Body-focused repetitive behaviors

Body-focused repetitive behaviors (BFRBs) are a group of related disorders characterized by repetitive, damaging behaviors involving the body. These behaviors are typically performed to manage anxiety, stress, or boredom, but they can result in physical harm and significant emotional distress. The most common types of BFRBs include trichotillomania (hair-pulling disorder) and dermatillomania (skin-picking disorder), though other behaviors such as nail-biting, cheek or lip biting, and biting nails are also included.

Trichotillomania involves the compulsive urge to pull out one’s own hair, leading to noticeable hair loss. Individuals with trichotillomania may pull hair from various parts of the body, including the scalp, eyebrows, eyelashes, or body hair. This behavior often occurs when the individual is feeling stressed or anxious, and it can lead to significant embarrassment, shame, and social withdrawal. The physical effects of hair-pulling can include bald spots, scarring, and infections.

Dermatillomania, or skin-picking disorder, involves the repetitive picking of skin, typically causing lesions, scars, and other forms of skin damage. The behavior is often focused on areas where the skin may be blemished, such as acne or scabs, but it can also occur in healthy skin. Like trichotillomania, dermatillomania is often performed to alleviate anxiety, and it can lead to feelings of shame and social isolation due to the visible damage caused by the picking.

The prevalence of BFRBs is estimated to affect approximately 1-2% of the general population. Trichotillomania is more commonly diagnosed in females, with an onset typically occurring in childhood or adolescence, whereas dermatillomania is also more prevalent in women. BFRBs can cause significant distress and impairment in an individual’s quality of life, leading to physical harm, social stigma, and challenges in personal relationships. These behaviors often persist long-term without intervention.