Common Questions About BFRBs

Skin picking can happen for many different reasons, including stress, anxiety, boredom, tension, sensory discomfort, or the urge to fix something that feels uneven or imperfect. Some people pick automatically without fully realizing they are doing it.

Skin picking is not simply a bad habit or lack of willpower. For many people, it becomes a repetitive cycle that may temporarily relieve tension or provide a sense of relief, even when it causes distress later.

Hair pulling can be connected to urges, stress, sensory experiences, emotional regulation, or automatic habits. Some people notice strong urges before pulling, while others pull without fully realizing it.

Many people feel frustrated or ashamed that the behavior continues even when they genuinely want it to stop.

Nail biting can happen automatically or in response to stress, boredom, concentration, anxiety, or sensory urges. For some people, it becomes a repetitive coping behavior that provides temporary relief or stimulation.

Many people bite their nails without fully noticing they are doing it, especially during periods of stress or focus.

Cheek biting can become a repetitive behavior connected to stress, tension, focus, sensory discomfort, or automatic habit patterns. Some people notice urges beforehand, while others realize it only after the behavior has already happened.

Like other BFRBs, cheek biting is often more complex than simply “trying harder” to stop.

BFRBs can become repetitive cycles that are difficult to interrupt, even when someone genuinely wants to stop. The behavior may temporarily reduce tension, provide relief, satisfy sensory urges, or happen automatically outside of awareness.

Shame, criticism, and pressure usually make the cycle worse rather than better. Change often involves building awareness, learning new strategies, and approaching the behavior with patience rather than punishment.

No. BFRBs are far more common than most people realize. Many people spend years believing they are the only one who pulls, picks, bites, or scratches because these behaviors are often hidden and surrounded by shame.

Connecting with others who understand the experience can reduce isolation and help people realize they are not alone.

BFRBs are more complex than ordinary habits. While the behaviors can become repetitive and automatic over time, they are often connected to urges, stress, sensory experiences, emotional regulation, or learned behavior patterns.

Many people with BFRBs feel frustrated that they cannot “just stop,” even when they genuinely want to. Shame and criticism usually make the cycle worse rather than better.

BFRBs are grouped within obsessive-compulsive and related disorders, but they are not the same thing as OCD. While there can be overlap, people with BFRBs are often driven more by urges, sensory experiences, emotional regulation, or automatic habits than intrusive obsessive thoughts.

Because of this, BFRBs often require specialized treatment approaches and support strategies.

Usually, no. BFRBs are not typically done with the intent to hurt oneself. They often involve urges, cycles of tension and relief, sensory triggers, or emotion regulation.

That said, BFRBs can still cause physical harm, emotional distress, and shame. Many people improve significantly with the right support and treatment.

Yes. Stress, anxiety, boredom, fatigue, sensory discomfort, and strong emotions can all increase urges or make behaviors more automatic.

Many people notice their symptoms become worse during stressful periods or when they feel emotionally overwhelmed.

Yes. BFRBs can affect children, teens, and adults. Some people begin experiencing symptoms in childhood, while others notice them later in adolescence or adulthood.

Supportive, informed responses from parents, partners, and loved ones can help reduce shame and encourage support-seeking.

Yes. Many people benefit from evidence-based approaches designed specifically for BFRBs. Treatment may include cognitive behavioral therapy, Habit Reversal Training (HRT), Comprehensive Behavioral (ComB) treatment, awareness training, stimulus control strategies, and approaches that support emotional regulation and self-compassion.

Different strategies work for different people, and recovery is often a gradual process rather than a quick fix.

NAC (N-acetylcysteine) is a supplement that has been studied for body-focused repetitive behaviors such as hair pulling and skin picking. Some people report improvement with NAC, while others do not.

Research is still ongoing, and supplements are not appropriate for everyone. It’s important to speak with a qualified healthcare provider before starting any supplement or treatment.

Yes. Many people make meaningful progress and experience significant improvement over time.

Recovery does not always mean urges disappear completely. For many people, recovery means increased awareness, reduced shame, improved coping skills, and feeling more in control of their behaviors and lives.

Repeated reminders to stop, comments about appearance, criticism, punishment, or making the behavior the center of every conversation can unintentionally increase shame and stress.

Supportive responses are usually more helpful than policing or pressure. Asking how to help, listening without judgment, and focusing on encouragement rather than criticism can make a meaningful difference.