Stop Children Picking At Scabs, Stitches & Surgical Dressings

All kids pick at scabs at some point and most the time it really isn’t a problem. But when your child’s picking is preventing the original wound from healing, or even making it worse, you need to step in to help the wound heal. Stitches and wound covering, from every day plasters to post-operative surgical dressings, can also be targets for picking and fiddling. This is the ScratchSleeves guide to helping you stop your child picking their scabs, stitches and surgical dressings.

Why kids pick scabs and stitches

Scabbing over is part of the skin’s healing process, but it’s easy to forget how fascinating this process is for kids. We all know that the healing process can be really itchy, which is enough to tempt the average adult into rubbing or picking a scab but for an inquisitive toddler or child a scab, stitches or dressing just has to be investigated further. What young children don’t understand is that scabs and stitches play an important role in the healing of their skin, and that picking them while the wound is healing could restart the bleeding. While scabs are still something of a novelty, kids are absorbed with them largely because they’re unknown. Explaining what a scab is, what it does and why it should be left alone may help to discourage scratching and picking to some degree.

Why are healing wounds so itchy?

When injured, the body produces histamines to assist the healing process. These are the same chemicals responsible for the itching and inflammation associated with allergic reactions. The histamines are then trapped within the scab as it forms and can cause itching. In addition, the healing nerves in the upper layer of the damaged skin send confused messages to the brain resulting in more itching in the skin around the injury. Some research also suggests that wounds may itch because scabs or stitches pull on new skin as it forms, and that the area around it begins to itch as a result. Dryness is also believed to be a possible culprit behind the itchiness of a healing wound, as the oil glands that normally keep skin lubricated and prevent dryness are affected by the damage done during the infliction of the wound.

Why stop a child picking their scabs

Scabs will fall off of their own accord when the skin underneath is ready for the outside world. Pick them off any sooner, and your child risk damaging the delicate new skin that is forming underneath. At best, this will mean another scab, so the wound takes longer to heal. But the second scab may be even bigger than the first. The delayed healing is more likely to leave a larger, permanent scar when it finally comes off.

Scabs also play an important role in keeping infections at bay. Picking at a scab, especially with grubby fingers, can introduce fresh bacteria into a healing wound and cause an infection which will further delay healing and may need a course of antibiotics as well. Infections can also make scabs even more itchy, prone to picking and may result in a larger scar.

Also, picking at an itchy scab while daydreaming can quickly turn into a difficult-to-break habit, so it’s a good idea stop your child from picking their scabs early to prevent a larger problem developing.

How to stop your child picking scabs, stitches and surgical dressings

• Minimise itching – using a Vitamin E rich cream or oil can reduce the itch of healing skin, which should in turn reduce the your child feeling to pick at his scabs, we’re fans of Bio-Oil. Itching can also be an early sign of infection so we use a dry antiseptic spray to minimise that source of itching without softening the scab. We have also used the same antiseptic spray on both paper and thread stitches but do check with the doctor that this will be okay with your child’s stitches.
• Keeping nails really short can reduce the ease of picking, but as kids nails grow so quickly you’ll need to cut or file your little ones nails every few days. Really short finger nails also have the advantage that they tend to harbour less dirt and bacteria than longer ones.
• Cover the wound – covering up the scab or stitches with a plaster or dressing will protect it in the short term. However, this is often not a practical solution either due to the location of the wound, the child’s willingness to have it covered or the dressing itself being itchy. Another drawback of this approach is that the covering a wound reduces the amount of air getting to it which promotes bacterial and yeast growth so increasing the risk of infection. The lack of air can also soften the scab, reduce the rate of healing and makes the scab easier to pick.
• Cover fingers or hands: putting plasters over the ends of your child’s fingers can reduce their ability to damage healing wounds. However the blood supply to the tip of fingers, particularly in young children, is very sensitive to pressure so medical advice is not to encircle the finger with a plaster. Scratch mitts or gloves can work for really little ones but are easy for older children to remove. ScratchSleeves provide an effective and low hassle hand covering solution. Not only do they stay on, but their double layer mitts are specifically designed to minimise the damage done by little fingers and they are easy for adults to put on (and take off) as and when necessary.
• Discourage habit formation. Mindless picking at an itchy scab can quickly turn into a habit so it’s a good idea to prevent this happening. While distraction is the best tactic with toddlers and younger children, an explanation on why wounds need to be left alone to heal properly and encouragement with a sticker chart may well be more effective with older children.

When to talk to the doctor

Most childhood scabs will heal of their own accord as soon at they are left alone, but occasionally a trip to the doctor is necessary when a wound becomes infected. Signs that a wound has become infected include:

• swelling of the affected area
• pus forming under the scab
• redness spreading from the cut or graze
• increasing pain or itching
• feeling generally unwell, often with a high temperature (38°C or above) or swollen glands

There are lots of reasons why kids like to pick at and play with a scab that’s formed on their skin, but there can be more serious motivations behind some skin-picking behaviour, especially in older children. Persistent picking at pimples and scabs can indicate anxiety or an obsessive compulsive disorder that you should discuss with your doctor, especially if your child appears to be creating new scabs rather than just picking at those resulting from the expected scraps and scuffs of childhood. However, the vast majority of scab-picking is down to childish curiosity.

Want more information?

Here’s a good place to start: https://kidshealth.org/en/kids/scab.html