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Scratching is a both very common, and a very personal behaviour. It is not only caused by itch. We all can scratch for other reasons, sometimes because of an emotional state, or when trying to concentrate, or when bored. Instinct is also involved: we are wired to scratch! And if scratching is repeated, it can be easily learnt as a habit: then it occurs automatically, without thinking (or, because we are thinking!). As a conditioned reflex it can become linked to particular times and circumstances.
Scratching can also seem to zone in on a favourite, accessible place on the body. In the drawings above the back of the hand, and the ear, may be examples. The photograph above shows a "hyperlinear palm" on the left caused by habitual rubbing, compared with a normal palm on the right Someone else may "prefer" to scratch the top of the head, or rub the skin above the upper lip, or the skin over one front shin with the back of the other lower leg. In the photograph below the link between an item of clothing and a favourite place was only too evident. All these behaviours leave the evidence behind: an area of chronic damage, including thickened skin called lichenification.
The Combined Approach to atopic eczema is an effective treatment of lichenification. After four weeks treatment however a person's favourite place may still be evidently receiving its regular scratching and rubbing. It is well worth completing the treatment successfully by healing the skin there too, with habit reversal + optimal topical treatment - the extra effort brings the best results.
This can sometimes be achieved using a hydrocolloidal gel dressing: please see the article Three-in-One.
Do you have a favourite scratching place that you can share with us? Please use the Comments Box below to let us know.