Habit Reversal Therapy by Dermatologists to Treat Body-Focused Repetitive Behaviors: Review and Case Reports

Background

Body-focused repetitive behaviors (BFRBs) are recurrent, habitual behaviors, such as skin picking, hair pulling, and other compulsions, that can result in distressing cutaneous manifestations of varying severity. Many patients with BFRBs present primarily to dermatologists and a significant proportion subsequently resist engaging with psychological or psychiatric healthcare professionals. Habit reversal therapy (HRT) is one of the most effective evidence-based management strategies for BFRBs and it can be facilitated by a range of healthcare professionals including general practitioners, dermatologists, and nurses, as well as psychologists. Few dermatologists are comfortable offering HRT, making it a severely underutilized technique in the management of various skin conditions associated with BFRBs.

Objectives

This article aims to highlight strategies that dermatologists can learn to offer to positively influence the patient experience. A practical approach to implementing simplified HRT for patients with BFRBs will be demonstrated through two case studies.