Lip Biting: Causes, Treatment, And Other Anxious Habits

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How to stop anxious lip biting

Medically reviewed by Timothy J. Legg, PhD, PsyD — Written by Adrienne Stinson — Updated on July 20, 2023

Causes
Symptoms
Treatment
Takeaway

Many people occasionally bite their lip when they experience anxiety. However, for some people, lip biting can become a habit that impacts on everyday life.

People with this nervous habit may get painful sores and redness on their lips.

Lip biting can be a difficult habit to break because the behavior can become so automatic that a person may no longer be aware of it. However, there are effective ways to overcome this habit.

Read on to learn about the causes of lip biting, similar anxious habits, and treatment options.

What causes lip biting?

In some cases, physical conditions can cause a person to bite their lips when they use their mouth for talking or chewing.

In other cases, the cause can be psychological. People may bite their lip as a physical response to an emotional state, such as stress, fear, or anxiety.

Physical causes

Physical causes of lip biting include:

Teeth alignment issues, known as malocclusion. These include overbite and underbite and can lead to overcrowding of the teeth.
Temporomandibular disorder, or TMD, which is a condition that affects the chewing muscles.

People with malocclusion or TMD may often bite their lips, cheeks, or tongue. A dental professional should be able to recommend treatment options, which may include dental braces or removing one or more teeth.

Psychological causes

Chronic lip biting is one example of a body-focused repetitive behavior, or BFRB. This term refers to any repetitive self-directed behavior that damages the skin, hair, or nails.

BFRBs occur as a coping mechanism in situations where a person is feeling uncomfortable or anxious. People with a BFRB find that repetitive behaviors can provide relief from painful emotions.

Relatively few studies have looked at lip biting as a BFRB. Most research has instead focused on the three most common habits, which are:

hair-pulling, or trichotillomania
skin-picking, or excoriation
nail-biting, or onychophagia

However, there is likely to be an overlap in the psychology behind different kinds of BFRBs, including lip biting.

Research from 2014 suggests that even thinking about these habits can trigger a person to act on them, so just thinking about lip biting can make a person start biting their lip.

BFRBs begin during the onset of puberty, from age 11–14. Research suggests that those who have close relatives who engage in a BFRB are more likely to develop one themselves.

Symptoms of lip biting

Some people may not have any side effects from compulsive lip biting, but it will cause certain complications for others, including:

painful sores on the lips
inflammation or swollen lips
lip redness

Lip biting is often a compulsive behavior, so a person may not notice the habit until there is already damage to the lips.

Treatment

Treatments for lip biting differ depending on the cause. It is possible to treat physical causes such as dental problems by resolving the underlying issue. When lip biting has a psychological cause, many people benefit from counseling or behavioral therapies.

Treatments for lip biting as a BFRB include:

Cognitive behavioral therapy (CBT)

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CBT may a recommended treatment for lip biting.

People with BFRBs or tics may benefit from cognitive behavioral therapy (CBT).

The TLC Foundation for BFRBs recommend CBT as an effective treatment.

CBT is a step-by-step approach that focuses on changing specific behaviors by identifying their causes.

It also teaches skills that help a person change their behavior and thoughts going forward.

Habit reversal training (HRT)

Habit reversal training (HRT) is one type of CBT. It is especially effective for BFRBs and tics.

There are three key steps in HRT therapy:

doing awareness training, so that people notice their habit when it arises
creating a competing response, which is a different action a person can do when they feel the urge to bite their lip
providing social support, which can be vital for helping a person overcome anxious habits

Dialectical behavior therapy (DBT)

Dialectical behavior therapy (DBT) is another option for treating BFRBs, including lip biting. People with BFRBs may need help regulating emotions such as anxiety. This therapy may be useful for treating the causes behind body-focused behaviors.

The four aspects of DBT are:

mindfulness
distress tolerance
emotion regulation
interpersonal effectiveness

Other behavioral therapies that can treat BFRBs include acceptance and commitment therapy (ACT) and the Comprehensive Behavioral Model of Treatment (ComB). These are both relatively new and more research is necessary to confirm their effectiveness.

Medication

The general opinion is that CBT and HRT therapy are both more effective than medication for BFRBs. There are currently no specific medications to treat BFRBs.

However, some individuals may achieve relief by taking antidepressant and anti-obsessive medications, such as clomipramine or selective serotonin reuptake inhibitors (SSRIs).

Medication may be useful for those who engage in BFRBs and also suffer from anxiety, depression, or obsessive-compulsive disorder (OCD).

Takeaway

Understanding the underlying cause of lip biting is essential to create an appropriate treatment plan.

If lip biting is leading to an impaired quality of life, a psychologist will be able to recommend the most appropriate treatment.

Anyone seeking help should use The TLC Foundation for Body-Focused Repetitive Behaviors’ Find a Therapist tool to locate a local psychologist.

Dermatology
Mental Health
Anxiety / Stress
Psychology / Psychiatry

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Find help and support: Find a therapist. (n.d.)http://www.bfrb.org/find-help-support/find-a-therapist
Grant, J. E. (n.d.). Medications for body focused repetitive behaviorshttps://www.bfrb.org/learn-about-bfrbs/186-medications-for-body-focused-repetitive-behaviors
Gupta, S., & Gargi, P. D. (2012, May 12). Habit reversal training for trichotillomania. International Journal of Trichology, 4(1), 39–41http://www.ijtrichology.com/text.asp?2012/4/1/39/96089
Learn about BFRBs: Other body-focused repetitive behaviors. (n.d.)http://www.bfrb.org/learn-about-bfrbs
Learn about BFRBs: Therapy for BFRBs. (n.d.)http://www.bfrb.org/learn-about-bfrbs/treatment/therapy
Morand-Beaulieu, S., O'Connor, K. P., Richard, M., Sauvé, G., Leclerc, J. B., Blanchet, P. J., & Lavoie, M. E. (2016, May 10). The impact of a cognitive–behavioral therapy on event-related potentials in patients with tic disorders or body-focused repetitive behaviors. Frontiers in Psychiatry, 7, 81https://www.frontiersin.org/articles/10.3389/fpsyt.2016.00081/full
Morris, S. H., Zickgraf, H. F., Dingfelder, H. E., & Franklin, M. E. (2013. September). Habit reversal training in trichotillomania: Guide for the clinician [Abstract]. Expert Review of Neurotherapeutics. 13(9), 1069–1077https://www.tandfonline.com/doi/abs/10.1586/14737175.2013.827477
My anxiety plan for body focused repetitive behaviors. (n.d.)https://www.anxietybc.com/adults/my-anxiety-plan-body-focused-repetitive-behaviours
O'Connor, K., Lavoie, M., Desaulniers, B., & Audet, J. S. (2018, March). Cognitive psychophysiological treatment of bodily-focused repetitive behaviors in adults: An open trial. Journal of Clinical Psychology, 74(3), 273–285https://www.ncbi.nlm.nih.gov/pubmed/28815684
O'Connor, K., St-Pierre-Delorme, M.-È., Leclerc, J., Lavoie, M., & Blais, M. T. (2014, August). Meta-cognitions in Tourette syndrome, tic disorders, and body-focused repetitive disorder. The Canadian Journal of Psychiatry, 59(8), 417–425https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143298/
Redden, S. A., Leppink, E. W., & Grant, J. E. (2016, April). Body focused repetitive behavior disorders: Significance of family history [Abstract]. Comprehensive Psychiatry, 66, 187–192https://www.ncbi.nlm.nih.gov/pubmed/26995252
Rego, S. A. (2012, April 15). Beating body-focused repetitive behaviors: A two-pronged approachhttps://adaa.org/sites/default/files/Rego%20194.pdf
Roberts, S., O'Connor, K., Aardema, F., & Bélanger, C. (2015, March). The impact of emotions on body-focused repetitive behaviors: Evidence from a non-treatment-seeking sample [Abstract]. Journal of Behavior Therapy and Experimental Psychiatry, 46, 189–197https://www.ncbi.nlm.nih.gov/pubmed/25460266
Schreiber, L., Odlaug, B. L., & Grant, J. E. (2011, February 21). Impulse control disorders: Updated review of clinical characteristics and pharmacological management. Frontiers in Psychiatry, 2(1)https://www.frontiersin.org/articles/10.3389/fpsyt.2011.00001/full
Snorrason, I., Berlin, G. S., & Lee, H.-J. (2015, April 7). Optimizing psychological interventions for trichotillomania (hair-pulling disorder): An update on current empirical status. Psychology Research and Behavior Management, 8, 105–113https://www.dovepress.com/optimizing-psychological-interventions-for-trichotillomania-hair-pulli-peer-reviewed-article-PRBM

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Medically reviewed by Timothy J. Legg, PhD, PsyD — Written by Adrienne Stinson — Updated on July 20, 2023

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What causes lip biting?

Physical causes

Psychological causes

Symptoms of lip biting

Treatment

Cognitive behavioral therapy (CBT)

Habit reversal training (HRT)

Dialectical behavior therapy (DBT)

Medication

Takeaway

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