Dermatillomania, Skin Picking, Onychophagia, Nail Biting, Skin Excoriation, BFRB
How to Manage and Treat BFRBs
Treatment recommendations for BFRBs include cognitive behavioral therapy , medication , and select supplements—most notably N-acetylcysteine, an amino acid. While for some, these options are highly effective, overall, they have a long-term success rate of less than 20 percent.
However, a precision medicine initiative recently launched by The TLC Foundation for Body-Focused Repetitive Behaviors is the largest effort yet to understand the neurobiology of BFRBs and find more effective treatments.
Find a therapist who specializes in body-focused repetitive behaviors.
CBT has been shown to help individuals with BFRBs identify triggers that cause picking or pulling. A specific form of behavioral therapy known as Habit Reversal Training may also be highly effective for recognizing behavior patterns and managing the negative emotions associated with BFRBs.
Managing Shame and Stigma
Although BFRBs affect millions, they are not well-understood and are rarely portrayed in the media. As a result, the behaviors are often seen as little more than “bad habits” that could be stopped using willpower .
Because of this misconception, many who live with BFRBs report debilitating shame surrounding the disorder. They may beat themselves up for their seeming inability to stop, or go to great lengths to hide the evidence of their hair pulling or skin picking—often using wigs or makeup, or refusing to let people see the parts of their body where they pick or pull. This intense shame can interfere with relationships, intimacy , and daily functioning.
Sharing feelings of guilt and shame with a loved one or therapist can be immensely helpful. Many with BFRBs also find comfort simply in learning that they are not alone. For this reason, support groups and online resources can be especially useful in reducing shame .
There is no cure for BFRBs; most who live with the disorders will need to manage and treat them for their entire lifetime . But improvement is possible, and many with BFRBs have developed treatment plans and coping mechanisms that have greatly reduced—or even eliminated—their need to pick or pull.
Explore More About Body-Focused Repetitive Behaviors
For a comprehensive understanding of body-focused repetitive behaviors, read our complete guide: