Skin Picking and Hair Pulling Explained. What are Body Focused Repetitive Behaviors?

The two most common behaviors are hair pulling and skin picking. These two have official names in the diagnostic manual. Hair pulling is called trichotillomania and skin-picking is called excoriation disorder. Even though trichotillomania has mania in the name, it has nothing to do with the mania of bipolar disorder.

Some other body focused repetitive disorders include:
Nail biting also called Onychotillomania
Lip biting
Nose picking

Some of the therapies used to help this condition are habit reversal training, which is a type of cognitive behavior therapy and a self-help technique called decoupling. With decoupling, you perform a different behavior whenever you feel the tension that normally triggers the compulsion. The idea is that this other behavior that you do, decouples or disrupts the connection between the emotion and the compulsion. Engaging in the other behavior allows you to gain some control over the compulsive behavior.

We don’t have any medications that are standardly used for this disorder. There’s been some evidence that inositol and N-acetylcysteine have been helpful. Both of these are supplements that you can get without a prescription. Other alternative therapies are yoga, aerobic exercise, acupuncture, biofeedback and hypnosis.

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References
Grant JE, Odlaug BL, Chamberlain SR, et al: Skin picking disorder. Am J Psychiatry 169(11):1143–1149, 2012 PubMed ID: 23128921

Torales J, Barrios I, Villalba J. Alternative Therapies for Excoriation (Skin Picking) Disorder: A Brief Update. Adv Mind Body Med. 2017 Winter;31(1):10-13. PMID: 28183072.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[ligma]

i cant believe this random well-dressed lady just read me like this for 7 minutes straight I'm so hurt

[Brakathor]

More than the fact that I'm an apparent freak, I'm concerned that the Google algorithm somehow KNEW that I'm a freak in this exact way. I did not search this video or subject, or anything related to it.

[SusanNicole.]

Having lip biting mentioned as even a small part of this video feels so validating. I’ve struggled with that for my entire life. I don’t think I’ll ever be able to stop.

[puppetseducer]

I'm a big skin picker, I have dark spots from picking at stress acne all along my jawline. I'll definitely be bringing this up with my therapist. Thank you for putting a name to it so I can better articulate this issue with her.

I've had coworkers catch me picking, and my parents of course, and they tell me to just "stop it". Like "gee, something I've never tried before." 🙄

[Elisa]

i literally can’t sleep sometimes because i can’t stop my hands searching for any scab or bump or imperfections to dig at all over my body.

[chloelp]

“My child is fine”
“Ma’am your child could spend half an hour searching for and popping pimples”

[patriciacox]

I'm 75, and I'm just about a hermit because I pick my face constantly. Then I pull off the scabs... leaving scars. I thought I was the only one, and I always feel so ashamed of myself. Good vibes to all, I'm glad you're out there...

[Narissa_]

I still remembered how mentally stressful and humiliating it was as a little kid to feel addicted to plucking my hair without realizing that trichotillomania was a thing. And then realizing that my eyebrows were completely gone…and knowing that I’d be yelled at for it, even though I was helpless at the time to resist it. I still remember the night before a doctors appointment, about a year after I thought I had gotten over it, I plucked one of my eyebrows clean without realizing. My dad got frustrated and asked me “why can’t you pull out your mustache hair instead?” That stung a lot. I wish I had access to this knowledge when I was younger, even just to know I wasn’t alone. It’s gotten much better with age, but still I feel the urge from time to time.

[zoe]

I don't know why this was on my recommended but I definitely have the hair pulling one which is scary how YouTube knows

[eviec]

Looking for the “perfect” piece of skin to pick or spot to pop is so difficult to avoid. I had no idea that other people did this as well, I’ve had people refer to me as disgusting before over this, so thank you so much for this video I feel less alone!

[Apostate_ofmind]

For anyone out there, what helped me was:

- have your actual skin in check, as i developed this because of very thick scabs forming on my scalp, which i obsessively piicked away from the scalp to look cleaner (dandruff looks better than bigger scabs).

- i put on dreadlocks. This assures i have less access to the scalp, but that i can always pull on them for relief, but since pulling involves more hairs at once, it doesnt do as much of a bald spot. The added weight also gives a constant pull which is perfect. Note: this doesnt completely get rid of the impulse, but it guides it into something more constructive, since if if it gets bad and i pull too many hairs in either direction (usually out of the dreadlock but still attached to the scalp), i can always use it as an excuse to redo the dreadlock, giving my hands something constructive to do while still pulling the scalp.
- use honey on the sores/scabs/imperfection of your skin. Honey relieves the itchyness which might trigger the action, and its a nice repellent because it makes you associate the 'skin-touching' with something umpleasant as the stickyness of the honey, so you catch yourself mid-act if youre being absentminded. Its also a perfect antiseptic and hydratant so it leaves your skin healthy (perfect for acne also).

Please upvote this so everyone sees!

[mekhalam]

I have relapsed with hair pulling from my scalp, eyebrows and eyelashes after going pull free for 3 years. I look like an alien rn but I feel so helpless :( I mourn my hair how it was and the stress triggers in my life have gotten worse + are constantly present so I keep pulling even now when there's new hair growth... please send prayers to me so I try my best to control my urges. I pray for my fellow hair/skin pullers/pickers ❤️

[morcika]

I noticed that I do it more when I’m tired or bored. It’s like a self-soothing behaviour but I can recognise it now and actively try and train myself off it.

[pswank]

I talked to a doctor about my dermatillomania when I was younger and he said to just stop the habit and nothing could be done. Currently, I'm studying to be a psychiatrist to do something about this issue- wish me luck.

[tkourun]

I picked my nose a lot as a child that graduated into nail biting and hair pulling as I got older. I have never talked to anyone about this because I'm worried they'll be as disgusted with me as I am with myself. I honestly never thought about what I have been doing as a control thing. Looking back that makes a lot of sense. It even gives me a similar calm to what self harm used to

[EvenstarSK]

I have keratosis pilaris which creates small build ups of sebum under the skin and makes hard little white bumps that are unnoticeable to most but they are so obvious to me. I've been picking at my skin due to this my whole life and it's so hard to stop. I wear long sleeves as much as possible to hide it.

Talking about this as a compulsive behaviour is making it easier to understand why I do it and it's good to know I'm not alone with this problem.

[KydaIndie]

Ummm it’s creepy how accurately she explained exactly what I do

[angelaadams]

I pick at my skin, it's like I'm trying to get rid of impurities on my body

[KevinKreger]

I had trichotieromania, scalp picking, for 20+ years. I read a few dermatology research papers that used NAC. I started NAC 18 months ago and the behaviour stopped in 2 weeks. It has not come back. I love your videos!

[justanothercommenter]

I've found knitting really helps with my skin/nail biting as well as pulling on skin on my lips till they bleed. It keeps my hands occupied so I can't be tempted. It's not foolproof but it's helped immensely