If you find yourself pulling your hair, picking your skin, biting your nails, or engaging in repetitive behaviors that feel difficult to control, you're not alone.

Body-Focused Repetitive Behaviors (BFRBs) are common, yet many people struggle in silence due to shame, embarrassment, or fear that others won't understand. These behaviors are not simply "bad habits" or signs of a lack of willpower. They are often complex coping mechanisms that develop in response to stress, anxiety, boredom, overwhelm, perfectionism, sensory needs, or difficult emotions.

At Rapowitz Wellness, I provide therapy for adolescents, college students, and adults struggling with hair pulling (trichotillomania), skin picking (excoriation disorder), and other body-focused repetitive behaviors in Alpharetta, Johns Creek, Roswell, Milton, and throughout Georgia.

What Are Body-Focused Repetitive Behaviors?

Body-Focused Repetitive Behaviors (BFRBs) are repetitive self-grooming behaviors that result in damage to the body. Common examples include:

  • Hair pulling (Trichotillomania)

  • Skin picking (Excoriation Disorder)

  • Nail biting

  • Cheek biting

  • Lip biting

  • Scab picking

  • Eyelash pulling

  • Eyebrow pulling

Many people describe feeling as though the behavior happens automatically. Others are fully aware of the urge but feel unable to resist it.

You may notice yourself pulling or picking while:

  • Studying or working

  • Watching television

  • Driving

  • Scrolling on your phone

  • Feeling anxious or stressed

  • Trying to fall asleep

  • Experiencing strong emotions

  • Feeling bored or understimulated

Signs It May Be More Than a Habit

You may benefit from specialized BFRB treatment if:

  • You've tried to stop multiple times without success

  • You hide bald spots, scabs, or skin damage

  • You avoid social situations because of embarrassment

  • You spend significant time pulling or picking each day

  • The behavior causes distress or affects your self-esteem

  • Family members frequently comment on the behavior

  • The behavior worsens during stressful periods

Many of my clients tell me they feel frustrated because they know the behavior is hurting them, yet they continue to do it anyway. This cycle often leads to shame, self-criticism, and isolation.

What Causes Hair Pulling and Skin Picking?

There is rarely one single cause.

BFRBs often develop through a combination of factors, including:

  • Anxiety and chronic stress

  • Perfectionism

  • ADHD and executive functioning challenges

  • Sensory regulation needs

  • Emotional overwhelm

  • Difficulty managing uncomfortable emotions

  • Family stressors

  • Major life transitions

For some individuals, pulling or picking provides temporary relief from tension. For others, it helps regulate focus, manage boredom, or create a sense of comfort.

Understanding the function of the behavior is a critical first step toward meaningful change.

Therapy for Trichotillomania and Skin Picking

Effective treatment for BFRBs goes beyond simply telling yourself to stop.

My approach combines evidence-based interventions with a compassionate understanding of the emotional experiences that often drive these behaviors.

Treatment may include:

Habit Reversal Training (HRT)

Habit Reversal Training helps clients identify triggers, increase awareness of urges, and develop competing responses that interrupt the behavior cycle.

Comprehensive Behavioral Treatment (ComB)

The Comprehensive Behavioral Model looks at the sensory, emotional, cognitive, environmental, and motor factors that contribute to pulling or picking.

Cognitive Behavioral Therapy (CBT)

CBT helps clients identify thought patterns, perfectionism, self-criticism, and anxiety that may contribute to urges.

Emotional Regulation Skills

Many clients benefit from learning healthier ways to cope with stress, frustration, boredom, and overwhelming emotions.

Relational and Insight-Oriented Therapy

We also explore the deeper emotional experiences that may contribute to vulnerability, stress, and self-soothing behaviors.

Frequently Asked Questions

Is hair pulling a form of OCD?

Hair pulling and OCD can look similar, but they are separate conditions. Some individuals experience both. A thorough assessment can help determine what is driving the behavior.

Can therapy help me stop picking my skin?

Yes. Research-supported treatments such as Habit Reversal Training and Comprehensive Behavioral Treatment can significantly reduce skin picking behaviors.

Do you work with teenagers?

Yes. I work with adolescents, young adults/college students, and adults struggling with hair pulling, skin picking, anxiety, perfectionism, and emotional regulation difficulties.

Is virtual therapy available?

Yes. I provide therapy for clients throughout Georgia through secure telehealth sessions.

Start Therapy for Hair Pulling or Skin Picking in Alpharetta

You do not have to manage these behaviors alone.

Whether you've been struggling for months or years, therapy can help you better understand your triggers, reduce urges, develop effective coping strategies, and build a healthier relationship with yourself.

If you're looking for a therapist specializing in hair pulling, skin picking, or Body-Focused Repetitive Behaviors (BFRBs) in Alpharetta, Johns Creek, Roswell, Milton, or anywhere in Georgia, I would be honored to support you.

Hair Pulling & Skin Picking Therapy in Alpharetta, GA

Specialized Therapy for Body-Focused Repetitive Behaviors (BFRBs)