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Trichotillomania, or hair-pulling disorder, is an example of a body focused repetitive behaviour (alongside skin-picking and nail-biting). Most people - and many animals - engage in some pulling/picking/biting as part of normal grooming behaviour, but some people find it difficult to stop, resulting in visible damage (lesions, scars, bald patches) and a lot of distress.

  

What are Body focused repetitive behaviours (BFRBs)?

 

BFRB's are the collective name for problematic picking, pulling or biting of skin, hair or nails. We all do a bit of picking/pulling/biting at ourselves because these are normal primate grooming behaviours, but for some people the urges make it very difficult to stop. BFRBs are under-recognised, and underestimated in terms of distress and functional impairment. Individuals can spend decades of their lives blighted by behaviours they cannot control, and for which there is little/no understanding or support available. As such, these are some of the most highly stigmatised of all mental health conditions.

More research is needed to understand the mechanisms and develop interventions for BFRBs.

 

Professor Clare Mackay is @thetrichprof and has suffered with trichotillomania since she was 12 years old.

Together with a growing team of collaborators and students, she is investigating mechanisms that will hopefully underpin new interventions for body-focused repetitive behaviours. A vital component of this is to raise awareness and reduce stigma, so that those suffering with these disorders feel empowered to ask for help.

 

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Follow @thetrichprof on Twitter, Facebook and Instagram

For those seeking information and support for pulling/picking/biting disorders (either for yourself or a loved one), BFRB UK & Ireland is a good resource. There are also a number of good Facebook support groups (including BFRB UK&I) where you can stay anonymous if you prefer.  

Infographic on trichotillomania created by Clare MackayShows:1.7% of people have trichotillomania (1.1m in UK)4:1 ration of female to male in clinical trials but community studies suggest equally affected50% never seek treatment & less than half who did felt their healthcare provider was aware of disorderCauses high levels of distress and difficulties with social, occupational and leisure activitiesTriggers include sensory, emotional, automatic & people can be unaware they are doing itCo-morbidities are common but 20% are 'pure'Sources: Woods et al (2006); Grant et al (2020)© Clare Mackay