Do you find yourself pulling your eyebrows, eyelashes, or scalp hair—or picking at your skin—without fully realizing you’re doing it? You’re not alone. These are body-focused repetitive behaviors (BFRBs), most commonly trichotillomania (hair-pulling disorder) and excoriation (skin-picking) disorder. They’re real, treatable conditions that can be triggered by many factors (stress is only one of them).
At Snead Psychological Services, I use evidence-based approaches and a warm, collaborative style to help you reduce symptoms, understand triggers, and build practical skills for day-to-day life. Sessions are one-on-one, confidential, and tailored to your needs.
Effective Treatment for Hair-Pulling and Skin-Picking Disorder
My approach integrates well-researched methods to improve awareness, reduce urges, and replace repetitive behaviors with healthier responses.
Cognitive Behavioral Therapy (CBT)
CBT is a structured, goal-oriented therapy that helps you notice the thoughts, emotions, and situations that precede BFRBs. Together, we:
- Map your personal trigger patterns
- Challenge unhelpful thoughts (e.g., “I can’t stop this”)
- Practice coping and urge-management skills
By the end of our early sessions, you’ll have a clearer understanding of when, where, and why urges show up—and what to do in those moments.
Habit Reversal Training (HRT)
HRT is the gold-standard behavioral treatment for BFRBs. It includes:
- Awareness training: catching urges in real time
- Competing responses: substituting a specific, less harmful action (e.g., clenching a fist, using a fidget, applying lotion) until the urge passes
- Stimulus control: adjusting environments (lighting, mirrors, tweezers access, gloves, hairstyles, bandages) to make pulling/picking less likely
I may also incorporate decoupling techniques to help redirect motor patterns and relaxation skills to lower overall arousal.
Depending on your goals, we can blend CBT + HRT with elements from Acceptance & Commitment Therapy (ACT) or the Comprehensive Behavioral Model (ComB).
Signs You Might Benefit from Help
1. Trichotillomania (Hair-Pulling)
- Recurrent pulling from scalp, lashes, brows, or other areas
- Noticeable hair loss (thinning, patches)
- A rising sense of tension before pulling and/or relief afterward
- Time lost to pulling, impact on self-esteem, social or work life
- Playing with or inspecting pulled hair; occasionally biting or chewing it
Excoriation (Skin-Picking)
- Recurrent picking that causes skin damage
- Strong urges and difficulty resisting or stopping
- Increased tension before and/or relief after picking
- Significant time spent on picking or camouflaging marks
- Interference with social, academic, or work functioning
- No dermatologic condition that fully explains the behavior
If you recognize yourself in several of these, treatment can help—earlier support often leads to faster progress.
How CBT + HRT Help in Daily Life
- Increased Awareness: Identify the thoughts, feelings, locations, and routines that precede urges.
- Competing Responses: Build a personalized “menu” of actions to use when urges spike.
- Stimulus Control: Modify cues (e.g., mirror time, lighting, tool access, clothing) to reduce automatic behaviors.
- Thought Restructuring: Develop kinder, more accurate self-talk to reduce shame and rebound urges.
- Skills for Setbacks: Learn brief resets, urge-surfing, and relapse-prevention strategies.
Why Choose Snead Psychological Services
You’ll receive care that is private, respectful, and tailored to you—from first contact through long-term maintenance.
Our process:
- Preliminary Assessment: We review your history, triggers, medical/dermatology factors, and goals.
- Personalized Plan: I co-create a treatment roadmap aligned with your preferences and comfort.
- Private Sessions: Collaborative, skills-focused work with practical homework you can use right away.
- Progress Check-Ins: Regular reviews to track improvement and fine-tune strategies.
- Ongoing Support: Maintenance sessions, relapse-prevention planning, and resources between visits as needed.
Schedule Your Appointment
You deserve compassionate, evidence-based support that fits your life. If hair-pulling or skin-picking has started to overshadow your peace, we can work together to change that.
Take the first step with Dr. Alex Snead at Snead Psychological Services—let’s build a plan that works for you.
Ready to get started? Schedule a consultation today.