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Can't stop pulling hair, picking skin, or biting nails

Also called: Trichotillomania, skin picking disorder, excoriation, nail biting

Not being able to stop pulling out hair, picking skin, or biting nails, even when you try, may be a body-focused repetitive behavior such as trichotillomania (hair pulling) or excoriation disorder (skin picking). These are common, often start in the teen years, and are linked to stress and anxiety. Behavior therapy works well.

Common causesStress, anxiety, OCD-related conditions, boredom
Usually serious?Usually not dangerous
Get checked ifIt causes hair loss, skin damage, or distress
If you think it's an emergency, call 911.Thinking about suicide or in crisis? Call or text 988.Being hurt or threatened at home? National Domestic Violence Hotline: 1-800-799-7233.Help with alcohol or drug use: SAMHSA Helpline, 1-800-662-4357.

Overview

People may pull or pick to relieve tension, during boredom, or without noticing. It can lead to bald patches, scabs, infections, and scarring, and many people feel embarrassed or hide it.

These behaviors are related to obsessive-compulsive disorder and often occur with anxiety or depression. Picking at skin because of feeling bugs on the skin is a different problem.

When to get medical care

Call 911Thoughts of harming yourself or others: call or text 988, or call 911 if you're in danger.
Get care todayPicked skin that's red, hot, swollen, or draining pus with fever.
See a doctor soonHair loss or skin damage from pulling or picking. Trying to stop and not being able to. Feeling ashamed, anxious, or avoiding activities. Swallowing hair (can cause blockages).

Causes

These behaviors are linked to stress, anxiety, boredom, OCD, ADHD, depression, family history, and some skin conditions like acne or eczema that start the picking.

OwieClear has pages on 1 condition that can cause can't stop pulling hair, picking skin, or biting nails. Each shows how soon to get care.

Common causes

What you can do at home

  • Notice when and where it happens and what triggers it.
  • Keep hands busy with a fidget item or stress ball.
  • Make it harder: wear gloves, bandages, or a hat, or keep nails short.
  • Manage stress and sleep.
  • Find support, such as the TLC Foundation for BFRBs.

Medicines

Habit reversal training and cognitive behavioral therapy are the main treatments. Some people benefit from N-acetylcysteine or medicines for anxiety or OCD, as advised by a provider.

At the doctor

The provider will ask about the behavior and how it affects you.

Questions you may be asked

  • What you pull, pick, or bite and how often
  • Triggers
  • Skin or hair damage
  • Mood and anxiety

The exam

A skin and scalp exam.

Tests

  • Usually no tests
  • Screening for anxiety, OCD, and depression

Prevention

Early help works best.

  • Get help early
  • Manage stress
  • Learn your triggers

Check your symptoms

Most symptoms have more than one possible cause. The symptom checker looks at all of your symptoms together, plus your age, and shows how soon to get care.

Start the symptom checker

Sources

Last updated 2026-11-13.