A Surprising New Finding About Trichotillomania

Photographed by Nicolas Bloise.
We tend to think of compulsive behaviors — such as hair-pulling, nail-biting, and skin-picking — as coping mechanisms used to deal with stressful situations. But, new research suggests there could be more behind these habits than we think.

The study, published in this month's issue of the Journal of Behavior Therapy and Experimental Psychiatry, looked at a group of 24 people dealing with these body-focused repetitive behaviors (BFRBs). Compared to 23 control participants, those in the BFRB group reported a much greater urge to engage in nail-biting, hair-pulling, and skin-picking in a variety of scenarios — including those situations designed to create feelings of frustration, boredom, and impatience. Interestingly, these feelings aren't traditionally thought of as triggering compulsive behaviors.

From here, the researchers conclude that these compulsive behaviors have a common root: perfectionism, which makes it difficult for people dealing with them to relax and do things at a "normal" pace. These people may be extra prone to boredom and frustration in addition to stress.

The most recent version of the Diagnostic and Statistical Manual categorizes nail-biting, hair-pulling (trichotillomania), and skin-picking (excoriation or dermotillomania) as being related to obsessive-compulsive disorder. This is distinct from impulse-control disorders, which are often characterized by urges to harm oneself. 

It's estimated that about 1-3% of the U.S. population struggles with hair-pulling and up to about 5% deals with skin-picking, while nail-biting is thought to be more common. The classification of nail-biting in particular has been somewhat controversial, with many people seeing it as simply a bad habit. Although this is likely true for some, for others, it may be one version of a disorder with serious consequences.


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