Body-Focused Repetitive Behaviors (BFRB) is a term used to describe excessive self-grooming that leads to emotional distress and physical harm. BFRBs include biting, pulling, picking, or scraping one’s own hair, skin, lips, cheeks, tongue, or nails. Many individuals with these behaviors spend up to hours each day focused on grooming tasks. Others may do this while asleep at night. It is common for these behaviors and their outcomes to be hidden from family members due to shame, as well as lack of awareness that treatment is available.
BFRB is currently classified as an Other Specified Obsessive-Compulsive and Related Disorder. This is a category of DSM-5 diagnoses that applies to those who have characteristics of obsessive compulsive disorders but do not meet the full criteria. No medication has proven to be effective for BFRB and research and supports are highly limited. Fortunately, the TLC Foundation for Body-Focused Repetitive Behaviors is bringing awareness to these misunderstood conditions and providing outreach to both patients and healthcare providers.
The training that Online OTs received through the TLC Foundation enabled us to understand the prevalence of these conditions and some of the sensory, cognitive, emotional, and physical components. Our telehealth habit reversal program utilizes both the TLC ComB protocol and CBIT competing responses to address unwanted repetitive behaviors. To request intake forms for a BFRB evaluation and treatment with Online OTs, please contact us. Services are available via telehealth in MA, NH, NY, VT, and ME.
Trichotillomania, often referred to as Trich, is a BFRB that involves excessive hair pulling. Eyelashes, eyebrows, scalp, and pubic area are common sites of pulling.
Excoriation is a BFRB that involves excessive skin picking, resulting in skin lesions.
Onychophagia is a BFRB that involves the habitual and destructive BITING of nails. This disorder may lead to skin infections as well as dental problems.
Onychotillomania is a BFRB that involves excessive picking, pulling, and manicuring of nails.
Lip Bite Keratosis is a BFRB that involves the repetitive biting of one's lips, causing physical damage.
Cheek Keratosis is a BFRB that involves biting the inner cheek, causing ulcerations, sores, inflammation, and/or a callous like formation.
Rhinotillexomania is a BFRB that involves chronic nose picking.
Tongue Chewing is a BFRB that involves chronic chewing of the tongue, resulting in sores and callouses.
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