Addressing body-focused repetitive behaviors in the dermatology practice

Dermatologists are often the first to treat the medical consequences of body-focused repetitive behaviors (BFRBs) such as hair pulling, skin picking, and others. BFRBs are still under-recognized, and effectiveness of treatments is known only in limited circles. Patients exhibit varied presentations of BFRBs and repeatedly engage in these despite the physical and functional impairments. Dermatologists are uniquely placed to guide patients lacking knowledge about BFRBs and experiencing stigma, shame, and isolation. We provide an overview of the current understanding of the nature and management of BFRBs. Clinical suggestions for diagnosing and educating patients about their BFRBs and resources for patients to seek support are shared. Most importantly, with patients’ readiness for change, dermatologists can guide patients toward specific resources for self-monitoring their ABC (antecedents, behaviors, consequences) cycles of BFRBs and recommend specialized treatment options.