apple cider vinegar and it cleared my scalp up and have been pick free for a few months but have no regrowth Would the amount of time i was picking mean chances of regrowth are minimal is there anything i could use or take to encourage any regrowth ?

Bernardino Arocha, MD, FISHRS · Answer

fendertele,The condition that you are suffering from is known as skin picking disorder or  trichotillomania depending on wether you pick the skin or hair. Excessive pulling of hair leads to permanent hair loss and scalp inflammation. This causes histamine release which can perpetuate the cycle. I would recommend that you do all you can to not touch your scalp. However, this may be easier said than done. Professional help with either a clinical psychologist, behavioral psychologist, or psychiatrist may be necessary to help control this condition. The use of histamine 1 and 2 blockers can help much to decrease the itch and desire to scratch.  There was also a study published recently that show significant benefit of using N-acetylcysteine, this is available without a prescription. Wishing you the best of luck!Sincerely,Bernardino A. Arocha, MD

Jeff Donovan, MD, PhD · Answer

That's correct. Both the number of years one has picked and the intensity of picking impacts on the injury to the scalp and ultimately the amount of scar tissue laid down in the scalp.Such scar tissue can lead to permanent hair loss. There is not alot that can encourage regrowth. You may wish to see a dermatologist. If their is some residual inflammation still present, treating this inflammation can sometimes trigger a bit of hair growth.

Brian Goertz, MD (retired) · Answer

After repeated plucking of hairs in a given area the hairs will not regrow as the growing follicular bulb will eventually be completely destroyed. Congratulations on not plucking for the last few months. If your compulsion to pluck returns see your primary care doctor and be referred if necessary for care.

William Rassman, MD (retired) · Answer

One picks the hair often enough to kill the hair in the area where the picking is done. This is an obsessive compulsive disorder best treated with medications that work for obsessive compulsive disorders and eventually a hair transplant. The big problem is that most of the people who get hair transplant go on to continue picking and lose the hair again.

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