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Picking Scabs
White Stretchy Plugs
I've always squeezed bumps and blemishes on my skin, but recently I've gone through a period of work-related stress. I was off work for 2 months, during which time my picking and squeezing got worse. I had lots of blemishes on my chest which I squeezed and picked until I had a few nasty little wounds. One of them became quite deep, and I discovered that when I picked the scab off there were a few little white pinhead shapes under it, in the wound. They were screaming out to me to be picked out, but I couldn't do it by hand - I had to use tweezers. Sometimes I found I would need a wool needle to ease the white thing out a bit before the tweezers could get hold of them. When I pulled, a white elasticy thing would stretch and then come out. It was about 2mm long. It was VERY satisfying to pull it out, so I looked for some more in my skin. This made my picking worse, and I now find I am thinking of it quite a lot of the day. I am longing to pull more stretchy white things out of my skin. I put up with quite a bit of discomfort and pain just to get the satisfaction of pulling out these stretchy white plugs. To heal my wounds I use Savlon antiseptic liquid, and they begin to dry up quite quickly. But this is the most tempting time to pick - the scab becomes very crusty and itchy, and I see little white bumps underneath which could be those white plugs I long to pull out. They are itchy and I am dying to pull them out!
Uhm - I've had two biopsies Bookwormlee. Both said there is nothing there. Would like to see my family doctor on a regular basis but there are over a thousand people in my town without a family physician. The two dermatologists I've seen were a let down. Will take your words into consideration. Thank you too :-)
I only ever saw 2 derms; 1st was for acutane (papulopustular roseacea) and 2nd was for the ulcer (only because 1st derm moved). My swabs said "moderate WBC" ...which is something (eosinophils were high too.. which means my body was fighting an infection.. self induced or not). I do agree with bookwormlee that picking makes it worse. However, I get these in new spots on the back of my neck where I never had them before. They itch and i scratch and think shit, theres another one--better not pick ...and they go away. I do not get them in my scar from my ulcer since it has gone away. I don't have a problem like I used to. Only because I dont pick. I do still think there is an underlying issue causing them in the first place. I have body aches and low vit d for too long (been taking supplements and they aren't absorbing) went from 27nmol to 40nmol (76 and above is normal) in 18 months. It usually takes a few months to correct, so my dr is sending me to a hormone specialist. When you notice funny things going on with your body it isn't crazy to think maybe theres something that is yet to be figured out. My dr also thought I was crazy for thinking my vit d was a problem and made me pay for the test. He takes me more seriously now that it came back with concerns and time has passed with same issues and tests to prove it. It takes years even decades to figure out auto immune disorders.
Just Some Guy, do you have multiple spots or just the one? If your dr thinks acutane could work I would do it. He would have to see the severity of your issue. For one or 2 spots he would never agree to it.
Hello GillCo. Currently I have two spots. The wound near my chin, which I had the biopsies done on, causes me issues now and then but it is on the mend. I know my Doctor will be pleased with the healing. My new "spot" is on my neck. It began four weeks ago as a small bump. I thought it was an ingrown hair. I have had these in the past. 2012 and 2015. I just don't understand. Say today my face cleared up - tomorrow morning I have absolutely no desire to dig away at my face - none. I don't sit in front of the mirror and say "This would be a good place to start digging, start a new infection." These bumps happen on their own and they are painful. We have all tried almost everything and yet ..... I liken it to waking up with a pair of vise grips on your finger then say - how do I relieve the pain? By removing the vise grips correct? But I didn't put the vise grips there to begin with.
When the medication the doctors were giving me weren't working, I googled to see what I could find. I could find no pictures of what I have nor no medical name. It lead me here. Reading everyone's stories was like reading my own. I think I will ask for some pain medication, a prescription for lidocaine perhaps. Maybe a penicillin we haven't tried yet. See if there might be a surgical route. Will let you people know tomorrow. Thanks so much
What type of biopsies? Shave are useless. You need a punch biopsy.
Spots popping up in never-been-touched areas could be a lot of things. Look up Discoid Lupus keratotic plugs. Maybe eczema/dermatitis. Maybe rosacea. Point is: you will never be able to diagnose it on your own. So either radically accept it or *completely* leave it alone and get it punch biopsied.
If you really want to get to the bottom of it, make an honest account of every time you’ve touched/irritated a bump. A bump pops up... do you scratch it? Poke it? Put topicals on it? Squeeze it? ‘Picking’ isn’t necessarily violently digging. These could be as simple as generic pimples/cysts that have been chronically irritated.
There is a 2-3 year pattern of posters here saying ‘it’s this!’... trying something for ‘this’ for a bit... things supposedly getting better... then ending up back here with the same issue. There is obviously a destructive cycle occurring.
You want to break the cycle, so do things differently. When you next get a spontaneous spot, don’t touch it *at all.* don’t put *anything* on it. If you truly struggle with either of these two tasks, you should acknowledge that there might be an obsessive component to this that’s sabotaging you. Leave the spot completely alone. Get it punch biopsied. If you’ve been in this circus for literal years, what do you have to lose by doing things differently one time?
GillCo yours sound a lot like my rosacea. I don’t deny the spots are real. What I’m mainly saying is we go about them wrong. We prolong the misery they cause and the extent of their damage. Once you sufficiently irritate a spot with topicals/touching, it’s game over. It morphs into a hell far beyond what it initially was. I’ve had tons of success with dapsone gel and a sulfur ointment to spot treat. The sulfur ointment on a spot where you can tell those plugs are lurking is like magic. I’ve read reviews from people with cystic acne raving about sulfur ointment and have long suspected this condition is some type of cystic acne. But it is made so much worse by our self-inflicted chronic wounding/irritation. And once things start scarring it becomes something entirely different. Also I highly recommend supplementing calcium, magnesium, vit d and zinc.
Hello All. Still alive - lol. The biopsies I had were surgical biopsies. Cut a little piece out. My doctor was very impressed with the healing of my first wound. Not so much with the developments of my second wound. He told me I had to leave it alone, there is an artery down there - ha ha. He took a swab of wound two. He has prescribed Novo-Lexin for 10 days. Has arranged for a CT scan of my neck. That appointment might take a bit. I did some research and found what I think is a good dermatologist in North York. Ranks number four in the province. My doctor has written a letter of referral. Nothing for the pain however I have learnt to deal with it. When I saw the emergency doctor May 29th of this year for wound number one, she gave me shit. She said, just like the doctors before her that the injury would not heal unless I left it alone. This emergency doctor said I might want to consider talking to a professional. So, I buckled down and told myself not to touch it no matter what. Did a pretty good job I must say. By the end of June, it still wasn't healing. When I cut myself slightly by shaving, a scab appears. Within a week that cut is healing. Cuts and scrapes on other areas of my body also heal quickly. Why won't these things heal like normal injuries? I will look for some sulfur ointment bookwormlee. Thanks again :-)
Remember when something is chronically irritated/wounded, it can take a LONG time to heal. It won’t heal like a normal wound because it is not a normal wound. It can also look and feel worse throughout stages of the healing. Do you have a sterile, dry gauze you can tape over it? Keep it covered. When you change the dressing, do so in dim lighting far back from the mirror.
Maybe see about a wound clinic. They will manage every step of the healing process. They’ll change the dressing and tell you exactly what to do on your end at home.
I would suggest everyone look into Habit Reversal Training and a specialist in OCD as well. Just entertain it because if you’re 3,4,5 years into dealing with this issue... what do you have to lose? I’m not trying to attack. I don’t deny these wounds are real and upsetting. I was in the exact same situation for 4 years. But it got to the point where I had tried everything. Every antibiotic, antifungal, even Accutane. I very reluctantly admitted that I perhaps was a part of the problem. I didn’t think I was bothering my spots that much. I saw an OCD specialist 6 times over 6 weeks. 6 months later, I have no more wounds. My skin is clear and intact. It was a gradual process. I don’t think about wounds or plugs anymore. I’m able to pursue cosmetic treatments for the one spot that did scar. I’m free and living life again.
It never changed the fact that I did have annoying spots with white plugs. But my obsessive irritation, fidgeting and putting different things on them made them 1000x worse. It made them non-healing open wounds. It made them scars.
If you’re making any kind of physical contact with the wound, you’re touching it too much. If you can see white plugs, you’re looking too close and under light that’s too bright. Those are good rules to follow.
You are too cute bookwormlee Hee Hee I am following your advice. No picking! I am not even looking at them. I will make you proud. I have a CT appointment November 11th. Novo-lexin isn't hurting things, may actually be improving but been down that road before. Used to treat skin and soft tissue infections - not sure if anyone has been on this yet - sure someone has. I am keep a bandage on wound two day and night. Much better today
It's also for people who may read this thread but not comment. I certainly was around the internet reading these message boards playing into the "what are these mysterious white plugs" circus I wasted years of my life on. The white plugs are trapped keratin. They're nothing special. They're also called milia. They hang out and are benign but can become infected/inflamed if irritated. Look up TRAUMATIC MILIA -- milia (or keratin plugs or 'white stretchy plugs') that form in response to irritation (chemical, physical, topical, etc.). So if you have a pimple or a red spot and you mess with it, you may end up with irritation milia or WHITE STRETCHY PLUGS in what is now a wound. If you pick at the milia or keep irritating them with topicals, they can become infected, inflamed and scar, and more milia can end up forming. It's a nasty cycle. How do you cure it? It's a long process. Don't touch or put anything on your skin for a solid two weeks. Literally nothing besides rinsing with a pH-balanced gentle cleanser 1x/daily. Understand that if you're getting irritation milia, your skin is freaking out. Humans survived for many many tens of thousands of years without 9-step K-beauty skincare routines. Trust me when I say you'll be fine doing nothing but rinsing 1x/day for a couple of weeks. If something is infected, go to the doctor and get antibiotics. Once your wounds close, the area will probably still look red, and there will be milia beneath the skin. Unfortunately milia are difficult to get rid of once they form because they're literally plugs of trapped keratin. You have a few options at this point but all require the assistance of a doctor. Tretinoin (over the course of many many months) is thought to be the only topical that can get rid of milia. It requires a prescription. Other options involve lasers/cyrotherapy/etc. Whatever you do, don't try to remove them yourself. As I have said before a mild keratolytic (sulfur, salicylic acid, azelaic acid, etc.) can be helpful for managing the redness/appearance of the white plugs aka keratin plugs aka milia while you pursue more aggressive treatment. If you truly do spontaneously develop lesions on parts of skin that have genuinely not been irritated in ANY way, go to the doctor because you could have an autoimmune disorder or something serious (or something certainly beyond the scope of self-internet diagnosis/treatment).
At the end of the day this is the internet and no one here is a doctor. If you have a sore that will not heal THIS IS NOT NORMAL. If your doctor does not listen - seek another. There is nothing wrong with seeing multiple doctors if you feel your concerns are not being validated. Like everyone else doctors are constantly learning. The medical field is constantly expanding. If this was something simple we'd all be diagnosed. It is a proven fact for myself and some others that the sore will not heal without plug removal. I do not advise picking but like I said it is a fact it will not heal and to reiterate it IS NOT NORMAL TO HAVE SOMETHING NOT HEAL FOR MONTHS :) I believe some of us have the same issue. Others have the same plus additional issues along with the lesion/plugs.
Here's a list of things it could be but you will need to do your own research and seek medical attention:
Basal Cell Carcinoma
Discoid or Squamous Lupus
Actinic Keratosis
Sporotrichosis
Lupoid Syscosis
Demodex
HSV
Tinea Barbae
Impetigo
Merkell Cell Carcinoma
Ringworm
Myiasis
HPV Skin Infection
Some Guy, How did the appointment go yesterday? How is your healing in general?
Hello PlugPlague :-) Appointment went very well. Wish all visits could go this good, the CT scan was scheduled for 2:30pm and I was out of there by 2:13pm. I got to get half naked! (lol) Won't have results for a few days. I did get results back from the swab my doctor took on my last visit - there was nothing there. Generally, healing is going good. I have stopped shaving which I think is helping, less irritation. I am doing my best to leave it alone bookwormlee. Not so hard as the pain seems reduced. Kind of like quitting smoking. Been sticking to petroleum jelly and the fucidin prescribed by my doctor.
The one thing that I asked my derm was "what are the white things? ... they keep growing under the scab"... he says "there are no white things." That is where diagnosis is failing.
I cant just pick off the scab in "public" esp since he says do not pick... so how would he see them the way I see them?
The biggest question I have.. If they are milia (which I have on the backs of my arms) then tell me that's what they are!! Right?? ...If I can show my friends and family and see them in pics I know I am not delusional and they are there.. so why cant the dr then tell me they are milia if that's what is it? It would be so simple then..
Hi friends! I hope all are doing well. So I have been dealing with this for about 3 years off and on. I have noticed that they show up in times of stress and while stress eating various sugary and high dairy foods. It seems they are triggered when the body is in a state of inflammation and perhaps when the immune system is slightly compromised. I think these things are definitely keratin plugs combined with opportunistic pathogens like certain bacteria and/or fungus that get into the pores. This causes a local immune response where the body is attacking the pores which causes inflammation. I think the plugs have vellus hairs in them as well. So the goal is to reduce stress, cut out dairy and lower the amount of sugar. Also omega 3 supplements, oil of Oregeno supplements, oral coconut oil as well as a vitamin D and A supplement, zinc and vitamin C all help with inflammation and help the body repair these sores. The next thing to do that finally helped my sores is to clean the sores and area well with salicylic acid body wash/face wash then rinse well and pat dry. Next clean the area with iodine solution on a cotton pad and let dry. Next apply a mixture of sulfur ointment, Rx mupirocin ointment, tea tree oil, oregano essential oil, raw unfiltered organic honey, and 2% salicylic acid spot treatment. You will want to cover the wounds with water proof bandages then do not touch for 36-72 hours while the various compounds go to work. This combination of medication will kill any opportunistic microbe infection as well as help dislodge the plugs. After 72 hours ideally you will remove the bandages then take a shower. In the shower apply a glycolic acid body wash and a salicylic acid body wash to the sores and let it sit for about 5 min while cleaning the rest of your body as these acids will break apart dead skin and loosen the plugs. Next if you can use a spinning brush with a larger head attachment for the body and be prepared for some pain then scrub the lesions with the brush as this will pull out the plugs and remove any dead tissue. Also wash your whole body with the salicylic acid wash to help remove any of these things in its early stage. After the shower only slightly pat dry and stay a bit wet. Apply Eucerin roughness relief body cream that contains urea and lactic acid to your entire body including the sores. I also spray Biore toner all over my body that contains salicylic acid so this way you have three exfoliating acids on your body. Let your body dry and the cream absorb so that you can apply bandages again for them to stick. I also apply tretinoin to the areas and my face where I normally get these plugs. The next thing is to follow the steps in the beginning of my post for dressing and bandaging these wounds then let another 72 hours go by. If you follow these steps eventually these things will heal. To keep them at bay you have to follow an anti-inflammation diet and keep stress low as well as drink tons of water and get some exercise to flush toxins out of the skin and body. Once these things have finally started to scab over and they look like you haven’t been picking GOTO THE DERMATOLOGIST. And do not tell them you have been picking just say you have noticed that pulling these things out helps the sores heal but that they won’t heal on their own. Then tell them the protocol you have been following and tell them that you have researched online and have found an entire community of people suffering from this mystery disease and that you need them to find out what this is as it is breaking your mental health. If they don’t help them demand a refund. Also tell them that these people in the online community are saying that doctors are dismissing them and not taking them seriously. Anyways this is what has helped me. I maintain everything with a high dose of tretinoin cream and oral doxycycline which reduces inflammation. I also moisturize heavily and use acids and urea on my body skin and occasionally on my face. I wash my body with salicylic acid and glycolic acid and I made my own toner using a salicylic acid 2% store bought toner and add a bunch of tea tree oil and put it in a spray bottle and spray my whole head and areas on body where these things pop up. That is my 2 cents I hope it helps and I am sorry there are so many steps. I have tried so many things.
Extremely frustrating GillCo. I did see your photos and I feel for you because they look like they cause a lot discomfort. Hopefully thats not the case physically. I know all too well the mental aspect that comes along with this. It is hard to tell just from photos with quality/lighting, some of your sores look similar some seem to be a secondary issue or something else. I know in my reading I've seen some stock images close to your photos. Has anything helped you whatsoever?
Ah. Good news I suppose. The results of my CT scan shows nothing significant. Plus, the dermatologist in Toronto has opted not to see me. My next visit with my family doctor is January 21st - lol. Both wounds behaving today. Will take that. A long way from the heart. Okay. You guys be good.