The Most Common Types of BFRBs

Closeup of woman pulling strand of curly hair

Discovering the path to wellness starts with understanding Body-Focused Repetitive Behaviors (BFRBs). These common yet often misunderstood conditions involve repetitive self-grooming behaviors that extend beyond typical grooming practices. If you or someone you know is experiencing issues with BFRBs, you’re not alone. Approximately one in twenty people worldwide struggle with BFRBs. 

BFRBs can affect people of any age, gender, or background, though symptoms often first appear in late childhood or early adolescence. Their impact extends beyond physical effects, frequently affecting self-esteem, social relationships, academic performance, and work. Many people report spending several hours each day engaged in these behaviors, leading to significant distress and interference with daily activities. Let’s explore these common behaviors and their unique characteristics.

Primary Hair and Skin-Focused BFRBs

  • Trichotillomania (Hair Pulling):some text
    • Involves pulling hair from the scalp, eyebrows, eyelashes, or other body areas.
    • Often creates a sense of tension before pulling and relief afterward.
    • Can result in noticeable hair loss or bald patches.
    • May involve specific rituals, like selecting certain types of hair.
  • Excoriation Disorder (Skin Picking):some text
    • Involves picking, scratching, or squeezing the skin.
    • Often targets perceived imperfections, scabs, or healthy skin.
    • Can result in tissue damage, scarring, or infections.
    • May increase during periods of stress or anxiety.

Oral and Nail-Related Behaviors

  • Onychophagia (Nail Biting) and Cheek Biting: some text
    • Extend beyond casual habits into repetitive, damaging behaviors.
    • Can create ongoing physical issues like damaged nail beds or mouth sores.
    • Often occur unconsciously, especially during focus or stress.
    • May impact daily activities and social interactions.
    • Can become cyclical as healing tissue creates new sensations.

Some individuals may experience less common but related behaviors, such as trichophagia (hair eating) or dermatophagia (skin eating). These often occur alongside primary BFRBs and may require additional medical attention. It's also common for people to develop specific patterns or rituals around their behaviors, which can be a significant factor in treatment.

Importance of Understanding the Different Types of BFRBs

Understanding these common types of BFRBs is crucial for several reasons. First, it helps you recognize that these behaviors are legitimate medical conditions, not merely "bad habits." Second, knowing you're not alone can alleviate feelings of shame and isolation. Finally, understanding your specific BFRB can guide you toward appropriate treatment and support.

Identifying patterns and triggers is essential for managing BFRBs effectively. Common activating factors include stress, anxiety, boredom, perfectionism, and specific sensory experiences. Understanding your triggers becomes a crucial foundation for developing management strategies that work for you.

Remember, while these behaviors share similarities, each person's experience is unique. Some individuals may experience multiple BFRBs, while others focus on one behavior. The impact on daily life can vary significantly from person to person, and what works for managing one person's BFRB may not work for another.

What Types of Treatments Help with BFRBs?

Treatment for BFRBs typically involves a combination of approaches. Cognitive Behavioral Therapy (CBT), notably the Comprehensive Behavioral Model (ComB), has shown significant effectiveness. Some people also benefit from medication, particularly when dealing with co-occurring conditions like anxiety or depression. Support groups, in-person or online, provide valuable community connection and practical coping strategies.

If you recognize yourself or a loved one in these descriptions, know that help is available. The TLC Foundation for Body-Focused Repetitive Behaviors offers resources, support groups, and connections to trained professionals who understand these conditions. Learning more about BFRBs is a significant step toward understanding and managing these behaviors more effectively.

Whether you're dealing with BFRB yourself or supporting someone who is, remember that management isn't about achieving perfection—it's about finding ways to manage these behaviors while living a full and meaningful life. With the right support, understanding, and tools, you can develop strategies to cope with BFRBs and work toward your personal recovery goals.

Diagnosis & Treatment
Hair Pulling
Nail Biting
Cheek Biting
Skin Picking
Hair Eating