Understand your urges, reduce shame, and regain confidence in your daily life.

Trichotillomania is a body-focused repetitive behavior (BFRB) that involves repeated urges to pull out hair, often resulting in noticeable hair loss. People may pull from areas such as the scalp, eyebrows, eyelashes, beard, or other parts of the body.

Many people with trichotillomania describe feeling a strong urge or tension before pulling, followed by a sense of relief or satisfaction afterward. While someone may genuinely want to stop, the behavior can feel automatic, difficult to control, and frustrating to change.

Excoriation disorder is a body-focused repetitive behavior that involves repeated skin picking, often leading to skin damage, wounds, scarring, or difficulty stopping despite wanting to.

Picking may happen in response to certain sensations, emotions, thoughts, or situations. Some people notice they pick when they are stressed or overwhelmed, while others find themselves picking automatically during activities like watching television, working, studying, or scrolling on their phone.

Many people with BFRBs feel frustrated because they know they want to stop but find themselves doing the behavior anyway. This is because these behaviors are often not simply a matter of willpower — they are habits that become reinforced over time.

Pulling or picking may provide temporary relief from tension, discomfort, boredom, or difficult emotions, which can make the urge feel even stronger in the future. Treatment focuses on understanding the patterns behind the behavior and creating new responses that interrupt the cycle.

Stress and anxiety can play a role in making hair pulling or skin picking more frequent, but they are not the only causes. Many people experience BFRBs during times of stress, but they can also happen during moments of relaxation, boredom, or when someone is deeply focused on another activity.

Understanding your personal triggers is an important part of treatment. Together, we can explore when and why the behavior happens so you can begin responding differently when urges show up.

Habit Reversal Training (HRT) is a behavioral treatment designed to help reduce body-focused repetitive behaviors like hair pulling and skin picking.

HRT focuses on increasing awareness of the moments leading up to the behavior, identifying triggers, and practicing a competing response — a different action that makes it harder to engage in pulling or picking. Over time, this helps create more opportunities to pause, make a choice, and respond differently to urges.

Treatment typically begins by learning more about your specific pattern of pulling or picking, including when it happens, what triggers it, and what sensations or emotions are connected to the behavior.

You will work on becoming more aware of urges as they happen and practice alternative responses that can interrupt the habit. Treatment may also include learning strategies for managing triggers, increasing awareness of body sensations, and practicing skills for riding out urges without automatically acting on them.

Yes. Many people seek treatment after struggling with these behaviors for months or even years. It is common to feel discouraged after trying to stop on your own, especially when the behavior feels automatic or outside of your control.

Therapy can help you better understand your patterns, reduce shame around the behavior, and develop tools that make change feel possible. Progress does not mean never having an urge again — it means having more choice in how you respond when those urges appear.

Although trichotillomania and OCD can look similar from the outside, they are different conditions. OCD typically involves intrusive thoughts, fears, or doubts that lead to compulsions performed to reduce anxiety or prevent something bad from happening.

BFRBs like hair pulling and skin picking are often driven by urges, sensations, habits, or a desire for relief or satisfaction rather than a fear-based obsession. Because the patterns are different, treatment approaches are also different — which is why specialized approaches like Habit Reversal Training are used for BFRBs.