What is a BFRB?

Body-focused repetitive behaviors (BFRBs) include any repetitive self-grooming behavior that involves biting, pulling, picking, or scraping one’s own hair, skin, lips, cheeks, or nails that can lead to physical damage to the body and have been met with multiple attempts to stop or decrease the behavior.

Background image for the top of the page: a girl with buzzed haircut painting her fingernails and smiling
Common BFRBs Include
Thumbnail for link to Hair Pulling page: a hand pulling hair from a person's head
Hair Pulling Disorder

(Trichotillomania) causes people to pull out the hair from their scalp, eyelashes, eyebrows, and other parts of the body resulting in noticeable bald patches. Approximately 5-20% of people who have hair pulling disorder also swallow the hair.

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Thumbnail for the link to the Skin Picking page: a hand picking skin on an arm
Skin Picking Disorder

(Excoriation) causes people to repetitively touch, rub, scratch, pick at, or dig into their skin, resulting in skin discoloration, scarring, and even severe tissue damage and disfigurement.

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Thumbnail for the link to the Nail Biting page: a person biting their fingernails
Nail Biting Disorder

(Onychophagia) causes people to bite their nails past the nail bed and chew on cuticles until they bleed, leading to soreness and infection.

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Thumbnail for the Cheek Biting page: a woman holding her cheek
Cheek Biting

Often referred to as "cheek chewing," chronic cheek biting can result in a myriad of complications. Redness, painful sores, and tears can occur in the mucosa, which is the inner lining of the mouth.

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Thumbnail for the Other BFRBs page: a person scratching their neck
Other BFRBs

Frequently include cheek and lip biting, nail picking, scab eating, and other self-grooming-related behaviors.

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What Causes BFRBs?

BFRBs are among the most poorly understood, underdiagnosed, and untreated group of mental health disorders. Research suggests that causes of BFRBs include improving or correcting an imperfection in physical appearance, in addition to self-regulation of intense emotions. Several studies have shown a higher number of BFRBs in immediate family members of persons with skin picking or hair pulling than would be expected in the general population. BFRBs are not self-harm.

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Myths and Misperceptions About BFRBs
Myth: Only women experience BFRBs.
Myth: BFRBs are considered self-harm.
Myth: Anxiety is the sole cause of BFRBs.
Myth: Bad parenting causes BFRBs.
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Self-Help Strategies

Body-focused repetitive behaviors are complex, multidimensional problems that require a multidimensional approach. Learning to understand the function of a BFRB, emotional and physical triggers to the behavior, and having a toolbox of strategies for working through triggers and urges are crucial components of success. The articles below offer various approaches and tips to help you or your loved one on the path to recovery.

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