Murase Emi M, Raygani Sawye, Murase Jenny E
Department of Biological Sciences, University of California, 1 Shields Ave, Davis, CA, 95616, USA.
School of Medicine, University of California, San Diego, La Jolla, CA, USA.
Dermatol Ther (Heidelb). 2025 Apr;15(4):811-818. doi: 10.1007/s13555-025-01380-8. Epub 2025 Mar 19.
Body-focused repetitive behaviors (BFRBs), such as skin-picking, hair-pulling, and nail-biting, impair quality of life (QOL). While habit reversal training (HRT) is effective, access is often limited. Internet-based self-help interventions offer an alternative, improving accessibility for patients unable to attend in-person therapy.
We reviewed randomized controlled trials analyzing self-help or internet-based interventions for BFRBs in adults. PubMed searches yielded 1033 studies, 12 of which met the inclusion criteria, focusing on self-guided interventions for various BFRBs.
The review found that the "Free from BFRB" website was the most studied resource and consistently had high patient satisfaction. Self-guided HRT, decoupling, and decoupling in-sensu consistently reduced symptoms and improved QOL. Decoupling techniques were especially effective for trichotillomania and nail-biting.
Internet-based self-help interventions, especially self-help HRT, decoupling, and decoupling in-sensu, offer effective and accessible treatment options for managing BFRBs, particularly for those facing barriers to traditional therapy such as stigma, cost, or location. Engagement and frequency of use are important for the efficacy of self-help options, and therapist-guided treatments may offer more personalized, comprehensive care.
专注于身体的重复行为（BFRB），如抠皮肤、拔头发和咬指甲，会损害生活质量（QOL）。虽然习惯逆转训练（HRT）有效，但往往难以获得。基于互联网的自助干预提供了一种替代方案，提高了无法参加面对面治疗的患者的可及性。
我们回顾了分析针对成人BFRB的自助或基于互联网的干预措施的随机对照试验。通过PubMed搜索得到1033项研究，其中12项符合纳入标准，重点是针对各种BFRB的自我指导干预措施。
综述发现，“摆脱BFRB”网站是研究最多的资源，患者满意度一直很高。自我指导的HRT、解耦和感觉解耦持续减轻症状并改善生活质量。解耦技术对拔毛癖和咬指甲尤其有效。
基于互联网的自助干预措施，特别是自助HRT、解耦和感觉解耦，为管理BFRB提供了有效且可及的治疗选择，特别是对于那些面临传统治疗障碍（如耻辱感、成本或地理位置）的人。参与度和使用频率对自助选择的疗效很重要，而治疗师指导的治疗可能提供更个性化、全面的护理。
