Body Focused Repetitive Behaviors (BFRB) are a group of behaviors in which an individual damages his or her appearance, or causes physical injury through pulling, picking, biting or scraping of the hair, skin or nails. BFRBs are considered impulse control disorders. They usually occur when a person is feeling overly stressed or excited or when inactive or feeling bored. The sufferer may not be fully aware of their behavior at the time, or may find it pleasurable or relaxing. Family members may have a difficult time understanding these behaviors and sometimes feel helpless, irritated, or angry. This negative attention can increase stress and even make the problem worse.
BFRBs affect 2-5% of the population. Most BFRBs begin in early puberty or adolescence and frequently continue into adulthood. In childhood both males and females are affected equally, but in adulthood more females are affected. Types of BFRBs include:
Hair Pulling Disorder (Trichotillomania) – The compulsive urge to pull out hair from various parts of the body resulting in noticeable hair loss. Areas where pulling usually occur include scalp, eyelashes, eyebrows, arms, legs, and pubic area.
Skin Picking Disorder (Dermatillomania/Excoriation) – The compulsive urge to pick at one’s skin resulting in noticeable damage (sores, scabs, infections). Common areas include: face, head, cuticles, back, arms and legs, hands and feet.
Other BFRBs – Severe Nail Biting, Nose Picking, Hair Cutting, Cheek Biting
The stigma associated with these conditions can make individuals feel embarrassed, frustrated, or ashamed of their behavior, making it difficult to seek help. Oftentimes other mental health conditions occur alongside the BFRB, such as anxiety and depression.
Additional information is available at the Trichotillomania Learning Center.