Understanding Body-Focused Repetitive Behaviors (BFRBs): Causes, Symptoms, and Treatment Options

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Body-Focused Repetitive Behaviors (BFRBs) are more common than many people realize, yet they often go undiagnosed or misunderstood. These behaviors can affect self-esteem, mental health, and quality of life—but with the right support, recovery is possible. In this post, we’ll explore what BFRBs are, what causes them, common signs and symptoms, and how mental health therapy can make a difference.


What Are Body-Focused Repetitive Behaviors?

BFRBs are a group of behaviors where individuals repeatedly damage their hair, skin, or nails, often as a way to cope with stress, anxiety, or uncomfortable emotions. Common examples include:


  • Hair pulling (Trichotillomania)
  • Skin picking (Dermatillomania or Excoriation Disorder)
  • Nail biting (Onychophagia)
  • Cheek biting (Morsicatio buccarum)


While these behaviors may start as a habit, they can become difficult to control and may interfere with daily life.

Two hands clasped together in a close-up, suggesting comfort or support.

Causes of BFRBs

The exact cause of BFRBs isn’t fully understood, but research suggests a combination of factors may be involved:


  1. Genetics – Family history can increase susceptibility.
  2. Brain chemistry – Differences in how the brain processes urges and emotions may play a role.
  3. Emotional triggers – Stress, anxiety, boredom, or fatigue often precede episodes.
  4. Learned behavior – BFRBs can develop as a coping mechanism and become habitual over time.


Common Signs and Symptoms

People with BFRBs may experience:


  • Noticeable hair loss, bald patches, or skin lesions
  • Frequent scabs, scars, or skin infections
  • Difficulty resisting the urge to pull, pick, or bite
  • Relief or satisfaction after performing the behavior
  • Attempts to hide affected areas with clothing, makeup, or hairstyles
  • Emotional distress, shame, or embarrassment related to the behavior


Treatment Options for BFRBs

Treatment for BFRBs is highly individualized, but effective approaches often include:


  • Cognitive Behavioral Therapy (CBT) – Helps identify triggers and replace harmful habits with healthier coping strategies.
  • Habit Reversal Training (HRT) – A structured approach that teaches awareness and alternative behaviors.
  • Mindfulness and relaxation techniques – Reduce stress and increase self-control.
  • Medication – In some cases, antidepressants or other medications may help manage urges.


How Mental Health Therapy Can Help

Therapy provides a safe, judgment-free space to address the emotional and behavioral aspects of BFRBs. A trained mental health professional can help you:


  • Understand the root causes of your behavior
  • Develop strategies to manage urges and triggers
  • Build self-compassion and reduce shame
  • Improve emotional regulation and stress management


With consistent support, many people see significant improvement in their symptoms and overall well-being.


Take the First Step Toward Recovery

If you or someone you love is struggling with body-focused repetitive behaviors, you are not alone—and help is available. At Rosecrans & Associates, our experienced therapists specialize in treating BFRBs with compassion, understanding, and evidence-based strategies.


Call us today at 847-461-8414 or Schedule an appointment online to start your journey toward healing.

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