What We Treat


More than 2.5 million Americans struggle with Trichotillomania or skin picking at some point in their lifetime. Most often, people develop symptoms during childhood or their early teens, but symptoms can begin later and persist well into adulthood.

Trichotillomania and skin picking are known as body-focused repetitive behaviors (BFRB), and unlike normal fidgeting and self-grooming, they are often related directly to negative emotions and are both the cause and result of significant distress. Both conditions feature the constant and irresistible urge to either pull out hair or pick at skin, usually in response to stress, but can also become automatic behaviors unrelated to emotional triggers. Trichotillomania and skin picking are chronic, and without proper intervention, both disorders can lead to significant problems long-term.

The most common signs and symptoms of Trichotillomania & skin picking are:
  • Repeatedly pulling out hair from one’s scalp, eyelashes, or eyebrows OR picking at one’s skin on the face or different preferred parts of the body (such as arms and neck)
  • Increased anxiety when unable to pull or pick, and a sense of relief during and after pulling or picking
  • Developing specific hair pulling or skin picking rituals
  • Constantly trying to stop pulling hair or picking skin without success
  • Significant distress in one or more life domains

At Union Square Practice, we assess each client and recommend a treatment plan that is customized to meet their needs. However, we know that for Trichotillomania and skin picking, one of the most effective treatment options is an evidence-based therapy called Habit Reversal Training (HRT). In addition to HRT, we offer medication and other forms of empirically-validated therapy.

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