Body-focused repetitive behaviors, or BFRBs, are an interrelated set of disorders categorized by “self-grooming” routines that include pulling, picking, biting, or scraping one's hair, skin, or nails. The prevalence of BFRBs is estimated to be at least 3 percent of the population, affecting both children and adults.
BFRBs—which include trichotillomania (compulsive hair pulling), dermatillomania (compulsive skin picking, also called excoriation disorder), and onychophagia (compulsive nail biting)—have been theorized to be related to anxiety disorders, impulse control disorders, and obsessive compulsive disorder. But most experts agree that they differ significantly from all three. Certain BFRBs are currently categorized as “impulse disorders” in the DSM-5.
Regardless of how the behaviors are categorized, they are difficult for individuals to control, and can result in physical injury like scarring, skin infections, or bald spots. They frequently cause extreme emotional distress, particularly if the disorder is undiagnosed or kept secret. BFRBs may also, unfortunately, resist treatment, and can even impair someone's ability to socialize or function at work.