Body-Focused Repetitive Behaviors

Body-focused repetitive behaviors or BFRBs may include any repetitive self-grooming behavior that involves biting, pulling, picking, or scraping one’s own hair, skin, or nails that results in damage to the body. While most people engage in one or some of these behaviors to a certain degree, an individual may want to seek help and support if the behavior begins to limit their life in some way, feels out of control, causes physical damage, or is causing social impact. Effective treatment involves improving awareness of the habit, building a competing response, and including social supports in the treatment process.

Trichotillomania (trick-o-till-o-may-nee-uh) also known as hair pulling disorder, is characterized by the repetitive pulling out of one’s hair, including from the scalp, eyelashes, eyebrows, and other regions. Research indicates that about 1 or 2 in 50 people experience trichotillomania in their lifetime. Without treatment, trichotillomania tends to be a chronic condition; that may come and go throughout a lifetime.

 Excoriation Disorder, also known as skin picking disorder or dermatillomania, is characterized by the repetitive picking of one’s own skin. Individuals who struggle with this disorder touch, rub, scratch, pick at, or dig into their skin in an effort to improve perceived imperfections, often resulting in tissue damage, discoloration, or scarring. Occasional picking at cuticles, acne, scabs, calluses or other skin irregularities is a very common human behavior. However, research indicates that 2% – 5% of the population picks their skin to the extent that it causes noticeable tissue damage and marked distress or impairment in daily functioning. Without treatment, skin picking disorder tends to be a chronic condition that may wax and wane over time.

Other Body-Focused Repetitive Behaviors include but may not be limited to picking at or biting nails, biting or chewing on lips, cheeks, and tongue, and in some cases, eating hair and skin.

Body-focused repetitive behavior symptoms may include:

  • Recurrent behaviors that result in hair loss, skin lesions, or other damage to the body
  • Repeated attempts to stop the behavior
  • Significant distress or impairment in social, occupational, or other area of functioning as a result of the behavior

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    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

    The TLC Foundation for Body-Focused Repetitive Behaviors. (2021). Learn about BFRBs.