To stop biting nails, peeling skin and pulling out hair, new research suggests a simple technique

For people who can’t stop biting their nails or picking at their skin, a new study suggests a simple technique could help.

Body-focused repetitive behaviors of compulsive pulling or pinching of hair or skin, unable to stop even as the behavior leads to scabs, scars and balding spots affect about 5 percent of people worldwide, according to the TLC Foundation for Body-Focused Repetitive Behaviors, an advocacy group for people with these conditions. (A common repetitive behavior is nail biting.)

The research, published Wednesday in JAMA Dermatology, found that an approach called habit replacement can help reduce these behaviors.

While the new technique of gently rubbing the fingertips, palm or back of the arm at least twice a day didn’t help everyone, about 53% of people in the study said they had at least some improvement compared with about 20% of people in a control group. (A video here shows some of the variations people can try.)

The rule is just to touch your body lightly, said study lead author Steffen Moritz, head of the clinical neuropsychology working group at University Medical Center Hamburg-Eppendorf, in Hamburg, Germany. If you are under stress, you may perform the movements faster, but not with more self-applied pressure.

The study was considered the first proof-of-concept research that needs further confirmation. However, experts said the results were encouraging.

In the six-week study, Moritz and colleagues looked at 268 people with trichotillomania (a condition in which people pull their hair out in response to stress or to calm down) or repeatedly bit their nails or the inside of their cheeks.

The researchers randomly assigned the volunteers into two groups. One group was given a manual and video showing them how to form the new, least harmful habit by gently rubbing their fingertips, palm or arm whenever they felt the urge to bite their nails or engage in the harmful behavior. They were also instructed to practice the new habit when they didn’t feel the need to tug, pick or bite.

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People in the control group were told they had been placed on a waitlist for treatment and received training to change the habit only after the study concluded.

Overall, nearly 80% of people in the treatment group said they were satisfied with the training and 86% said they would recommend it to a friend. People who bit their nails seemed to benefit most from the habit replacement technique.

How can arm rub stop you from biting your nails?

The new approach is a variation of other behavioral techniques for body-focused repetitive behaviors, which include habit reversal training and something called decoupling. While some medications, including antidepressants, are prescribed off-label to people with body-focused repetitive behaviors, there are no FDA-approved medications specific to the condition. Cognitive behavioral therapy is thought to be the most effective approach.

In habit reversal training, people are taught conflicting responses, said Natasha Bailen, a clinical psychologist at the Center for OCD and Related Disorders at Massachusetts General Hospital and Harvard Medical School.

So they might involve, for example, clenching your fists really hard when you need to pull your hair out or pick at your skin. It might be sitting on your hands, he said she. The goal is to use one muscle group so that you cannot physically perform the harmful behavior.

In decoupling, a habit is unlearned by performing a similar movement but changing it at the last minute. For example, if you bite your nails, you might bring your hand to your face but touch your earlobe instead of your mouth.

Moritz said the study’s habit replacement training differs in that it aims to replace the sometimes pleasurable sensation of picking and pulling with something that also feels good but won’t be harmful to a gentle touch. In fact, the training manual in the study recommends people avoid touching their bodies in rough ways or applying too much pressure, such as scrubbing their skin in the shower or brushing their teeth too hard.

I’d say one-third to one-half of patients with BFRBs [body-focused repetitive behavior] they benefit from decoupling, but the rest don’t, Moritz said. And so the idea was to find another technique that was perhaps more suitable for these non-responders.

The training also recommends that people indulge in things like a massage, warm bath, or applying lotion both knowingly and, ideally, lovingly.

More research is needed

John Piacentini, chair of the board of directors of the TLC Foundation for Body-Focused Repetitive Behaviors, said it’s great that this study raises awareness of BFRBs because they’re so poorly understood, often misdiagnosed, or missed altogether.

There are reasonably good treatments out there that most doctors either don’t know about or don’t do, he said.

However, he did note some of the study’s limitations, including that the control group was not receiving some type of alternative treatment, the study was relatively short at just six weeks, and it was unclear whether the intervention was influenced by other conditions such as anxiety or depression, or if it helped reduce harm.

In this population, we’re really looking for treatments that really impact or really reduce the severity of these specific symptoms, he said.

The study authors also listed several limitations, including that the participants were recruited from social media, lacked diversity (most were white women in their 30s), and lacked the confirmed diagnosis.

I was very excited that there was more work to be done in this area of ​​self-help, Bailen said, adding that habit replacement techniques could be helpful for those waiting for treatment or in combination with other therapies.

Gaining access to mental health services can be quite a challenge these days, and waiting lists can be incredibly long, she said. But I think the more research they’re able to do and the more they’re able to develop these self-help materials, we can help narrow the treatment gap. And this is definitely important.

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This article was originally published on NBCNews.com