Hair Pulling &
Skin Picking
Treatment in Boerne, TX

Hair pulling and skin picking are not simply “bad habits” or behaviors someone can stop through willpower alone. These patterns, often called body-focused repetitive behaviors or BFRBs, can include trichotillomania, which involves hair pulling, and excoriation disorder, which involves skin picking.

If you or your child are struggling with hair pulling, skin picking, or another repetitive behavior that feels difficult to control, treatment starts by understanding the pattern behind the behavior. The urge may be connected to a physical sensation, stress, boredom, anxiety, a specific environment, or an automatic habit that happens before you even realize it.

At Blueprint Therapy, treatment for BFRBs is structured, practical, and personalized. The goal is not to shame the behavior or tell you to “just stop.” The goal is to understand what keeps the cycle going and build a plan that helps interrupt it.

A Personalized Strategy to Break the Cycle

To treat hair pulling and skin picking, I use the ComB model, which stands for Comprehensive Behavioral Treatment. ComB is an evidence-informed approach designed to identify the unique factors that drive a person’s pulling or picking behavior.

Instead of using a one-size-fits-all solution, we look at the specific ingredients that make the urge stronger, then create targeted strategies to change the pattern.

How the ComB Model Works

The ComB model uses a framework called SCAMP. This helps us look at five areas that may be feeding the urge to pull, pick, or engage in another BFRB.

Sensory

We look at whether a specific physical feeling, texture, sensation, or visual cue triggers the urge. For some clients, the behavior may begin because something feels uneven, uncomfortable, noticeable, or difficult to ignore.

Cognitive

We identify thoughts or beliefs that may give the behavior permission to happen. This can include thoughts like, “I’ll just fix this one spot,” “I need it to feel right,” or “I already started, so it doesn’t matter.”

Affective

We explore whether the behavior happens more during certain emotional states, such as anxiety, boredom, frustration, stress, excitement, or fatigue.

Motor

We look at the physical habits and automatic movements that happen before or during pulling or picking. Many BFRBs occur on autopilot, especially during quiet, distracted, or repetitive moments.

Place

We identify where and when the behavior is most likely to happen. This may include a specific chair, bathroom mirror, car, bed, desk, couch, or while watching TV, studying, scrolling, or getting ready for the day.

Turning Insight Into Action

Once we understand your unique pattern, we do more than talk about it. We build practical tools to interrupt the cycle.

Treatment may include changing the environment, creating barriers that make the behavior harder to do, using sensory substitutes, building competing responses, practicing mindfulness strategies, and learning how to catch the urge earlier.

Over time, clients become better at understanding their own patterns and using strategies that fit real life. The goal is to leave treatment with tools you can continue using long after sessions end.

BFRB Therapy for Children, Teens, and Adults

Blueprint Therapy provides treatment for hair pulling, skin picking, trichotillomania, excoriation disorder, and other body-focused repetitive behaviors in Boerne, TX, with secure telehealth available across Texas when clinically appropriate.

For children and younger adolescents, parents may be included in treatment so they can better understand the behavior, reduce shame, and support skills outside of sessions.

You Do Not Have to Explain It Perfectly to Get Started

You do not need to know exactly why the behavior is happening before reaching out. We can begin by identifying the pattern, understanding what keeps it going, and building a practical plan to interrupt the cycle.

Schedule a free 15-minute consultation to learn whether BFRB treatment at Blueprint Therapy may be a good fit.