Many people occasionally bite their lip when they are anxious. 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.
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 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.
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.
BFRBs begin during the onset of puberty, from age 11–14.
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.
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)
People with BFRBs or tics
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:
- 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.
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).
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.