Understanding How Habit Reversal Therapy Can Reduce Scratching in Eczema Patients
Itch is one of the most challenging symptoms of eczema, and while we’ve all probably heard or said, “Stop scratching!” it’s not helpful for those struggling with the condition. However, research shows that reducing scratching can improve eczema symptoms.
To explore this further, ESC spoke with registered psychologist Shawn Reynolds, PhD, about habit reversal therapy—a technique designed to help individuals break the itch-scratch cycle. Dr. Reynolds shares insights on how this approach may offer relief for eczema patients.
What is Habit Reversal?
When we have a habit we don’t like (such as itching), we can learn to better manage it by understanding more about it. The goal of habit reversal therapy is usually not to fully eliminate the behaviour, but to make it more manageable and less damaging.
Most of the time, what doesn’t help is telling your child, loved one, or even yourself, “Just stop scratching!” If that worked, we wouldn’t need strategies like the ones below.
But, if it didn’t, here are some strategies that might help:
- Increasing our awareness of it (When does it happen?)
- Thinking about our response (Do I have to scratch right now?)
- Trying different responses (I’m going to scratch if it still itches in 10 seconds; when I scratch, I will use my palm but not my nails)
- Evaluating our responses (Did scratching make it better? After I waited, did I still feel a need to scratch?)
What are Habit Reversal Techniques?
Awareness: We can benefit by simply being more aware of when we are scratching. Tracking this can help us to know the times of the day and situations when scratching is most likely to happen.
Environment: Are there places I am more likely to think about scratching? Do certain clothes make this better/worse?
Sensory: Are there things I can do that help and don’t involve scratching (like ice instead of fingernails)?
Habit Reversal Techniques
Treatment of habits focuses on three areas:
- Urge Management. That is, understanding the urge – when does it most often happen? What do I do when it happens?
- Response Management. When the urge comes, what do I do about it? What other techniques can I use besides the habit?
- Damage Control. When I can’t manage the urge, how can I limit damage from it? Can I shorten the time in the habit, or use less damaging strategies (like rubbing with ice instead of itching with something sharp)?
These techniques can help you gain more control over the scratching, and hopefully will help you in caring for your eczema.
Eczema Society of Canada thanks registered psychologist Shawn Reynolds, PhD, for his volunteer contribution to this educational content.
This blog was developed as part of our Life with Eczema program, and funding support for this initiative has been provided by AbbVie, Pfizer Canada, and Sanofi.
Disclaimer: Information provided in this resource does not constitute medical advice and is not intended to be used as a diagnostic tool. The information is up-to-date at time of publication. All medications, interventions, and treatment plans have risks and benefits, and it is important that individuals discuss their or their child’s specific healthcare needs with a qualified healthcare professional.
October 2024
