Hair Pulling and Skin Picking Therapy in Alpharetta
Hair pulling (trichotillomania) and skin picking (excoriation) are more common than most people realize, and they are very treatable. We help children, teens, and adults understand what drives the urge and build real tools to change it.
Understanding Hair Pulling and Skin Picking
Hair pulling and skin picking belong to a group of conditions called body-focused repetitive behaviors, or BFRBs, which also include nail biting and cheek or lip biting. Someone might pull hair from the scalp, eyebrows, or eyelashes, or pick at skin, scabs, or small imperfections, often longer and more often than they meant to, and in ways that cause hair loss, skin damage, or a lot of distress.
BFRBs are not a bad habit or a lack of willpower. For some people the behavior happens almost automatically, while reading, studying, scrolling, or watching TV. For others it is more focused, a response to an urge, tension, boredom, or the feeling that something needs to be smoothed or fixed. Pulling or picking can bring brief relief or a soothing feeling, which is a big part of why it is so hard to stop. Many people feel embarrassed and work hard to hide the effects, so they often struggle on their own for years.
These behaviors often begin in late childhood or the teen years, though they can start at any age. Hair pulling and skin picking are each estimated to affect about 1 to 2 percent of adults, and many more people deal with milder forms. They are grouped with OCD and related conditions and often show up alongside anxiety or ADHD, but they are their own condition with their own treatment approach. Families in Alpharetta, Roswell, Milton, Johns Creek, Sandy Springs, and across North Fulton can get help in person or by telehealth anywhere in Georgia.
- Pulling hair from the scalp, eyebrows, or eyelashes
- Picking at skin, scabs, cuticles, or blemishes
- Noticeable hair loss, thinning, or skin damage
- Repeated attempts to stop or cut back
- Pulling or picking without realizing it
- An urge or tension before, and relief after
- Hiding the effects with clothing, makeup, or hats
- Avoiding swimming, haircuts, or being seen up close
How We Treat Hair Pulling and Skin Picking
The most effective treatment for BFRBs is a specialized form of cognitive behavioral therapy built around habit reversal training. Instead of relying on willpower, treatment helps you figure out exactly when, where, and why pulling or picking happens, then builds practical strategies that make the behavior harder to do and less needed. We go at your pace, and there is no shaming or scolding.
For children and teens, parents play a big role. We help families move away from reminders, nagging, or punishment, which usually add stress and secrecy, and toward the kind of support that actually helps. If you would like to learn more on your own, the TLC Foundation for Body-Focused Repetitive Behaviors is a trusted place to start.
Habit Reversal Training
Builds awareness of the behavior and its early warning signs, then pairs it with a competing response, something you do with your hands instead, so pulling or picking becomes easier to interrupt.
Comprehensive Behavioral Model
Looks at the sensory, emotional, thinking, physical, and place-based triggers behind each person's pulling or picking, and matches a specific strategy to each one.
ACT
Acceptance and Commitment Therapy helps you make room for urges and uncomfortable feelings without acting on them, which makes the other strategies easier to stick with.
