The Maryland Anxiety Center in Towson, Maryland, provides care for body-focused repetitive behaviors (BFRBs), including hair pulling and skin picking. Learn about these concerns, what can trigger them, and how therapy can help you work toward different responses.
Understanding Hair Pulling and Skin Picking
Hair pulling and skin picking can become distressing patterns that are difficult to reduce or stop. They can affect physical appearance, relationships, school, work, and other parts of daily life.
Hair Pulling (Trichotillomania)
Trichotillomania involves repeatedly pulling hair from different parts of the body, resulting in hair loss. People with this condition have made repeated attempts to decrease or stop pulling and experience distress or interference with important areas of life.
Skin Picking (Excoriation Disorder)
Excoriation disorder involves repeated skin picking that can cause wounds, infections, and scarring. People may repeatedly try to stop or reduce picking while continuing to experience distress or difficulties in daily life.
What Can Trigger Hair Pulling or Skin Picking?
Pulling and picking can be associated with different experiences, including:
- Physical sensations: itching, burning, or an urge to keep the fingers occupied.
- Thoughts about appearance: wanting to remove a particular hair or smooth a blemish.
- Emotional states: anxiety, boredom, anger, or frustration.
- Settings and activities: being in front of a mirror or watching television.
Some episodes happen with limited awareness. Others involve a more deliberate effort to relieve discomfort or correct a perceived imperfection.
Learn more about how emotions and triggers relate to BFRBs.
Understanding Shame Associated with BFRBs
Hair pulling and skin picking can bring feelings of embarrassment or shame. People may worry about others noticing the behavior or its effects, withdraw from relationships, or spend considerable time disguising hair loss or skin damage.
Addressing self-blame and practicing self-compassion are among the strategies discussed in our article on understanding shame associated with hair pulling and skin picking.
How Can Therapy Help with Hair Pulling and Skin Picking?
Therapy can help you understand the patterns surrounding pulling or picking and develop alternative ways to respond.
The Comprehensive Behavioral Model (ComB) focuses on understanding the behavior and the needs it serves. The process includes:
- Building awareness of when pulling or picking happens.
- Tracking potential triggers.
- Identifying sensations, thoughts, or emotions connected with the behavior.
- Working with a therapist on alternative responses to those needs and triggers.
Read more about the behavioral approach to BFRB treatment.
What to Expect When Starting Therapy
When you contact The Maryland Anxiety Center, a brief phone screening helps determine whether the practice’s services are an appropriate match. If so, an initial evaluation is scheduled with the Center’s director.
The first appointment includes a psychosocial and diagnostic evaluation. You can discuss your concerns, share relevant history, and ask questions.
Following the assessment, your therapist explains the diagnosis, treatment options, and treatment rationale. Treatment planning is collaborative and tailored to your needs.
Meet Our Clinicians
Learn about the clinicians behind our practice and their professional backgrounds in anxiety and related disorders. Our staff bios explain their qualifications, specialized training, and approaches to care.
Frequently Asked Questions
Are hair pulling and skin picking always caused by anxiety?
No. Anxiety can be involved, but BFRBs can also be associated with boredom, restlessness, frustration, other emotions, and sensory experiences. Pulling or picking may also happen with limited awareness.
How can therapy help with body-focused repetitive behaviors?
Therapy can help you recognize when the behavior occurs, identify triggers, and work on alternative ways to respond. The ComB approach considers the needs and experiences connected with the behavior.
When should I seek help for hair pulling or skin picking?
Consider seeking help if repeated efforts to stop have been unsuccessful, the behavior causes distress or physical damage, or it interferes with relationships, school, work, or daily activities.
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The Maryland Anxiety Center was founded by Andrea G. Batton, LCPC with a vision of creating a practice where clinicians and staff work cohesively and collaboratively with patients to provide optimal psychological care. The Maryland Anxiety Center specializes in the treatment of anxiety and related disorders from a cognitive behavioral perspective, the gold-standard and most effective treatment for such conditions.