Body-Focused Repetitive Behaviors (BFRBs): Expert Care in NYC and Beyond
BFRB Management and Psychodermatology
Body-Focused Repetitive Behaviors (BFRBs) are complex self-grooming behaviors in which individuals pull, pick, scrape, or bite their hair, skin, or nails. While these actions often result in physical damage, they are recognized as more than just “habits”—they are chronic behavioral health conditions. Treatment of these conditions falls under psycho dermatology, a subspecialty of medicine that addresses the interface between psychiatry (the mind) and dermatology (the skin, hair,and nails). This includes how emotional and mental states affect skin health, and conversely, how skin conditions impact a person’s psychological well-being
At Aglow Dermatology, Dr. Dina Strachan offers a specialized, empathetic approach to these conditions. Her expertise is built on a lifelong interest in the mind-body connection, having conducted psychological and behavioral research as an undergraduate and received formal training in psycho dermatology during her residency.
What is a BFRB?
BFRB, or body focused repetitive behavior, is primarily a psychiatric/behavioral disorder with secondary skin manifestations. The dermatologic types of BFRB include several related behaviors:
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Trichotillomania: Compulsive hair pulling (from the scalp, lashes, or brows).
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Dermatillomania (Excoriation Disorder): Chronic skin picking. This includes acne excoriee.
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Onychophagia: Severe nail biting.
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Morsicatio Buccarum: Lip or cheek biting.
The Dermatologist’s Role: Healing and Collaboration
While BFRBs are often triggered by anxiety, stress, or even boredom, they have a strong genetic component. These are behavioral health issues that require a multi-disciplinary approach.
The dermatologist’s role is different from, yet collaborative with, that of a mental health professional. While a therapist helps manage the “why” and the internal triggers, Dr. Strachan focuses on the “what”—the physical manifestations. Her role includes:
Medical Treatment: Healing infections, managing inflammation with topical steroids, and repairing the skin barrier.
Aesthetic Restoration: Helping patients regrow hair or eyelashes and treating the scarring or dark spots (hyperpigmentation) caused by picking.
Behavioral Substitutions: Recommending strategies such as applying a soothing barrier cream as a substitute for picking, which helps the skin heal while satisfying the tactile urge.
A Comprehensive Path to Recovery
Dr. Strachan strongly believes that dermatological care is most effective when paired with professional behavioral support. She recommends that patients work with a therapist who specializes in cognitive-behavioral strategies for BFRBs. For those seeking resources or specialized providers, she frequently refers patients to BFRB.org (opens in new tab) (The TLC Foundation for Body-Focused Repetitive Behaviors) for education and support.
Expert Care from Anywhere: Telemedicine Services
You don’t have to be in Manhattan to benefit from Dr. Strachan’s expertise in psycho dermatology. We offer convenient telemedicine visits for patients located in:
Whether you are struggling with hair loss, skin scarring, or the emotional weight of a BFRB, Dr. Strachan provides a judgment-free environment focused on medical excellence and behavioral understanding.
Schedule Your Consultation
Take the first step toward healing your skin and hair. Schedule a consultation or telemedicine visit with Dr. Dina Strachan today.