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The consequences of scratching eczema
The Consequences of scratching eczema
Part of The Combined Approach to eczema is the behavioural analysis of scratching - an A,B,C:
Antecedents, Behaviour, and Consequences
Here we consider the consequences: the picture above shows clearly tell-tale scratch marks, or excoriations, together with an increase in skin lines, or hyperlineation, and redness, or erythema. Feeling this skin would reveal roughness and thickness compared with healthy skin.
Such physical consequences of scratching are accompanied by emotional and social consequences.
At assessment, before starting The Combined Approach, thinking through these consequences is part of the recommended protocol.
In clinic we ask:
- "After vigorous scratching, how does your skin look and feel?"
- "How do you then feel in yourself?"
- "What effect does all this have on those closest to you?"
Here are some common responses:
Though these responses are not surprising, they are important to highlight at assessment.
Over the next four weeks The Combined Approach will change the consequences by introducing new and safe skin-healing behaviours.
It is especially valuable to note often significant others have been offering advice by saying "Stop scratching!".
Paradoxically this can lead to an increase in self-damaging behaviour.
Changing undesirable behaviour is best achieved by substituting new desirable behaviour:
It's a matter of what should be done, rather than a matter of what should not be done.