Picking the problem

White scars like this on a patient’s neck can lead to a prolonged difficult consultation. They are the result of the patient picking and causing trauma to the skin.

They can be seen in acne, but often there is no precipitating lesion. Some patients complain of an area of intense itch that is only relieved by scratching, thereby causing the white scar.

Often this becomes a tension-relieving activity causing lesions on the neck, face, shoulders and upper back, but only in areas the patient can reach. The condition is mainly seen in women and is rare in