Can BFRBs Lead to Other Health Problems?
Written by Julie DiMatteo, Ph.D., ABPP
Body-focused repetitive behaviors can sometimes look minor from the outside. A person may pull a strand of hair, pick at an uneven area of skin, bite a nail, or chew the inside of their cheek. However, when these behaviors happen repeatedly and feel difficult to stop, they can cause physical damage and emotional distress.
Many other health problems and physical effects can come up as a result of a BRRB. Let’s talk about the possibilities and why seeking support is the best option.
What Are Body-Focused Repetitive Behaviors?
Body-focused repetitive behaviors, or BFRBs, involve repeatedly pulling, picking, biting, or scraping parts of the body. They include:
Trichotillomania, or hair-pulling disorder
Excoriation, or skin-picking disorder
Nail biting
Nail picking
Cheek, lip, or tongue biting
Other repetitive grooming behaviors that cause physical damage
BFRBs are not simply bad habits, signs of weak willpower, or intentional self-harm. They are a group of mental health conditions that require the same attention and care as any other concerns.
Health Effects Of Skin Picking
Repeated skin picking can create open wounds, scabs, bleeding, inflammation, and changes in skin color. When the skin barrier is repeatedly broken, bacteria may enter the area and cause an infection. Skin picking can also result in scarring and, in more severe cases, disfigurement.
You may unintentionally prolong healing by returning to a scab or irregular area of skin. Seek medical care if an area becomes increasingly painful, warm, swollen, produces pus, develops spreading redness, or is not healing after a reasonable amount of time. You should also seek a doctor if you have a fever or feel generally unwell alongside a possible infection.
Health Effects Of Trichotillomania (Hair Pulling)
Trichotillomania can lead to thinning hair, bald areas, broken hairs, scalp irritation, and skin damage. In some cases, repeatedly pulling from the same location may damage hair follicles, affecting how the hair grows back.
Hair pulling may also cause soreness or infection when the skin is damaged. People may spend considerable time arranging their hair, applying makeup, or using hats, scarves, or other items to conceal affected areas. A dermatologist can evaluate hair or scalp changes and check for other medical conditions that could be contributing to hair loss or irritation.
What If Someone Swallows the Hair They Pull?
Some people with trichotillomania also chew or swallow pulled hair. Hair cannot be digested in the same way as food, so swallowed hair can collect in the digestive tract and cause complications.
If you are pulling and then eating your hair, talk to a doctor if you’re experiencing stomach pain, nausea, vomiting, or other gastrointestinal symptoms. Your doctors are there to help you have the best health possible, and will not shame you.
Health Effects Of Nail Biting or Picking
Repeated biting or picking can injure the nail, cuticle, nail bed, and surrounding skin. Possible effects include tenderness, bleeding, inflammation, irregular nail growth, and infection.
Chronic nail biting can damage the tissue responsible for nail growth. It may also transfer bacteria or viruses between your mouth, fingers, and face.
Talk to your doctor if you develop significant swelling, worsening pain, drainage, or other signs of infection. A dermatologist can also evaluate persistent changes in the color, texture, shape, or growth of a nail.
Health Effects Of Cheek or Lip Biting
Chronic cheek, lip, or tongue biting can cause painful sores, tears, thickened tissue, and irritation inside the mouth. As tissue becomes rough or uneven, you may feel a stronger urge to bite the area in an attempt to smooth it.
A dentist or physician can examine sores that repeatedly return, do not heal, become increasingly painful, or make it difficult to eat or speak. Medical evaluation is important because not every change inside the mouth is caused by a BFRB.
How Can BFRBs Affect Emotional Health?
Physical complications are only part of the experience. BFRBs can also affect your confidence, concentration, relationships, and enjoyment in everyday life. Many people with BFRBs try to conceal their behavior, which can take considerable time and energy.
If you’ve tried stopping without success, you’re not a failure. That just shows how difficult BFRBs are to deal with alone. Fortunately, there are many specialized professionals ready to help you.
Can Therapy Help You Overcome a BFRB?
Yes, it is possible to overcome your BFRB with the right support. A psychologist can help you address the behavior while a physician, dermatologist, or dental and help you treat the physical damage.
At CBT Specialists, we use evidence-based cognitive and behavioral strategies for hair pulling, skin picking, nail biting, and related behaviors. Treatment may include Comprehensive Behavioral Treatment, or ComB. This approach examines several factors connected with the behavior, including:
Sensory experiences and physical urges
Thoughts that occur before, during, and after the behavior
Emotions such as anxiety, boredom, frustration, or tension
Movements and routines associated with pulling, picking, or biting
Places, activities, and situations in which the behavior is more likely
Therapy can help you understand when, where, and why a BFRB occurs. Once you understand your patterns, we can help you find practical strategies that work for you. Treatment is always tailored to you and your needs.
Find BFRB Treatment at CBT Specialists
BFRBs are treatable, and you do not need to wait until physical damage becomes severe before seeking help. Earlier support can help you better understand the behavior, reduce its impact, and develop a more compassionate response to setbacks.
CBT Specialists provides treatment for BFRBs at our offices in Rochelle Park, NJ, and Ventura, CA, as well as through telehealth throughout New Jersey, New York, California, and all PsyPact states. Our doctoral-level clinicians have advanced training in CBT and specialized approaches for hair pulling, skin picking, and related concerns.
During a free 15-minute consultation, we can discuss the behavior you are experiencing, answer your initial questions, and determine whether our approach may be a good fit.