About one-third of people with hair-pulling or skin-picking disorders reported past-year cannabis use | Research

The takeaway

In a survey of people with body-focused repetitive behaviors, 33% reported past-year cannabis use, and cannabis users pulled or picked more days per week and reported greater distress.

Mental health clinicians working with body-focused repetitive behaviors and researchers studying cannabis-psychiatric comorbidity.

33% past-year cannabis use

What the researchers found

Approximately 33% of individuals with trichotillomania or skin picking disorder reported past-year cannabis use. Cannabis use was associated with more days per week spent pulling or picking, and in trichotillomania specifically, cannabis use was associated with heightened distress.

Why it matters

Cannabis use rates in people with body-focused repetitive behaviors have received little research attention despite rising cannabis use in psychiatric populations. Understanding whether cannabis use correlates with worse BFRB symptoms could inform treatment approaches.

The numbers in context

Approximately 33% of participants reported past-year cannabis use. Cannabis users reported more days per week of pulling or picking. In trichotillomania specifically, cannabis use was linked to heightened distress.

How the study worked

Online survey of individuals with body-focused repetitive behaviors (BFRBs) collecting rates of past-year cannabis use and clinical measures of trichotillomania and skin picking disorder severity.

What this study cannot tell us

Cross-sectional design cannot determine causation. Online survey introduces self-selection bias. No information on cannabis use frequency, quantity, or product type. Small scope limits generalizability.

How to read the evidence

Preliminary cross-sectional survey with a narrow clinical population. Provides initial descriptive data but cannot establish directionality.

When this study was published

2025 publication

The bigger picture

This study opens a new line of inquiry into how cannabis intersects with compulsive behavioral conditions. Whether cannabis worsens BFRBs or people with more severe symptoms are more likely to use cannabis remains unclear.

Questions still open

Does cannabis use worsen pulling/picking behaviors, or do people with more severe symptoms turn to cannabis? Would specific cannabinoids (CBD vs. THC) have different effects on BFRBs?

Common questions

What are body-focused repetitive behaviors?

BFRBs include conditions like trichotillomania (compulsive hair pulling) and skin picking disorder (excoriation). They involve repetitive self-grooming behaviors that cause distress or physical damage.

Does cannabis cause more hair pulling or skin picking?

The study found an association but could not determine the direction. People who used cannabis pulled or picked more days per week, but it is unknown whether cannabis drove the behavior or whether those with worse symptoms were more likely to use cannabis.

Read the original research

Rates and Clinical Correlates of Cannabis Use in Trichotillomania and Skin Picking Disorder.

The Journal of nervous and mental disease, 213(6), 145-149

View on PubMed ↗Publisher’s paper ↗

Citation

Collins, Madison; Grant, Jon E. (2025). Rates and Clinical Correlates of Cannabis Use in Trichotillomania and Skin Picking Disorder.. The Journal of nervous and mental disease, 213(6), 145-149. https://doi.org/10.1097/NMD.0000000000001832