"Why Skin Picking and Hair Pulling Are So Much More Than Just "Bad Habits"

When I first realized I wasn’t the only one constantly picking at my skin or biting my nails until they hurt, it felt like a relief, but also a bit heartbreaking. For so long, I thought it was just something I did to cope with stress. After doing some research on my repetitive behaviors, I learned that skin picking, hair pulling, and nail biting aren’t just stress habits. They’re part of something bigger called Body-Focused Repetitive Behaviors, or BFRBs. BFRBs are repeated self-grooming actions—such as biting, pulling, picking, or scraping at one’s hair, skin, lips, cheeks, or nails—that can cause physical harm and typically persist despite repeated efforts to stop or reduce them. What many people don’t know is that BFRBs aren’t rare, but they’re often overlooked or misdiagnosed. They’re one of the most untreated types of mental health disorders out there.

BFRBs are commonly caused by anxiety-induced situations and stress. Some research suggests that the cause of these repetitive behaviors is due to improving or correcting an imperfection in physical appearance, like smoothing out a rough patch of skin, as well as the self-regulation of intense emotions. For some people, these repetitive behaviors are deeply rooted in genetics, including myself. It should be known that BFRBs are not self-harm. 

The most common BFRBs are nail biting and skin picking. About 20-30% of the population engages in severe nail biting. Approximately 2-5% of the population picks their skin to the extent where it causes visible tissue damage to the skin or distress in daily functioning. That's a lot of us. And teens are especially vulnerable to developing these habits. Stressful or anxiety-inducing environments can create a need for coping mechanisms to manage overwhelming emotions. I remember how overwhelming high school could feel—social pressure, academic stress, emotions you can’t explain. BFRBs were a way to soothe those overwhelming feelings.

Here’s the harder part: BFRBs can also significantly affect your mental health. When individuals experience shame or guilt, they may avoid social situations or activities, causing them to isolate themselves due to fear of more embarrassment. Teens feel like this all the time, whether they're at a gathering and something embarrassing happens, all they want to do is go home and hide from society. This behavior can lead to severe mental distress, putting them at risk for psychiatric disorders like mood or anxiety disorders. Teens who struggle with BFRBs often spend a lot of time trying to hide or cover up damage to their scalp, skin, or nails. This can impact their daily routines, including school and social activities, as both the behavior itself and the effort to conceal it can take up a significant amount of time. It can feel like a never-ending cycle. You want to stop. You try. But it just won’t let go. That’s why awareness matters, and it’s why I wrote this, to help others and show that you’re not alone.

There are currently no effective treatments to stop BFRBs; however, it is recommended to talk to your doctor if your BFRBs are chronic. The TLC Foundation for Body-Focused Repetitive Behaviors is a great resource to use, and you can reach out to professionals about your BFRBs.

It’s not “just a habit.” It’s real, it’s hard, and it deserves compassion, not shame.

“The TLC Foundation for BFRBs.” Bfrb.org, 2019, www.bfrb.org/.