Physical Interaction

Emblem for Skin Support Module - Refrain from Excessive Interaction with the Skin to Maintain Skin Health

Executive Summary

Repetitive interaction with the skin can lead to further damage of the skin barrier, lead to secondary infection and prevent the healing process. Controlling these behaviors is essential for restoring healthy skin.


Inflammatory skin issues such as seborrheic dermatitis are often accompanied by a constant itch, which can be the result of a damaged skin barrier and increased microbial activity.

This itch, while not necessarily bad itself, can trigger repeat scratching and picking. Unfortunately, these sort of interactions with the skin are known to cause further damage to the already disrupted skin barrier and lead to perpetuation of the initial itch.

This is what is called the itch-scratch cycle.

Damaged Skin -> Itch -> Scratch -> Pain and Inflammation -> Serotonin -> Itch

This cycle creates nothing but problems and is something that needs to be controlled in order to give the skin a chance to finally heal.

Not limited to itching
Though it’s called the itch-scratch cycle, the concept also applies for skin picking and any other repetitive physical interaction with the skin.

Ideas for Integration

In order the itch-scratch loop, we need to become vigilant and stop scratching and physically interacting with your skin. It may be difficult, but you must remember that scratching and touching the skin is doing nothing but harm.

Here are a few ideas to help you get started:

  • Keep nails short to reduce damage
  • Moisturizers can help reduce itch
  • Habit reversal training may be helpful
  • Work on resolving stress (see first note for details)

Negative Effects of Physical Interaction with the Skin

Repetitive touching, picking and scratching of the skin has been shown to [pubmed id=”19550302,16000683″]:

  • Disrupt of the skin barrier
  • Lead to secondary infections
  • Increase the chances of scarring
  • Increase emotional distress and induce anxiety

Why It’s Important for Inflammatory Skin Disease

Breaking the itch-scratch cycle and refraining from physical interaction with the skin is important for inflammatory skin disease because it can:

  • Stabilize barrier function
  • Eliminate a significant source of stress and anxiety
  • Allow the skin to initiate the healing process

Additional Notes

  • Depression and stress appears to be a significant contributor to the itch-scratch cycle through the induction of serotonin [pubmed id=”8197313″]
  • Depression and anxiety also play a role in self-injurious skin picking [1, 2]

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