What should you know about dementia and picking at skin?

A person with dementia may pick because the skin itches, feels dry, or has a small wound, or because the action is soothing or occupies restless hands. Anxiety, boredom, pain, medication effects, and difficulty explaining discomfort can contribute. Memory problems may make it harder to remember that the skin is already damaged. Picking can break the skin, cause bleeding, and allow infection. Look for when it happens, what was happening beforehand, and whether a particular area seems painful or itchy.

Arrange a GP consultation if picking is new, frequent, distressing, or causing sores. Keep nails short, moisturise dry skin with a suitable product, cover open areas with a clean dressing, and offer a safe hand activity such as folding towels or handling a soft object. Use calm redirection rather than criticism. Check clothing, room temperature, and personal care routines for irritation. A clinician can examine the skin, review medicines, and consider a mental health assessment when anxiety or distress is prominent.

Get prompt medical help for spreading redness, warmth, swelling, pus, fever, worsening pain, heavy bleeding, or a deep wound. Seek urgent support if the person is suddenly much more confused, cannot stop injuring themselves, or seems frightened or unsafe. Do not use restraints or harsh measures without professional guidance; these can increase distress and injury.

Ask whether the skin needs treatment, whether a medicine or illness could be causing itching or restlessness, which dressing is suitable, how to redirect the behaviour, and whether a mental health assessment or specialist review would help.