Nail biting (onychophagy)

Nail biting, also known as onychophagy or onychopahgia, is a relatively common, and usually harmless, habit that people use to cope with stress or anxiety. Nail biting involves biting both the nail itself and the skin around the nail, including the cuticle. Excessive nail biting can cause a person's nails to become damaged and may lead to other health issues. Although most people simply consider nail biting a bad habit, the American Psychiatric Association (APA) reclassified it from an "impulse control disorder" to a form of obsessive-compulsive disorder (OCD). Because nail biting is so common, numerous tips and tricks have been developed to help people kick the habit.

Background

In medical terms, nail biting is considered an oral parafunctional habit, which is using the mouth for something other than talking, chewing, or drinking. Other examples of oral parafunctional habits are thumb or finger sucking, pen chewing, and teeth grinding. Estimates indicate that nail biting is most common among adolescents, with about 45 percent of teens engaging in the behavior. An additional 30 percent of children, 25 percent of young adults, and 5 percent of older adults bite their nails. Most people cease biting their nails by the age of thirty.

Stress or anxiety and boredom are among the most common triggers of nail biting. However, some research indicates that a person's genes may influence whether he or she becomes a nail biter. Similarly, some people may learn the habit from watching family members or friends and imitating their behavior. One study has indicated that the pursuit of perfection may be to blame for chronic nail biting. The study, published in 2015, found that perfectionists engaged in nail biting and other similar nervous habits when they felt bored, annoyed, or frustrated.

Degrees of nail biting vary from mild to severe. In severe cases, people may not realize that they are biting their nails until they inflict pain on themselves. They may bite their nails, cuticles, and surrounding skin until they make themselves bleed. From a psychological standpoint, severe nail biting may be considered a form of self-mutilation, like cutting. It may be a symptom of another psychological condition such as OCD or attention-deficit hyperactivity disorder (ADHD). Indeed, the APA went so far as to reclassify nail biting from an "impulse control disorder" in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to a form of OCD in the fifth edition (DSM-5).

Impact

The impact of nail biting is minimal for people who engage in the behavior only on occasion. For chronic nail biters, the impacts are more pronounced. These people may experience both physical and emotional effects.

The physical effects of nail biting are numerous. Excessive nail biting leaves nails and cuticles looking red and irritated. The skin around the cuticles may become broken and bloodied. Broken skin is more prone to infections that can cause swelling, redness, and pus. Excessive nail biters may develop warts on their hands caused by a certain type of human papillomavirus, or HPV (not the type that causes genital warts or cervical cancer). The undersides of a person's nails are more difficult to keep clean than the rest of the hand and often harbor germs, including bacteria that can make people sick, such as Salmonella and E. coli. People can ingest these bacteria when they bite their nails. Over time, nail biting can damage a person's teeth. Nail biting may not only weaken a person's teeth but also cause the teeth to become misaligned.

The emotional effects of nail biting vary to some degree. For some, nail biting is actually enjoyable. Biting away a hangnail or shaping a nail a certain way can make nail biters feel good. They experience a sense of reward, at least temporarily, from biting their nails. However, nail biting often leads to negative feelings later. Many chronic nail biters are embarrassed by the poor condition of their nails and cuticles. They may become self-conscious, develop low self-esteem, or experience feelings of self-loathing. Some become trapped in a cycle of stress and anxiety. They bite their nails to cope with stressful situations or feelings of frustration and anxiety. Later, when they see the damage they have inflicted on their nails, they experience even more stress and anxiety.

Many people eventually reach a point at which the pain and humiliation of their chronic nail biting inspires them to take action. Some overcome the habit through sheer force of will. Others employ a variety of tips and tricks to kick the habit. Keeping nails trimmed and filed can help because biting short nails is more difficult than biting long ones. Weekly manicures have helped some people stop biting their nails. Others have found that wearing acrylic nails discourages nail biting and protects their natural nails as they grow. Wearing nail polish can be effective. Some cosmetic companies even produce bitter-tasting nail polishes designed specifically to discourage nail biting.

Applying olive oil to nails makes them softer, which some nail biters find less pleasing. People may try wearing gloves or placing adhesive bandages over their fingertips to prevent them from biting their nails. Some people wear a rubber band on their wrist and snap it each time they catch themselves biting their nails. This discourages nail biting by conditioning them to associate nail biting with physical pain. Occupying the hands with other activities can help. For example, people may try crocheting or knitting, playing an instrument, or squeezing a stress ball when they feel bored or stressed. Chewing gum can prevent nail biting, too, as it keeps the mouth busy. Activities such as yoga and meditation reduce stress and anxiety, which are known triggers for nail biting.

If a person's nail biting has progressed from a simple bad habit to a compulsion, he or she may need professional help to stop. In such cases, people should seek input from a mental health professional who is qualified to recognize more serious underlying conditions, such as OCD or ADHD, and recognize other treatments, such as counseling or medication.

Bibliography

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Mercola, Joseph. "Is Biting Your Nails Dangerous—or Just Gross?" Mercola, 26 July 2014, articles.mercola.com/sites/articles/archive/2014/07/26/nail-biting.aspx. Accessed 8 Feb. 2017.

"Nail-Biting–Topic Overview." WebMD, 20 Feb. 2015, www.webmd.com/anxiety-panic/tc/nail-biting-topic-overview. Accessed 8 Feb. 2017.

Pacan, Przemyslaw, et al. "Onychophagia as a Spectrum of Obsessive-Compulsive Disorder." Acta Dermato-Venereologica, vol. 89, no. 3, 2009, pp. 278–80.

Pratt, Michelle. "What Is Onychophagy?" NAILS Magazine, 1 June 2009, www.nailsmag.com/article/40674/what-is-onychophagy. Accessed 8 Feb. 2017.

Stafford, Tom. "Why Do We Bite Out Nails?" BBC, 10 July 2014, www.bbc.com/future/story/20140710-why-do-we-bite-our-nails. Accessed 8 Feb. 2017.

Standen, Amy. "Nail Biting: Mental Disorder or Just a Bad Habit?" NPR, 1 Oct. 2012, www.npr.org/sections/health-shots/2012/10/01/161766321/nail-biting-mental-disorder-or-just-a-bad-habit. Accessed 8 Feb. 2017.

Taleb, Rim M., and Issam A. Shaarani. "Nail Biting: A Habit or a Disease?" Medscape, 19 May 2016, www.medscape.com/viewarticle/863395. Accessed 8 Feb. 2017.