Trichotillomania, compulsive non-cosmetic hair pulling, and Dermatillomania, compulsive skin picking, are two of the many Body-Focused Repetitive Behaviors (BFRBs),  in which a person can cause harm or damage to themselves or their appearance. Other BFRBs include biting the insides of the cheek and nail-biting. Compulsive hair pulling results in noticeable hair loss, or bald patches. Hair can be pulled from any site on the body, with areas that are most easily reached being the most likely sites.  Teens and adults who suffer from hair pulling experience intense shame and distress. They may avoid activities that they fear will reveal their hair loss such as being outside on windy days, standing near people taller than themselves, exercise classes, or going to hairdressers. Those who suffer from trichotillomania often incorrectly fear that hair pulling must indicate that they are especially “sick” or “self-injurious” because they are unable to stop. Scientists and therapists who are familiar with hair pulling and skin picking know that these behaviors are a habit that is probably caused by a genetic predisposition that accidentally becomes self-reinforcing.

Other body-focused repetitive behaviors such as compulsive skin picking, compulsive nail-biting, cheek biting and nose picking are very similar to trichotillomania in their effect on the family and the sufferer’s self-image. They often co-occur with trichotillomania. These disorders are understood to be similar to trichotillomania and the same treatment approach that is used for trichotillomania is used for these disorders. Many scientists are now beginning to classify this group of disorders in a category of their own, body-focused repetitive disorders.


Treatment of trichotillomania and other body-focused repetitive behaviors involves detecting and defining the patient’s individual profile for pulling or picking. Since no two patients with these disorders are alike, a customized plan of behavioral and cognitive strategies must be developed. These strategies are applied to gradually dismantle the automatic chain of events that leads to pulling or picking and to replace it with more adaptive behaviors.  The goal of treatment is to achieve either a substantial decrease in pulling or picking, or abstinence from pulling and picking, so that the patient no longer has to feel embarrassed about hair loss and concealment of hair loss.

The staff at The Anxiety Treatment Center of Greater Chicago will help you, or your child, overcome body-focused repetitive behaviors one step at a time. We want to help stop the cycle of pulling or picking so that you, or your child, can feel full of confidence and beauty.

For More Information:

Globe1 The TLC Foundation for Body-Focused Repetitive Behaviors
Globe1 – On-line Behavioral Program
Globe1 American Academy of Child & Adolescent Psychiatry – Hair Pulling – Facts for Families