Trichotillomania & Other Body-focused repetitive behaviors (BFRBs)

Trichotillomania & Other BFRBs

Body-Focused Repetitive Behaviors (BFRBs) are a group of conditions characterized by repetitive self-grooming behaviors that result in damage to the body. These behaviors are often performed compulsively or habitually and can be difficult to control. Trichotillomania (Hair-Pulling Disorder) is one of the most well-known BFRBs, along with Excoriation Disorder (Skin-Picking Disorder), and nail-biting.

Trichotillomania involves repetitive, uncontrollable pulling of one’s own body hair. Most commonly, hair is pulled from the scalp, eyelashes, and eyebrows, though any area of the body may be affected. 

Treatment for Trichotillomania & Other BFRBs

The most effective treatment for BFRBs is Cognitive Behavioral Therapy (CBT), particularly Habit Reversal Training (HRT). HRT and certain types of medication have been shown to be helpful in treating Trichotillomania. The primary behavioral treatment approach combines HRT with stress management and behavioral contracting. Treatment typically begins with self-monitoring of hair-pulling episodes, along with tracking the feelings and situations that most often trigger the behavior. Children are then systematically taught to use a competing response—such as squeezing a ball or tightening their fist—whenever they feel the urge to pull. Relaxation training and other stress management techniques are also incorporated to help manage hair-pulling urges.