Body-Focused Repetitive Behaviors in Children

Body-focused repetitive behaviors or BFRBs include any repetitive self-grooming behavior that involves biting, pulling, picking, or scraping one’s own hair, skin, or nails that results in damage to the body. While many of these “habits” are common in childhood, treatment may be warranted if the behavior begins to limit life in some way, feels out of control to your child, causes physical damage, or is having a social impact.

Trichotillomania (trick-o-till-o-may-nee-uh) is characterized by the repetitive pulling out of one’s hair, including from the scalp, eyelashes, eyebrows, or other regions of the body. Research indicates that about 1 or 2 in 50 people experience trichotillomania in their lifetime. Without treatment, trichotillomania can be a chronic condition that may wax and wane throughout the lifetime.

Excoriation Disorder is characterized by the repetitive picking of one’s own skin. Individuals who struggle with this disorder touch, rub, scratch, pick at, or dig into their skin often resulting in bleeding, tissue damage, discoloration, or scarring. Occasional picking at cuticles, acne, scabs, calluses, or other skin irregularities is a very common human behavior. However, research indicates that 2% – 5% of the population picks their skin to the extent that it causes noticeable tissue damage and marked distress or impairment in daily functioning. Like trichotillomania, without treatment, excoriation disorder tends to be a chronic condition that may wax and wane over time.

Other Body-Focused Repetitive Behaviors include but may not be limited to picking at or biting nails, biting or chewing on lips, cheeks, and tongue, and in some cases, eating hair and skin.

Body-focused repetitive behavior symptoms may include:

  • Recurrent behaviors that result in hair loss, skin lesions, or other damage to the body
  • Repeated unsuccessful attempts to stop the behavior
  • Significant distress or impairment in social, occupational, or other area of functioning as a result of the behavior

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