Habit reversal therapy in the management of body focused repetitive behavior disorders

Dermatol Ther. 2020 Nov;33(6):e13811. doi: 10.1111/dth.13811. Epub 2020 Jul 7.


Body-focused repetitive behavior disorders are a group of disorders characterized by repetitive actions that include skin picking, hair pulling, nail biting, and other compulsions. These disorders can range from a common habit to a pathological disorder, that negatively impacts the psychiatric health and social well-being of an individual. Diagnosis can be made clinically, and monitored using different scales and assessments. Various treatments have been tried with differing successes. There are currently no first line curative medications for these disorders, but cognitive behavioral therapy has seen the most success in treatment. Specifically habit reversal therapy has shown the most promise in reducing the repetitive behaviors and symptoms seen in these disorders. Habit reversal therapy has also seen success through augmentation with additional therapies such as mindfulness, or treatment with a selective serotonin reuptake inhibitor in a patient with comorbid obsessive compulsive disorder. This paper aims to explore the efficacy of different treatment modalities specifically the effectiveness and approach of habit reversal therapy.

Keywords: BFRB; Habit reversal therapy; psychocutaneous disorders; psychodermatology.

Publication types

  • Review

MeSH terms

  • Cognitive Behavioral Therapy*
  • Habits
  • Humans
  • Nail Biting
  • Obsessive-Compulsive Disorder* / diagnosis
  • Obsessive-Compulsive Disorder* / therapy
  • Trichotillomania* / diagnosis
  • Trichotillomania* / therapy