Nail biting

Nail biting is a relatively common habit that can affect people of any age—from young children, teenagers to adults. It is usually a sign of anxiety and has been linked to perfectionist traits and obsessive-compulsive disorder. However, for some people chronic nail biting, or onychophagia, is simply a sign of boredom and a way to cope with everyday stress. So what does nail biting say about you and what are some ways in which you can combat this addictive habit…

What is nail biting

Onychophagia is defined as a chronic nail biting behaviour affecting about 20-30% of the general population. Sometimes it can involve the skin around the nailbed which can be chewed or picked at. The habit can be so ingrained that the person may not realise that they are doing it and in children it may be a copied behaviour from another family member.

Why people bite their nails

Nail biting is a problem with impulse control as well as a habit. Feeling chronic stress and tension can lead people to develop certain habits as a mechanism to deal with added pressure. Although it might seem strange, nail biting is a common reaction to stress in both children and adults.

The effects of nail biting

It may come across as a seemingly harmless issue but there is more to this condition than meets the eye—affecting general wellbeing and susceptibility to nail infections.

Psychological effects

Nail-biting can be a source of guilt and shame feelings in the nail biter causing significant mental distress. This may lead to depression, isolation or withdrawal from activities that they once enjoyed. There may be  stigmatization in the inner family circles or at a more societal level and embarrassment over the aesthetics of their nails.

Grooming behaviours

In 2012, the American Psychiatric Association decided to re-classify nail biting as a form of obsessive-compulsive disorder (OCD), along with other forms of "pathological grooming" such as skin picking and hair pulling. 

Quality of life

A 2014 study found that chronic nail biting is associated with impairment in quality of life. The level of impairment rose depending on the time spent biting nails and with more severe deformity. Tension when trying to resist nail biting, suffering due to nail biting or nail-eating behaviour also negatively influenced quality of life.

However, not all nail biting is pathological, and the difference between harmful obsession and normal behaviour is not always clear. It may not be a sign of underlying mental health concerns but more simply boredom or a way to deal with stress.

Dental problems

If you spend a lot of time biting your nails this can affect your dental health. In some people it may negatively impact proper dental occlusion which is a term used to describe how our upper and lower teeth come together when you rest or chew your food. Over time your teeth may wear down prematurely, shift out of their proper location or become misshapen.

Infection

Our fingers harbour millions of bacteria and other potential pathogens such as pinworms under the nails. This can potentially lead to systemic infections and disturbances in the digestive system. If the nail bed and skin surrounding the nail is damaged this can develop into local infections by bacteria, yeast and other microorganisms that enter through tiny tears or abrasions. This can lead to warts, swelling, redness or pus around your nail.

Ways to reduce nail biting

Whether you have a child who bites their nails or you do it yourself, here are some simple techniques you can use to break the bad habit and address underlying anxiety.

Nail lacquer

This can be seen as a simple solution to deter nail biting, especially in children. The solution is painted onto the nails and when placed in the mouth causes a bitter and unpleasant taste. While this may work for some people it doesn’t address the underlying cause of habitual nail biting in more severe cases. Other suggestions include wearing cotton gloves when at home or applying tape or band aids over the ends of the fingers to provide a physical barrier.

Keep your hands or mouth busy

People find that they are less likely to chew their nails when they are doing an activity such as typing, driving or even socialising with friends. While it’s not always possible to be doing these activities all the time you could try other suggestions such as chewing gum, doing a puzzle, massaging your hands, placing them under your legs when sitting or playing with a fidget spinner. This helps to provide a distraction and replaces the behaviour with another activity.

Keep you nails trimmed and manicured

If your nails are shortened this may reduce the urge to chew your nails. Some people use chewing their nails a method of keeping their nails short instead of using nail clippers or scissors. Once a week spend some time caring for your nails by cutting them, giving them a quick file and if necessary pushing back your cuticles. Use a nail cream regularly to hydrate your nails and surrounding skin to promote repair.

You could also look into getting regular manicures—if you are taking the time to invest in the care of your hands it may act as a deterrent to deform them.

Reduce anxiety

Implementing techniques which aim to reduce your anxiety can help in addressing the main cause of chronic nail biting. This may involve counselling, hypnotherapy, exercise, meditation or yoga. Supplements which assist in reducing stress and anxiety include B vitamins, magnesium and mildly sedating herbs such as passionflower, withania and magnolia.

N-acetyl cysteine

A 2013 study supports the hypothesis that N-acetyl cysteine (NAC) decreases nail biting behaviour in children and adolescents over the short term. It is a supplement which has proven efficacy in overcoming a variety of substance addictions, obsessive compulsive disorder, hair pulling, skin picking, anxiety and depression.  NAC is relatively well tolerated and severe adverse effects are rare, but it must be prescribed by a health professional.

References

1. https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/nail-biting/faq-20058548
2. Pacan P, et al. Onychophagia is associated with impairment of quality of life. Acta Derm Venereol. 2014 Nov;94(6):703-6 https://www.ncbi.nlm.nih.gov/pubmed/24535041
3. Maraz A, et al. Pathological grooming: Evidence for a single factor behind trichotillomania, skin picking and nail biting. PLoS One. 2017 Sep 13;12(9):e0183806 https://www.ncbi.nlm.nih.gov/pubmed/28902896
4. Ghanizadeh A, et al. N-acetylcysteine versus placebo for treating nail biting, a double blind randomized placebo controlled clinical trial. Antiinflamm Antiallergy Agents Med Chem. 2013;12(3):223-8 https://www.ncbi.nlm.nih.gov/pubmed/23651231
5. Deepmala, et al. Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review. Neurosci Biobehav Rev. 2015 Aug;55:294-321 https://www.ncbi.nlm.nih.gov/pubmed/25957927