Signs and symptoms commonly include a relentless urge to pick the nose, repeated and voluntary nose picking despite awareness of negative consequences, and attempts to control or stop the behavior that are unsuccessful. The behavior can cause nasal mucosal injury, bleeding, crusting, irritation, and infection, and may interfere with social, occupational, or academic functioning. Some individuals engage in rituals or specific sequences around nose picking, while others may pick in response to stress, anxiety, or boredom.
Causes and risk factors are typically multifactorial and may involve underlying anxiety or mood disorders, obsessive–compulsive tendencies, or other body-focused repetitive behaviors such as skin or nail picking. Sensory-seeking, poor impulse control, and learned habit formation can contribute. Comorbidity with obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, or autism spectrum conditions has been reported in case studies, though causal links remain unclear.
Diagnosis is typically clinical, based on history and impairment, with evaluation to exclude medical conditions such as chronic rhinitis, infections, or structural nasal issues. In research and clinical practice, assessments for body-focused repetitive behaviors and OCD-spectrum symptoms may be used to understand severity and comorbidity.
Treatment evidence is limited and largely extrapolated from approaches used for OCD and other BFRBs. Behavioral therapies, particularly habit reversal training and exposure and response prevention, are central. Cognitive-behavioral therapy, psychoeducation, and addressing comorbid conditions are advised. Pharmacotherapy with selective serotonin reuptake inhibitors or other OCD-directed medications may be considered in cases with significant comorbidity or overlap with OCD symptoms. Prognosis varies; some individuals respond to therapy, while others persist with significant impairment. Prevalence data are limited, and rhinotillexomania is not well quantified in population studies.