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The present study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on anxiety sensitivity and alexithymia in women with skin picking and hair pulling disorders in Tehran. This quasi-experimental study employed a pretest-posttest control group design. A total of 30 female students from the Islamic Azad University, Tehran Medical Sciences Branch, who met the research criteria for skin picking and hair pulling disorders, were selected using purposive sampling and randomly assigned to experimental (n = 15) and control (n = 15) groups. The experimental group received eight sessions of ACT, while the control group received no intervention. Data were collected using demographic information, the Anxiety Sensitivity Index, and the Toronto Alexithymia Scale at baseline, post-intervention, and a three-month follow-up. The results indicated no significant difference between the two groups in the pretest stage, confirming group homogeneity. However, posttest and follow-up results showed significant reductions in anxiety sensitivity and alexithymia scores in the experimental group compared to the control group (p < 0.05). These findings suggest that ACT is effective in reducing emotional and cognitive symptoms associated with skin picking and hair pulling disorders and may be considered a beneficial therapeutic approach for women affected by these conditions.