Nail biting is one of the most popular habits. Also known as onychophagia, nail biting may seem like a harmless habit, but it can have serious physical and psychological consequences as nail biters often feel ashamed and embarrassed.
Although he says it has not affected his life negatively, Tebogo Flacko from Pretoria has been biting his nails for about 15 years and believes he developed the habit of nail biting from thinking a lot.
“I started biting my nails in primary school. Now, I am a business owner, so whenever I have to strategise, I just find myself biting my nails. I have, however, gone about eight weeks without biting my nails. I’ve started painting my nails, and it has helped me stop the habit,” he says.
The mental and physical toll
Siyanda Manyika from Nelspruit, who has also stopped biting his nails after three years, says nail biting had a negative impact on his health because he was sick most of the time due to how unhygienic nail biting is. Further, he states that there is a connection between nail biting and other habits like overthinking and being stressed.
“It’s been years since I’ve started biting my nails, and the main cause of the addiction was being stressed and having insecurities. I would feel satisfaction for that period of time when I’m biting my nails, and then the problem starts afresh. I’m trying to cope with the situation by hanging out with friends because I used to spend most of the time locked in my room.
I did try to stop the habit before by using tricks I learned from the internet. Fortunately, I’ve managed to stop after seeking professional help,” says Manyika.
Starts at a young age
According to Cape Town-based dermatologist Dr Matete Mathobela, the rate of nail biting usually decreases with age, but in some people it persists into or only begins in adulthood. It is estimated to affect up to 20–30% of the general population and up to 45% of children ages 10 until puberty.
“Nail biting is a non-destructive, temporary automatic habit where individuals bite their nails when they are bored, stressed, waiting in a line, or even reading a book or watching TV. It is common in adolescents, and its prevalence decreases with age.
“Nail biting can persist and develop into a pathological, severe oral habit. Often, nail biting is intentional, and the affected individuals will often cease other activities to bite their nails.
“Such individuals often have underlying medical or psychological disorders; they bite to the extent of injuring themselves,” says Mathobela.
After developing the habit of biting her nails as a form of cleaning them in primary school, Lorraine Nhemo from Soshanguve says it is a habit that is not easy to stop.
“I have never tried to stop biting my nails because I get triggered every time I see them grow, and it has become normal for me. It makes me feel very satisfied once I see my nails are short from biting them,” she says.
Mathobela explains that nail biting can often be associated with anxiety and depression, but individuals can also suffer from attention deficit hyperactivity disorder, oppositional defiant disorder (36%), separation anxiety disorder, enuresis, tic disorder, and OCD. Intentionally biting to the point of causing injuries to teeth or nails, other habits like hair pulling, signs of depression or anxiety, or any suspicion of mental disorder.
Complications of nail biting
Mathobela says there are many complications of nail biting that can affect the nail, including the nail plate and periungual region, the oral cavity, and the gastrointestinal tract.
- In chronic nail biters, partial or complete loss of the nail plate can occur, exposing the nail bed. As a result, the nail bed hardens, leading to irreversible nail plate shortening and scarring. Chronic trauma to the nail matrix may lead to overstimulation of melanocytes, leading to longitudinal melanonychia (brownish-black discolouration of the nail).
- Nail biting can also predispose patients to secondary infections: bacterial (acute paronychia), viral (periungual warts, herpetic whitlow), and fungal.
- Oral and dental complications include gum injury, leading to swelling and abscesses; increased incisor damage from cracking and erosion; poor alignment of teeth; and inflammation of the tooth root.
- Nail biting can also cause damage to the temporomandibular joint, leading to pain, especially during chewing.
- Nail-biting patients can have very bad bacteria in their mouths. This can lead to local and systemic infections if there is oral trauma or when enteric bacteria are ingested.
Mathobela explains that individuals who are not aware of their nail biting should be made aware and given incentives for stopping. These are usually people who bite mildly and never really cause any skin trauma, and they tend to outgrow the habit.
However, individuals who intentionally bite their nails, as well as those who might have other habits like pulling their hair and biting their lips, should get medical help for both psychotherapy (stimulus control, habit reversal, other forms of counselling, aversion therapy) and medical therapy.
“No treatment is necessary for mild onychophagia, as a child can often outgrow the habit eventually, mostly by their teenage years,” highlights Mathobela.
“For others, it depends on the severity of the condition and the underlying psychiatric condition; it might take months to years.”
Possible ways to stop nail biting
Mathobela also suggests a few ways to try and stop nail biting, as it may be difficult at a later stage.
- Try learning what the triggers are. Reduce boredom for the ones biting from, boredom or reduce stress for the ones biting from stress.
- Keep the nails short and well-trimmed with no splintered cuticles.
- Making nail-biting physically difficult – bandages or gloves for smaller kids or for those who won’t be embarrassed by it.
- Professional manicures may also help, as individuals, especially girls, might be motivated to keep them for longer, therefore breaking the habit of nail biting.
- The application of an unpleasant-tasting polish to the nails might interfere with the enjoyable aspect of biting.
“Persons with nail-biting habits need a lot of support from their families. They should never be shamed for their behaviour. It’s best to try to understand why they are biting and encourage them to stop. Seek professional help for severe cases,” Mathobela advises.
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