Body-Focused Repetitive Behaviors (Hair Pulling & Skin Picking)
Body-Focused Repetitive Behaviors (BFRBs), such as hair pulling (trichotillomania) and skin picking (excoriation disorder), involve repetitive behaviors that can be difficult to control despite repeated attempts to stop. BFRBs can affect self-confidence, relationships, school, work, and daily life. Many people feel embarrassed or ashamed and hide their symptoms from others.
When Body-Focused Repetitive Behaviors Take Over
Body-focused repetitive behaviors, such as hair pulling and skin picking, can become difficult to control and may lead to distress, shame, physical damage, or avoidance of social situations. Although these behaviors may briefly relieve tension or happen automatically, they can significantly interfere with daily life.
Common Symptoms May Include:
- Recurrent hair pulling or skin picking that is difficult to stop
- Noticeable hair loss, skin damage, or scarring
- Repeated attempts to reduce or stop the behavior without success
- Feelings of tension before pulling or picking
- Temporary relief or satisfaction after the behavior
- Avoiding social situations because of embarrassment
- Shame, frustration, or guilt about the behavior
How CBT Can Help
Cognitive Behavioral Therapy (CBT), including Habit Reversal Training (HRT), is considered the gold standard evidence-based psychological treatment for Body-Focused Repetitive Behaviors, such as hair pulling and skin picking. Treatment helps people become more aware of pulling or picking behaviors, identify triggers, learn healthier responses to urges, and develop practical strategies to reduce these behaviors over time.
Our Approach at HVCCT
Treatment focuses on Habit Reversal Training (HRT), a leading evidence-based treatment for body-focused repetitive behaviors. Clients learn to recognize urges, triggers, and patterns associated with hair pulling or skin picking and practice competing responses that make the behavior more difficult to perform. Treatment may also include modifying the environment, developing alternative ways to manage emotions and sensory urges, and strengthening motivation and support. Together, these interventions help clients reduce repetitive behaviors and feel more confident and in control.
Making progress with hair pulling, skin picking, and other body-focused repetitive behaviors often involves increasing awareness of triggers and practicing alternative responses between sessions. Explore our tips for getting the most out of therapy.
Ready to take the next step?
If hair pulling or skin picking is interfering with your life, you don’t have to face it alone. Our experienced therapists are here to answer your questions and help you determine whether CBT is the right approach for you.