What Are Body-Focused Repetitive Behaviors (BFRBs)?
Have you ever found yourself absentmindedly biting your nails or picking at your skin when you’re stressed? For some people, these behaviors go far beyond a nervous habit. They’re called Body-Focused Repetitive Behaviors, or BFRBs, and they can be incredibly difficult to stop.
BFRBs are repetitive self-grooming behaviors like pulling, picking, biting, or scraping parts of the body. The key difference between a casual habit and a BFRB is this: the person has tried to stop — often many times — and feels unable to. The behavior can cause noticeable physical damage and a great deal of emotional distress.
What Do BFRBs Look Like?
The two most recognized BFRBs are:
Trichotillomania (hair-pulling disorder)
Excoriation disorder (skin-picking disorder)
Hair pulling may involve the scalp, eyebrows, eyelashes, facial hair, or the pubic area.
Skin picking often affects the face, scalp, chest, back, arms, or legs.
For many people, there’s a strong urge to “fix” something — smooth out a bump, remove an uneven hair, or make the skin feel just right. What may start as an attempt to perfect a small imperfection can quickly turn into hours of picking or pulling.
Why Do People Do It?
BFRBs are not about wanting to hurt yourself. They’re different from self-harm in both purpose and intent. Instead, these behaviors are often ways of coping with uncomfortable feelings.
Common triggers include:
Stress
Anxiety
Boredom
Restlessness
Sometimes the behavior happens almost automatically — like zoning out while watching TV. Other times, it’s a response to feeling overwhelmed or tense. The behavior may bring brief relief, but it’s often followed by shame, frustration, or guilt.
The Emotional Impact
Because BFRBs can leave visible marks — thinning hair, bald spots, scabs, or scars — many people struggle quietly. They may avoid social situations, wear hats or makeup to cover areas, or feel embarrassed talking about it. It’s also common for people with BFRBs to experience anxiety, depression, OCD, or ADHD. The overlap can make the cycle even harder to break. And unfortunately, many people blame themselves, thinking, “Why can’t I just stop?” But BFRBs are not about a lack of willpower.
Is There Treatment?
Yes — and that’s important to know. One of the most effective treatments is a form of Cognitive Behavioral Therapy (CBT) called Habit Reversal Training (HRT). This approach helps people:
Become more aware of when and why the behavior happens
Identify triggers
Learn alternative responses
Build healthier ways to cope with stress
With the right support, people can reduce symptoms and feel more in control. www.bfrb.org