Body Focused Repetitive Behaviors (BFRB's) are a group of mental health conditions characterized in the DSM-5 by repetitive and excessive self-grooming behavior that involves biting, pulling, picking, or scraping one’s own hair, skin, or nails. The behaviors are characterized by repeated attempts to stop or decrease the seemingly uncontrollable behavior.
BFRB's vary in severity and can lead to physical damage to the body (such as bald spots, cuts, or infections). This physical damage is compounded by notable mental distress or impairment of daily functioning and social activities. Despite causing physical damage, BFRB's are different from self-harm behaviors.
BFRBs include but are not limited to hair pulling (trichotillomania), skin picking (dermatillomania or excoriation disorder), nail biting (onychophagia), lip or cheek biting (lip bite or cheek keratosis), and nose picking.
According to the TLC Foundation for Body Focused Repetitive Behaviors, the primary evidence-based treatments for BFRB’s include Cognitive Behavioral Therapy (CBT), Habit Reversal Training, Comprehensive Behavioral Therapy (ComB), Acceptance and Commitment Therapy (ACT), and Dialectical Behavioral Therapy (DBT). HabitAware's Keen smart bracelet is also available as a tool to help build awareness of these often subconscious/trance-like behaviors. Currently there are no medications specifically designed for BFRBs.