What are BFRBs?

Body-Focused Repetitive Behaviours (BFRBs) are a group of complex mental health disorders that are characterised by the uncontrollable urge to pull, pick, scratch, cut, or bite one’s own skin, hair, or nails. These behaviours are not simply “bad habits”; they are often chronic, difficult to control, and associated with high levels of emotional distress. They can have profound impact on everyday life, including work, education, relationships, and general social functioning.

BFRBs also have significant dermatological, trichological, and physical consequences. Repetitive picking, pulling, scratching, and biting can lead to skin lesions, excoriations, bleeding, scarring, pigment changes, and secondary infection, as well as hair thinning, hair loss, and, in some cases, more persistent alopecia. Because shame and stigma are so common, many people conceal their behaviours, meaning clinicians may first encounter the physical signs before the underlying condition is disclosed.

Despite affecting an estimated 4 million people in the UK and Ireland alone, BFRBs remain widely misunderstood and heavily stigmatised. As a result, many people live in secrecy and shame, and only a small minority ever seek support from a healthcare or therapeutic provider. For many individuals, dermatology and hair clinics are the first point of healthcare contact, placing skin and hair specialists in a key position to recognise BFRBs early, reduce shame, and prevent progression of tissue and hair damage.

Although BFRBs are often viewed purely as psychological conditions, emerging research points to more complex interactions between the brain, skin, and immune system, with potential implications for the experience of urges to pick, pull, and bite. Understanding this skin–brain relationship - and what it means for assessment, treatment, and interdisciplinary care - will be a central theme of this year’s conference.