Nail biting

by Dr Deborah Lee, Dr Fox Online Pharmacy

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There’s nothing nice about nail biting. I know it for a fact as I bit my nails for 50 years!

However, it is possible to stop nail biting.

  • Why do people bite their nails?
  • What are the health risks of nail biting?
  • Which treatments can help you break the habit?

Read on and find out. Maybe now is the time to tick the habit forever?

 

Why do people bite their nails?

Nail biting has a proper medical name – it’s called onychophagia. If you find you are constantly putting your fingers in your mouth and tearing off the ends of your nails – you are a sufferer.

Around 20-30% of the population are said to be nail biters, so it’s incredibly common. In one study, 37% of those aged between 3 and 21 years, were nailbiters, but the prevalence dropped off after this, in older age groups.

Over 30% of nailbiters have another family member suffering from the disorder, suggesting there may be a genetic tendency to nail biting. If both your parents are nail biters, this increases your risk of becoming a nailbiter by a factor of 3 to 4.

Although an association between nail biting and anxiety disorders has been noted, in some people, nail biting is felt to be a learned habit. In one study, only 25% of nailbiters met the criteria for a diagnosis of obsessive compulsory disorder (OCD) or anxiety.

Bottle feeding, dummies, and thumb sucking in childhood may also increase the risk of nail biting.

 

What are the health risks of nail biting?

Nail damage

Repeated nail biting over time can damage the nailbed, meaning nails will only grow short, and are often ridged or weakened. The tip of the nails can lift, and there is an increased risk of infections around the nail folds. Nailbiters often pick the skin around the nails. A particularly painful condition is a nail fold infection called a paronychia. Infections such as warts caused by the human papillomavirus, or herpes virus, can also affect the skin around the nails.

 

Teeth become damaged

Persistent biting puts pressure on the teeth and gums and can lead to chipped teeth and inflamed gums. Repeated biting is said to contribute to crowding, rotation of the teeth, and malocclusion of the jaw. Hence nail biting can cause dental pain.

 

Temporomandibular joint (TMJ) dysfunction

TMJ dysfunction is an unpleasant condition, due to stress or abnormal pressure on the joint. It can cause a variety of symptoms including mouth pain, inability to open the jaw wide, dental sensitivity, headache, neck and ear pain, dizziness, tinnitus and vertigo. Nail biting has been linked to TMJ dysfunction. In one 2015 study, 45.8% of those with TMJ dysfunction were nail biters.

 

Altered mouth bacteria

In one 2013 study, enterobacteria – a specific family of bacteria – were found in the mouths of 65.6% of nail biting children (aged 11-15), in comparison to 8.1% of non-nailbiters – a highly statistically significant difference. Enterobacteria include salmonella, shigella and E.coli, all of which can cause serious illness. This may be especially important in people who need dental treatment.

 

 

Which treatments can help you break the habit?

 

Bitter nail solution –  A range of anti-nail biting products are available which you can paint on or apply to the nails. When you bite the nail, these give off a horrible bitter taste. Ask your pharmacist for advice.

 

Nail care – grooming and manicures – Taking care of your nails, filing, keeping the cuticles neat and well moisturized, and keeping your nails oiled, are all important for good, general nail care. Any infections should be promptly treated.

 

Covering the nails – It may be that covering the nails with gloves or bandages is the best way to keep them protected. You may want to do this for example, overnight, by wearing gloves in bed.

 

Cognitive behavioural therapy (CBT) – CBT is a type of talking therapy, in which the sufferer learns more about their condition, any possible underlying triggers, and is helped to develop alternative coping strategies. It can be useful to help stop nail biting. It is possible to self refer for CBT on the NHS.

 

Hypnotherapy – In this form of treatment, the patient enters into a state of hypnotic stance. While hypnotized, patients become more accepting of the need to change their behaviour. Hypnosis has been found to be effective for anxiety-related conditions such as hair pulling and nail biting.

 

Habit Reversal Therapy (HRT) – Nail biting is often thought to be a learned habit. Once the pathway is instilled in the brain, it is almost impossible to stamp it out. However, the technique of HRT aims to achieve this by increasing awareness, introducing an alternative – for example chewing gum instead, and improving social support as a form of reward system. In one study, using this approach, nail length was shown to increase.

 

Aversive therapy – This involves a three-pronged approach. Removing the triggers – taking care of the nails and cuticles. Covering the nails in bandages so they are harder to bite, and adding the bitter liquid to the nails as a negative reminder if biting happens.

 

Medication – As nail biting is sometimes part of obsessive-compulsive disorder (OCD), the use of serotonin reuptake inhibitors (SSRIs) such as fluoxetine may be helpful. In the past, the tricyclic antidepressant clomipramine was used. N-acetylcysteine is an antioxidant that has been used with success in children. Always discuss this with your GP before starting any medication.

 

Chewing gum – Some specialists have recommended the use of chewing gum, as it serves as a distraction technique. Use sugar-free gum so as not to increase your risk of dental caries.

 

Self-help books – Self-help books can be a good option. For example, children may benefit from the 2008 book ‘What to do when bad habits take hold’, by Dr Huebner. Adults may like ‘Self-help for nail biting adults,’ by Asanka S. Jayarathne.

 

Mindfulness – The art of mindfulness includes the belief that focusing on other arts, hobbies, music and interests, helps separate the mind from distress and allow it to focus on pleasurable activities. As part of engaging in mindfulness, you will be advised to engage in these types of leisure pursuits, which also help increase self-confidence.

 

Final thoughts

I learned a lot about nail biting writing this post. I bit my nails until I was 50 – when I tried to stop – nothing seemed to work. However, I stopped at 50 when I started having artificial nails! I went to a nail salon and had overlays and acrylic paint, and I never looked back. You can’t bite your nails when you have artificial nails. They are too tough and it is not physically possible.

I wanted to tell you that my confidence improved immediately. Plus, the cuticles were magically transformed and for the first time in my life, I was proud of my hands!

Here’s the thing – when I stopped having the artificial nails, I didn’t go back to biting my nails! I had managed to break the habit forever!

You can have the nails created to look very natural – you don’t have to have coloured nail polish. I would recommend this as a way of stopping nail biting.

  • Is it time you did something amazing for your hands and nails?

 

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