Trichotillomania/ Skin Picking

Cognitive-behavioral therapy (CBT) for trichotillomania/skin picking (and other body-focused repetitive behaviors) can effectively decrease pulling/picking in adults, teens, and children. Therapy sessions focus on teaching the skills of Awareness Training, Stimulus Control and Competing Response Training. Awareness Training allows individuals to become experts in their pulling habits by keeping close track of when, where, and how much hair is being pulled. Stimulus Control modifies high-pulling situations in ways that decrease the likelihood of pulling. Competing Response Training teaches individuals strategies to tolerate urges to pull while using techniques that actively prevent pulling.  When pulling is consistently disrupted within different situations, the urge to pull tends to decrease. Research has established that CBT can result in substantial reductions in hair pulling and skin picking. Treatment for other body-focused repetitive behaviors (e.g. nail/cuticle biting, nose picking, cheek biting, lip picking, skin biting, etc.) is identical to treatment for trichotillomania/skin picking.