Body-focused repetitive behaviors (BFRBs) such as trichotillomania and skin picking disorder are associated with decreased self-esteem and poor quality of life. The objective of this study was to evaluate dronabinol, a cannabinoid agonist, for the reduction of BFRB symptoms. Fifty adults with either trichotillomania (n = 34) or skin picking disorder (n = 16) were recruited for a randomized, double-blind, placebo-controlled study. Participants received 10-week treatment with dronabinol (5-15 mg/day) or placebo. The primary efficacy outcome measure was the change on the clinician-rated National Institute of Mental Health scale for hair pulling or skin picking. Both dronabinol and placebo treatment were associated with significant reductions in BFRB symptoms. Dronabinol did not significantly separate from placebo on any efficacy measure. At week 10, 67% of the treatment group were classified as responders (Clinical Global Impressions-Improvement Score of very much or much improved) compared to 50% in the placebo group (P value = 0.459). This study assessed the efficacy of dronabinol, a synthetic form of tetrahydrocannabinol, in the treatment of BFRBs, and found no differences in symptom reductions between dronabinol and placebo.

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January 2025

Division of Dermatology, Department of Medicine, CHU de Québec-Université Laval, Québec, QC, Canada.

Background: Skin picking disorder (SPD) is classified as a primary psychodermatologic disorder, in which lesions are self-induced. It is frequently encountered by dermatologists, but the management is still a source of discomfort for the majority.

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Body-focused repetitive behaviors (BFRBs) such as trichotillomania and skin picking are disorders at the interface of psychiatry/psychology, dermatology and dentistry. The disorders can be both either a consequence or a cause of severe somatic disorders. If BFRBs remain undetected and untreated, they tend to become chronic with at times serious somatic complications.

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Article Synopsis
  • - The study explores the relationship between body-focused repetitive behavior (BFRB) disorders, like trichotillomania and skin picking, and anxiety disorders, finding that comorbidity is common, with notable prevalence rates for various anxiety disorders.
  • - A meta-analysis of 119 studies revealed that current and lifetime prevalence rates for anxiety disorders among individuals with BFRBs are significant, such as 19.2% for generalized anxiety disorder and 27.5% for any anxiety disorder.
  • - Although comorbid anxiety is frequent in BFRB cases, the correlation between anxiety severity and BFRB severity is only low to moderate, indicating a complex relationship that warrants further research and consideration in clinical practice. *
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