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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Impulse Control Disorder. Have Scabs On Head Due To Scratching And Growing Pressure. Is There Topical Solution?

Hello, This inquiry is most likely for a dermatologist but perhaps a psychiatrist has some special remedies as well. I have had what I believe to be impulse control disorders my entire life. When I was younger I did research trying to figure out what in gods name could make me pull my hair out constantly. I discovered it to be Trichotillomania , which has gone through phases of ups and downs over the years. It definitely can be triggered by anxiety(whatever inner turmoil I am trying to subdue) but I find I do it the most when I am relaxed and reading or watching a movie on the couch. I noticed a few years ago, that I would get pimples on my scalp every now and then, and then I would subconsciously obsess over them, popping them, making scabs and then repeatedly picking at the scabs. Recently I started taking adderall again after being off of it for a year, because the content of my schoolwork is quite intense. For some reason I had a HUGE episode of severe picking until I formed a very noticeable thinning of my hair, i wouldnt say bald spot because it covers most of the top of my head...not exactly a single spot. =( I have been very aware of it and my hands creeping to my scalp to pull the little baby hairs since this incident, but I have kept it at bay for the most part. The problem I am having however, is the fact that with controlling the hair pulling, I have become COMPLETELY engrossed in picking scabs that I have formed, myself, from scratching my head. I have read so many posts and forums about this and the sensation we feel and the need to rub, scratch or pick at that area. Now....after all that said..... my scalp is in disarray and I have at least ten scabs and very odd looking patchy hair. I am wondering if I have an infection, or if I could get one from digging a hole into my skin? I am noticing a dull/deep pain in my neck sometimes if I lean back or to the sides. I feel pressure in the front of my head or the back if I put pressure on my neck. Sometimes if I look up or back I feel like I might black out from a growing pressure in my head. Right now in the front of my neck on the right of my trachea if I push in it hurts and puts pressure at the top/front of my brain. Under my jaw there feels to be pressure as well. I know there are lymph nodes all around this area and I am just wondering what is going on and if anyone had any answers.. 1).Can I cause a serious life threatening situation from doing this? 2).If I have been doing this for YEARS (probably 20) and lymph nodes are constantly becoming inflamed and draining, am I causing bacterial fluids in my lymph nodes and all over my body in excess???? 3). Is there a topical solution that you know of to soothe or numb the scalp so sensations are dulled? Or maybe some kind of antibiotic liquid I can put on it? I have been using an organic homeopathic scalp therapy shampoo that has lots of natural oils to soothe and heal the scalp and it seems to feel better right after, but I find myself washing my hair a lot trying to evade my urge to pick. I also have been wearing a hat when I sit to do my studying, seems to help a bit. Peppermint shampoos feel nice as well. PLEASE IF ANYONE knows of something to apply to the scalp that can help numb/soothe/alleviate this sensation on my scalp and answer my other questions I would GREATLY appreciate it. Sorry for the long post, but I wanted to explain as best I could.
Mon, 30 Sep 2013
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Dermatologist 's  Response
Hi trichotilomania is a psychiatric order where the patient pulls his hair by slightest emotion.due to pulling of hair there is a possibility of folliculitis which causes irregular patches of hair loss and corresponding lymph nodes are swollen.use a antipsychotic drug like pimizide to decrease trichotilomania use of antibiotic twice daily and anti inflammatory agent like combiflame and application of mupirocin ointment over the lesions.
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Impulse Control Disorder. Have Scabs On Head Due To Scratching And Growing Pressure. Is There Topical Solution?

Hi trichotilomania is a psychiatric order where the patient pulls his hair by slightest emotion.due to pulling of hair there is a possibility of folliculitis which causes irregular patches of hair loss and corresponding lymph nodes are swollen.use a antipsychotic drug like pimizide to decrease trichotilomania use of antibiotic twice daily and anti inflammatory agent like combiflame and application of mupirocin ointment over the lesions.