Body-Focused Repetitive Behaviors (BFRBs)
Body-focused repetitive behaviors (BFRBs) are a group of complex disorders that involve repetitive self-grooming behaviors, such as hair pulling, skin picking, and nail biting, which can result in physical damage. These behaviors are not simply habits or tics; rather, they are compulsive behaviors that can lead to emotional distress and impact daily life.
Prevalence and Onset
Research suggests that over 3% of the population—more than 10 million people in North America—struggle with a BFRB. Despite their prevalence, these disorders often go undiagnosed and untreated, leading to feelings of shame and isolation. Symptoms typically begin around puberty and can fluctuate in severity over time. While both men and women can experience BFRBs, women are more commonly affected. Studies indicate that genetics may play a role in the development of these disorders, though the exact causes remain unclear.
Common Types of BFRBs
BFRBs manifest in different ways, with some of the most common including:
Trichotillomania (Hair-Pulling Disorder) – Individuals pull hair from their scalp, eyelashes, eyebrows, or other areas, leading to noticeable bald patches.
Excoriation (Skin-Picking Disorder) – Repetitive picking, scratching, or digging into the skin, which can cause scarring, discoloration, or severe tissue damage.
Onychophagia (Nail-Biting Disorder) – Chronic nail-biting that extends past the nail bed and can lead to soreness, infection, and nail deformities.
Other Related Behaviors – This may include frequent cheek chewing or lip biting to the point of bleeding.
Effects of BFRBs
For some individuals, BFRBs may be a mild frustration, while for others, they cause significant emotional distress. Common consequences include:
Physical harm, such as skin infections, scarring, or repetitive motion injuries.
Gastrointestinal complications, especially if hair is ingested (trichophagia), which can lead to digestive blockages.
Emotional and social impact, including shame, anxiety, and withdrawal from relationships or social activities.
Family stress, as misunderstandings about the condition can create tension between loved ones.
Treatment Approaches
Managing BFRBs typically involves a combination of therapeutic strategies, support, and sometimes medication.
Cognitive Behavioral Therapy (CBT)
Research supports CBT as one of the most effective treatments for BFRBs. This approach helps individuals identify triggers, develop coping strategies, and modify thought patterns related to their behavior. Techniques such as Habit Reversal Training (HRT) and Acceptance and Commitment Therapy (ACT) can be particularly beneficial.
Medication
Currently, no medications are specifically FDA-approved for treating BFRBs. However, some individuals find relief with certain medications, particularly those that also address co-occurring conditions like anxiety or depression.
Support and Education
Understanding and support are crucial in managing BFRBs. Connecting with others through support groups—either in-person or online—can provide encouragement and reduce feelings of isolation. Organizations like the TLC Foundation for Body-Focused Repetitive Behaviors offer valuable resources, educational materials, and support networks for individuals and families affected by BFRBs.
Finding Help
If you or a loved one is struggling with a BFRB, seeking professional guidance is essential. Treatment should be tailored to the individual's needs, as no single approach works for everyone. You can visit www.bfrb.org for more information or schedule a consult with Stacey Kamp LMFT.
By increasing awareness and promoting compassionate understanding, we can help those affected by BFRBs find effective treatment and support on their journey to recovery.
