Why am I damaging my hair, skin, and nails when I am stressed?!

Do you bite your nails or cuticles until they hurt?
Do you pull your hair until you have bald spots?
Do you pick at your skin until you have multiple bloody spots on your face?

You are not alone! You are one of the many people that live in shame and secrecy struggling to manage what are called body-focused repetitive behaviors (BFRBs).

text reads... Why am I damaging my hair, skin, and nails when I am stressed?

Why am I damaging my hair, skin, and nails when I am stressed?!

Do you bite your nails or cuticles until they hurt?
Do you pull your hair until you have bald spots?
Do you pick at your skin until you have multiple bloody spots on your face?

You are not alone! You are one of the many people that live in shame and secrecy struggling to manage what are called body-focused repetitive behaviors (BFRBs).

Here are 5 things to know about body-focused repetitive behaviors or BFRBs:

1.    BFRBs are behaviors that cause damage to the body’s protective layer. These behaviors include 

  • hair pulling (from any area of the body, but most commonly the head, eyelashes, eyebrows, beard, and pubic area) 
  • nail biting 
  • skin/ scab picking 
  • nose picking 
  • lip biting or chewing 
  • tongue chewing 
  • thumb sucking 

They can sometimes be referred to as over-grooming or out of control grooming. Currently, in the Diagnostic and Statistical Manual of Mental Disorders 5 (This is the book that clinicians use to help diagnose various mental health disorders), Trichotillomania (Hair-Pulling Disorder), and Excoriation (Skin-Picking) Disorder are included under Obsessive-Compulsive (OCD) and Related Disorders. Researchers and clinicians used to think that BFRBs was a symptom of OCD. Now we know that BRFBs is a separate disorder, which can co-exist with other mental health concerns, such as substance use, anxiety, depression, ADHD, or OCD, etc.

2.    BFRBs are not just bad habits that you will grow out of. 

These behaviors can often be automatic and can sometimes be performed without awareness until significant damage or pain has occurred. This is what makes BFRBs so difficult to stop; it is hard to stop something you are not aware you are doing. Furthermore, BFRBs can be done when we are stressed, worried, bored, tired, trying to focus, or doing mundane tasks like driving. BFRBs seem to serve the purpose of helping us manage our feelings, thoughts, and other uncomfortable internal experiences.

3.    BFRBs are different from self-harm.

BFRBs often get confused with self-harm, however people with BFRBs do not have intent to harm themselves to self-soothe. Pain to the body is the byproduct of pulling or picking, not the focus or goal of these behaviors. Often the desire to pick and pull may come from wanting to remove a perceived flaw in their hair or skin. It may also come from the enjoyment of inspecting, playing with, or ingesting the product that was extracted. These behaviors can be harmful to our health over time, since open wounds and putting our fingers in our mouth can result in infections and the spread of illness.  

4.    BFRBs cause more than cosmetic damage. Because of the shame around these behaviors, the damage caused to the skin, hair, and nails is often camouflaged, or concealed. When it becomes difficult to hide the damage we have caused our bodies, we hide our bodies from the world. People with body-focused repetitive behaviors BFRBs may avoid doctor’s appointments, dentist visits, and haircuts for fear they will be asked about their scars or bald spots. They may avoid going outside in windy/ rainy weather for fear their camouflage will be washed off or blow out of position. People with BFRBs may avoid being close to or touched by others for fear of judgment. This physical isolation also comes at a cost of emotional isolation that affects our self-care, self-worth, and feelings of intimacy.

5.    BFRBs are more common than we think. 

These behaviors know no bounds; BFRBs can affect any gender, sex, race, ethnicity, and socioeconomic status. These behavior patterns tend to develop at a young age, however many people go decades before knowing there is a name for them and that there is treatment and help!  

Get HELP! Although these behaviors are often understudied and misunderstood, there is help. If you live in the Buffalo area and need support managing BFRBs, you are welcome to contact me for a free consultation. If you live outside of Western New York, you can search for a provider on the TLC Foundation for BFRBs website (https://www.bfrb.org/index.php). 

Why am I damaging my hair, skin, & nails when I am stressed?