Specialized Support for Skin Picking, Hair Pulling, and Repetitive Behaviors

If you struggle with skin picking, hair pulling, or other repetitive behaviors, you may know how frustrating it can feel to want to stop but find yourself doing it anyway. Sometimes, you might not even realize you're doing it until you've already started.

These behaviors can show up when you're feeling stressed, anxious, bored, or overwhelmed. You might also notice an urge to fix an imperfection or make something feel just right. 

Over time, this can leave you feeling frustrated, embarrassed, or discouraged, especially when the behaviors affect your skin, hair, confidence, or daily life.

Body-focused repetitive behaviors, or BFRBs, are repetitive behaviors directed toward your body that can sometimes cause physical harm or emotional distress.

Some common examples include:

• Skin picking: Picking at your skin, scabs, bumps, or perceived imperfections.
• Hair pulling: Pulling hair from your scalp, eyebrows, eyelashes, or other areas of your body.
• Nail biting: Repeatedly biting or damaging your fingernails.
• Nail or cuticle picking: Picking at your nails or the skin around them.
• Other repetitive grooming behaviors: Repeatedly touching, squeezing, checking, or manipulating areas of your body.

These behaviors can happen almost automatically, without you fully realizing it, or they may occur when you feel an urge, tension, or discomfort that is difficult to ignore.

If this sounds familiar, you're not alone. BFRBs are more than just habits that you should be able to stop. They can be complicated patterns, and learning to change them often takes time, practice, and the right support.

Therapy can help you understand what happens before, during, and after a repetitive behavior so you can begin making changes that feel realistic and manageable.

Together, we'll explore your experiences and find strategies that work for you. Treatment may include:

• Habit Reversal Training (HRT): Learning to recognize your behaviors and triggers, then practicing alternative responses when urges arise.
• Awareness training: Noticing when, where, and how picking or pulling happens, including moments when you may not realize you're doing it.
• Competing responses: Practicing alternative actions that make it harder to engage in picking or pulling, such as gently holding an object or positioning your hands differently.
• Stimulus control: Making small, practical changes to your surroundings or routines to reduce triggers and make repetitive behaviors less accessible.
• Managing urges: Learning how to experience an urge without automatically acting on it.
• Emotional regulation and coping skills: Exploring how stress, anxiety, boredom, and other emotions may influence your behaviors.
• Cognitive and behavioral strategies: Working through perfectionism, self-criticism, or the feeling that something needs to be fixed or feel just right.
• Exposure-based strategies, when appropriate: Practicing tolerating triggers, urges, or uncomfortable sensations without relying on familiar repetitive behaviors.

Your treatment plan will be tailored to your needs, experiences, and goals. We'll work together to identify what may be contributing to your behaviors and build skills you can practice in everyday life.

Habit Reversal Training is a structured, evidence-based behavioral approach commonly used to help people change repetitive behaviors, including skin picking and hair pulling.

HRT focuses on helping you become more aware of your patterns and develop new ways to respond when urges arise.

Treatment may involve:

• Recognizing your triggers: Identifying situations, emotions, or physical sensations that tend to happen before picking or pulling.
• Noticing your patterns: Exploring when and where behaviors occur, such as while watching TV, working, driving, or looking in the mirror.
• Practicing competing responses: Learning alternative actions to use when you notice an urge or catch yourself engaging in the behavior.
• Making small environmental changes: Finding practical ways to make picking or pulling less automatic.
• Practicing between sessions: Building awareness and strengthening new skills in your daily routine.

The goal isn't to be perfect or to feel ashamed when a behavior happens. Instead, we'll focus on helping you understand your patterns, respond to urges differently, and recognize progress along the way.

At Carolina Anxiety & OCD Wellness, I offer:

• Virtual therapy for teens and adults throughout North Carolina.
• Specialized support for skin picking, hair pulling, and other repetitive behaviors.
• Habit Reversal Training (HRT) and other evidence-based behavioral strategies.
• Individualized treatment for nail biting, nail picking, and related behaviors.
• Support for anxiety, perfectionism, and emotional triggers that may contribute to repetitive behaviors.
• A warm, collaborative, and nonjudgmental space where you can talk openly about what you're experiencing.

You don't have to feel embarrassed about your struggles or figure everything out on your own. Whether you've been dealing with these behaviors for years or have only recently started looking for support, therapy can help you take manageable steps toward change.

Ready to get started? Reach out to Carolina Anxiety & OCD Wellness to discuss your concerns and explore whether therapy may be a good fit for you!