Prolonged Healing of a Scab
Age: 25, Gender: Female, Diagnosed with dermatillomania I have been dealing with a scab that originated from an ingrown hair that I impulsively picked. This has persisted for approximately three months. Initially, I picked at it during its healing process, but I've made an effort to refrain from doing so, though occasionally I find myself doing it out of habit. The location of the scab makes it difficult to capture a clear photo, but I've noticed that the skin beneath it has become quite red, albeit it seems to be less deep than before. Previously, the wound descended into several layers of skin—perhaps two or three—but currently, it appears to have reduced to just one layer, which is significantly more inflamed. I've attempted to research this issue, but many sources raise concerns about skin cancer. Nevertheless, my scab hasn’t increased in size and has actually flattened somewhat, which leads me to believe it lacks the typical signs of malignancy. Moreover, I’m concerned that if I confess to my doctors about my skin-picking behavior, they may not take my concerns seriously. The scab appears to be merging more with the surrounding skin, despite it still being a scab. Each time I impulsively scratch at it, it looks increasingly raw and exhibits a reddish-pink hue beneath. Could my skin-picking habit be the reason for this irritation? I've found limited resources on how chronic skin picking affects scabs and their healing duration, so I’m uncertain about what is deemed normal and what might warrant professional evaluation. I appreciate your consideration!
Answers (1)
4/1/2025, 7:50:43 AM
OpenHealth AI
It's understandable to be concerned about a prolonged healing scab, especially when it involves habits like skin picking. A scab that hasn't healed well for three months often indicates some underlying issues that may be related to both skin and behavioral factors. Here's a breakdown of your situation and some next steps to consider.
Main Points
- Chronic skin picking can delay healing: This habit can irritate the skin, leading to more redness and prolonged healing.
- The current state of the scab: A scab that's flattening but remains red may indicate inflammation, which could be exacerbated by picking.
- Professional assessment may be beneficial: You should feel comfortable discussing your skin-picking habit with healthcare providers, as they are trained to address both physical and behavioral concerns.
Explanation
Picking at scabs can disrupt the healing process by introducing bacteria, causing inflammation, and preventing the skin from properly repairing itself. The redness and irritation you noted may indeed be linked to your dermatillomania (skin picking disorder), which influences how your skin responds to injuries. It's a common condition and you’re not alone in experiencing difficulties in managing it.
Next Steps
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Focus on wound care: Keep the area clean and dry. Apply a gentle moisturizer or a healing ointment (like petroleum jelly) to promote moisture, which may aid in healing. Avoid touching or picking at the scab as much as possible.
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Use reminders: Place reminders in your environment to help deter picking, such as wearing gloves, fidgeting with an object, or keeping your hands busy with other activities.
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Monitor for changes: Continue observing the scab's condition. If it begins to swell, ooze, or become progressively painful, or if the surrounding area increases in redness, it could signal an infection or other concerns.
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Consider professional support: It’s important to discuss your skin-picking habit with a healthcare provider or dermatologist. They can help address both the physical healing aspects and provide strategies for managing the picking behavior. They will be supportive and can discuss treatments that may include behavioral strategies or therapy options.
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Practice self-compassion: Acknowledge that making changes to your habits takes time, and give yourself grace as you work towards healing.
If you have more questions or need clarification on any point, feel free to ask!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.