The Dermatologist Said, You Scratch Because It’s a Habit

Psoriasis on shoulder and eczema on palm Aug 08
The itchy patches on my right shoulder and palm are much, much better than they werelast week. The patch on my palm has almost dried out!

For the past week, I’ve been a relatively good patient. I’ve been using the steroid cream sparingly, and skipped a few days of application because I didn’t have time in the morning and I was so exhausted at night that I completely forgot about it (if I’ve forgotten about it, it’s a sign that the eczema patches are really a lot better!). On a few nights, I also skipped the antihistamines because they made me too drowsy; on one night I took them, I passed out as soon as I hit the bed and completely missed my alarm, making me 45 minutes (45!!!!) late for work.

This morning, I returned to Dr Nice Derm’s office for a check up. The rash on my shoulder has improved significantly and I was finally able to wear a strapless dress to the clinic, baring my shoulder for the world to see! The rash had healed so much that Dr Great Derm was confident enough to say that I do not have psoriasis, and that the rash on my shoulder is also eczema. He also said that having both psoriasis and eczema together is very rare. Although eczema and psoriasis are generally treated the same, psoriasis requires much stronger steroids than what he gave me last week, and it would take much longer to clear up. That’s great news!

Except he also said something utterly idiotic that left me… bewildered (for lack of a better word).

“You’re scratching because it’s a habit, not because it’s itchy. This is especially true in cases where the rashes occur repeatedly in the same area, like the inner elbows or back of the knees. Most kids grow out eczema around the age of 13 or 14, and those who don’t usually aren’t taking good care of themselves, for example, they’re not making an effort to avoid allergens or they’re not keeping up with a good skincare routine. I wonder, of all the times you’re scratching, how many of them are because you’re actually itchy?

Uh… how about EVERYTIME? WHAT?! I’m sorry but as a dermatologist, a specialist and not a general practitioner, that has to be the most ignorant thing you can say to a patient with dermatitis. I don’t doubt that there are habits associated with behaviours, like when people scratch their heads when they’re thinking about something (they’re not scratching because they’re itchy), but for someone with an itching skin condition, I’m pretty sure the need to scratch is very real. When our bodies come into contact with allergens, we release histamines that make the skin itch – so trust me, the skin IS ITCHING. And sure, everyone knows not to scratch because scratching only makes the itch worse, and we try our darnest not to, even though we’re absolutely dying for a light tap with the finger for relief. But to say that we’re doing it out of habit is undermining our illness. Which is just offensive.

Clearly this guy doesn’t have eczema and probably has never had an itchy episode of any sort, because if he had been, he would know that none of the scratching is habitual and it takes an extreme amount of willpower to not scratch when the rash is SO DAMN ITCHY.

Do you think you scratch because you’re really feeling itchy or because it’s become a habit?

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