Is it a Habit or a BFRB? Understanding Skin Picking and Hair Pulling
Managing skin picking or hair pulling isn't about willpower; it’s about having the right tools. This resource provides a starting point for residents in Alberta who are ready to move past 'brain noise' and learn practical strategies for managing BFRBs.
Many people spend years hiding the fact that they pick their skin, pull their hair, or bite their nails until it hurts. They often feel a deep sense of shame, thinking, "Why can't I just stop? It’s just a bad habit." But if you’ve tried to stop using "willpower" and found it impossible, there is something you should know: it isn't just a habit. It is likely a BFRB.
What is a BFRB?
BFRB stands for Body-Focused Repetitive Behaviour. It is a term for a group of behaviours where someone pulls, picks, or scrapes their own hair or skin. The most common types are:
Trichotillomania: Chronic hair pulling.
Excoriation: Chronic skin picking.
Is Skin Picking a Type of OCD?
This is a question I hear a lot in my practice. BFRBs do fall under the category of “OCD and Related Disorders.” While BFRBs and OCD are related, they work differently in the brain.
OCD is usually driven by a scary thought (an obsession) that makes you feel like you must do something to stay safe (a compulsion).
BFRBs are usually driven by a physical urge or a sensory feeling. You might feel a "bump" on your skin or a "coarse" hair and feel like you need to fix it to feel "just right."
Why Do BFRBs Feel Impossible to Stop
For many, these behaviours become a way to manage "brain noise." You might find yourself picking or pulling when you are:
Stressed or Anxious: It helps "vent" some of that nervous energy.
Bored or Zoning Out: You might do it while watching TV or driving without even realizing it.
Seeking Perfection: You might be trying to make your skin feel perfectly smooth or your hair feel "even."
Because the behaviour actually provides a tiny moment of relief or "soothing," your brain learns to crave it. This creates a loop that is very hard to break on your own.
How We Tackle BFRBs Together
The good news is that you don't need more willpower; you need better tools. I use evidence-based therapies such as Habit Reversal Training (HRT) and Comprehensive Behavioural (ComB) Treatment which have been shown to be effective in learning to manage BFRBs. In our sessions, we focus on practical strategies that help you:
Identify Your Triggers: We figure out the "where, when, and why" of the behavior.
Change the Environment: We find ways to make the behavior harder to do (like using fidget tools or changing your lighting).
Find New Responses: We practice "competing responses" - these are new things to do with your hands that satisfy the urge without causing harm.
Find Support in Alberta
You don’t have to keep hiding. Whether you are in Calgary, Edmonton, Red Deer, Lethbridge, or anywhere else in Alberta, I provide virtual sessions designed to help you regain control and lower the volume on that "must pick" or "must pull" urge.
Ready to break the cycle? Book your first appointment here.
Ready to turn down the volume on other mental loops in Alberta?
Discover how to handle Intrusive Thoughts more effectively.
Learn why the brain zooms in on appearance in Body Dysmorphic Disorder (BDD).
Dr. Sasha Shifrin
Registered Psychologist
Virtual Therapy for OCD, BFRB, and Anxiety in Alberta.