Overview

Biting your nails or onychophagia to give it its medical term, is a form of BFRB’s (body focused repetitive behaviours) which most commonly occur in childhood.  Most people develop the habit at around the age of three or four and it can sometimes be used to replace finger or thumb sucking in children, who can often go on to outgrow the habit. 

It can also start during adolescence or adulthood; nail biting is quite common and is believed to affect between twenty to thirty percent of the population at some point during their lives.  As children or adolescents are most prone to nail biting  they will account for around forty percent of this figure and it’s believed that half of all teenagers will bite their nails.  Although nail biting can continue into adulthood it can also decrease with age.

The condition often starts as a coping mechanism to help people deal with feelings of boredom, nervousness, frustration, loneliness or feelings of hunger.  Severe cases of nail biting are the most common form of BFRB’s, which also include, skin picking or dermatillomania, hair pulling or trichotillomania, and teeth grinding or bruxism.  Whilst for most people, nail biting is no more than a harmless habit that does not require treatment and is just aesthetically unappealing, for others it can be a compulsive habit that can cause damage to the nails and skin.

Symptoms of nail biting

Other than the obvious symptom of constantly biting their nails people can also experience symptoms such as:

·      Feelings of anxiety or distress before they start to bite their nails

·      They can worry about the reaction of others when they see their nails in case it’s a negative one and they feel ashamed

·      Have feelings of shame, embarrassment, self-consciousness or guilt related to the damage caused to their nails and skin because of their constant biting

·      Have a sense of pleasure or relief when they have bitten their nails

·      In extreme case  they might socialise less because they fear being mocked or judged

Nail biting can either be an unconscious habit where you are not actually aware that you are doing it, or it can be a focused behaviour.  It can range from occasional biting during times of stress or boredom, to severe cases that can be damaging to the nails and surrounding tissue.

Reasons or causes for nail biting

It’s not really fully understood why people bite their nails although it is closely linked to feelings of stress, anxiety, boredom and frustration.  It can also be an inherited tendency or learnt behaviour for some.

Nail biting is also commonly associated with emotional or psychological conditions which can include:

·      Anxiety

·      ADHD (attention deficit hyperactivity disorder)

·      Enuresis or loss of bladder control whilst sleeping

·      Major depressive disorder

·      OCD (obsessive compulsive disorder)

·      ODD (oppositional defiant disorder)

·      Separation anxiety

·      Tic disorder or Tourette’s syndrome

Whilst not everyone with these disorders will necessarily bite their nails, biting your nails does not necessarily mean you have a psychological disorder either.

Associated conditions and complications

Whilst biting your nails doesn’t generally cause permanent damage there are some negatives, such as:

·      If you cause damage to the tissue surrounding your nails because of constant biting or tearing then they could stop growing properly, which could result in your nails looking abnormal.  It could also cause fungal infections of the nail plate.

·      It’s also possible to cause damage to your teeth from biting your nails which could result in chipped, cracked or even broken teeth, which could make you self-conscious about smiling.  It can even cause problems with your jaw such as temporomandibular joint problems over time or cause abscesses in the mouth.

·      Your hands are a breeding ground for germs, in particular the nails as dirt and bacteria can become trapped there.  People touch their lips or mouths with their fingers several times a day, which increases your chances of transmitting germs, especially if you have open cuts you may have caused through biting your nails, which can result in infection or illness.  If you swallow bitten off nail and skin, it can lead to stomach or intestinal  upset or infection.

Ways you can try to help you to stop biting your nails

There are a variety of different ways you can try to stop biting your nails, it will take time and effort on your part, and whilst the results won’t be immediate they will be worthwhile.

·      You could try over the counter remedies that you paint on your nails, which have an unpleasant taste to try and discourage you from biting your nails

·      Try keeping your nails short and smooth by filing them regularly as this will make it less tempting to chew or bite them

·      Fidget toys or squeezing a small ball in your hand can work as a distraction technique to stop you putting your fingers near your mouth or being tempted to chew or bite your nails

·      Putting tape or plasters on your nails or wearing gloves so that you don’t have immediate access to your nails or want to put your fingers near your mouth could also help

·      Try to  reduce your nail biting habit slowly, you can do this by not biting one particular finger or your thumb until you stop biting all of your nails

·      You could try to work out what causes you to bite your nails, by keeping a note of situations when you are prone to do so, and then try and avoid these situations if possible

·      Try treating yourself to regular manicures, as if you are investing your time and money in looking after your hands and nails, you will be able to see how nice they can look when you care for them, which could help discourage you from biting them

When to consult your doctor

If your nail biting has resulted in any of the following symptoms then you should speak to your doctor as you may require treatment:

·      Infections to the nail or surrounding skin

·      Pain or swelling around the nails

·      The nail starts to separate from the skin around it

·      Your nails start to become either thinner or thicken

·      Bleeding around your nail and fingers

·      Your nails have stop growing

·      Your nails have either curled, become discoloured or have started to become ingrown

Whilst your doctor can help with any physical damage caused by your nail biting, if you have tried repeatedly without success to stop biting them, then your doctor may suggest that you see a therapist to try to overcome the habit.

Therapy can be helpful in reducing and overcoming your habit of nail biting by using different types of therapy either alone or in combination.  This can include therapies such as:

CBT (cognitive behavioural therapy)

CBT is a form of talking therapy that helps you to identify  negative thoughts, emotions and situations that cause you to bite your nails.  This can help you to then replace these negative behaviours with healthier ones.

HRT (habit reversal training)

Habit reversal training is a form of therapy that teaches alternative behaviours and coping mechanisms, which you can use when the urge to bite your nails arises.  This could be by either chewing gum, clenching your hands or touching an object that is textured, or by doing some deep breathing.

Self-monitoring

By tracking the frequency and intensity of your nail biting, you can not only identify your progress but also see areas that could benefit from improvement.

ACT (acceptance and commitment therapy)

Acceptance and commitment therapy is a type of psychotherapy, that works by helping people to develop psychological flexibility.  It is based on the idea that difficult emotions are just a part of life.  It teaches you how to accept your thoughts and feelings without judgement, to be mindful of the present moment, and make choices that move you towards your goal and align with your values.  Written by Jan, Jeana and Wendy at Barnsley Hypnosis and Counselling (UK). For more free Information click above link.