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BFRBs (Hair Pulling / Skin Picking)

Understanding BFRBs In Kids & Teens

Body-Focused Repetitive Behaviors (BFRBs) are repetitive behaviors that involve touching, picking, pulling, or biting the body, even when a child wants to stop. These behaviors often provide temporary relief from stress, anxiety, or tension, but over time they can lead to frustration, distress, shame, or physical harm.

BFRBs are not just “bad habits.” They are often a way children and teens attempt to regulate discomfort, stress, or internal tension.

  • Hair pulling from the scalp, eyebrows, or eyelashes
  • Twirling or twisting hair repeatedly
  • Skin picking on the face, arms, or other areas
  • Picking at scabs, acne, or small imperfections
  • Nail biting or cuticle picking
  • Cheek or lip biting

How KidWise Helps With BFRBs

At KidWise Counseling, we help children and teens manage BFRBs in a compassionate, practical, and non-judgmental way while building greater awareness, confidence, and control over time.

Notice triggers and urges

Helping children become more aware of when the behavior happens and what tends to lead up to it.

Build alternative coping tools

Teaching practical strategies that support regulation and reduce the urge to engage in the behavior.

Reduce the behavior gradually

Working toward change in a way that feels manageable, realistic, and supportive.

Track progress over time

Helping children and families notice patterns, celebrate wins, and build momentum.

Increase confidence and control

Supporting children as they feel less stuck and more capable of managing urges.

Rather than responding with shame or punishment, treatment focuses on understanding the behavior, reducing triggers, and helping children build healthier ways to cope.

What support may include

Awareness & Triggers

Awareness & Triggers

Helping children recognize when the behavior happens and what thoughts, feelings, or situations may be connected to it.

Coping Strategies

Coping Strategies

Teaching practical tools that help reduce urges and create new ways to respond in the moment.

Building Confidence

Building Confidence

Helping children feel more in control, less ashamed, and more encouraged as progress builds over time.

Support for parents matters too

When a child is struggling with a BFRB, parents often feel unsure how to respond. They may worry about making the behavior worse, become frustrated, or feel stuck between wanting to help and not knowing what actually supports progress.

At KidWise Counseling, parents are given practical guidance to better understand the behavior, respond with support instead of shame, and reinforce progress at home in a calm, consistent way.

  • Better understand triggers and patterns
  • Respond in a supportive, non-judgmental way
  • Reinforce progress at home
  • Help children feel more confident and less alone
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Parent Support

Parents play an important role in helping children manage BFRBs. With guidance and consistency at home, families can support progress while reducing shame, frustration, and tension around the behavior.

Frequently Asked Questions About BFRBs

No. BFRBs are more than habits. They are often connected to stress, anxiety, tension, or the need for relief, even when a child wants to stop.
With support, children and teens can make meaningful progress by building awareness, learning new coping tools, and reducing the behavior gradually over time.
Directly telling a child to stop often increases shame or tension. Supportive treatment focuses on understanding the behavior and building practical strategies instead.
Yes. Parent support is an important part of treatment, especially when families want to better understand patterns and reinforce progress at home.

BFRBs Can Show Up In Different Ways

Body-focused repetitive behaviors do not always look the same. For some children, it may be hair pulling or twisting. For others, it may be skin picking, nail biting, or biting the inside of the mouth during moments of stress, boredom, or tension.

Hair
Pulling

Skin
Picking

Nail & Cuticle Picking

Cheek or
Lip Biting

If BFRBs are getting in the way, support is available

KidWise Counseling helps children, teens, and families better understand body-focused repetitive behaviors and move forward with more confidence, support, and clarity.
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