BODY-FOCUSED repetitive behaviors (BFRBs), including skin-picking, hair-pulling, and nail-biting, significantly impact quality of life, yet access to effective treatments remains a challenge. A new review of randomized controlled trials reveals that internet-based self-help interventions provide a promising alternative for patients unable to attend in-person therapy.
Published research analyzed 12 studies examining digital interventions for BFRBs, with the “Free from BFRB” website emerging as the most studied and consistently well-received resource. Self-guided habit reversal training (HRT), decoupling, and decoupling in-sensu were found to significantly reduce symptoms and improve patient quality of life. Notably, decoupling techniques were particularly effective for managing trichotillomania and nail-biting.
These findings underscore the potential of internet-based self-help strategies, particularly for individuals facing barriers to traditional treatment such as cost, stigma, or geographic limitations. However, engagement and consistent use appear to be critical factors in achieving meaningful symptom reduction. While self-guided interventions can be effective, therapist-supported options may provide more comprehensive care.
As the demand for accessible mental health solutions continues to grow, digital interventions could bridge the treatment gap for BFRBs, offering a practical and scalable approach to symptom management.
Reference: Murase EM et al. Narrative Review of Internet-Based Self-Help Tools for Body-Focused Repetitive Behaviors: Recommendations for Clinical Practice. Dermatol Ther. 2025. doi:10.1007/s13555-025-01380-8.
Anaya Malik | AMJ
