ONYCHOPHAGIA

By Gary M. White, MD

Onychophagia or nail biting


Onychophagia, or nail biting, is a habit most common in children that results in shortened, split, and irregular nails. The term onychotillomania is used when tools such as pliers or scissors are used to destroy the nail plate. This disease, in contrast to onychophagia, may signify an underlying psychiatric disturbance.

Treatment

The patient should be encouraged not to bite. A distasteful topical substance may be applied to the nail (e.g., Sally Hansen Nail Biter). A tricyclic antidepressant such as clomipramine is also an effective treatment. A small double-blind comparison study showed clomipramine to be superior to desipramine [Arch Gen Psychiatry 1991:48;821-7]. Pimozide has been used for onychotillomania.

One patient, who successfully learned to control his condition, recommended the following three essentials as key to recovery:

  1. The will to stop.
  2. Keep a nail file handy. Some people say this is the most important one, because they only bite their nails because of rough edges. If that's true for you, it'll help a lot, but I bit my nails out of boredom and/or stress.
  3. Apply a nail hardener. Make your nails all smooth (it helps obviously to not have bitten them for 1-2 days) with a file. Apply nail hardener. It basically looks like see-through nail-polish and will make your nails shine a little bit. The nail hardener does 2 things: First, it makes biting your nails more difficult, because they are actually thicker now and not as soft as before. Second, it makes biting your nails not attractive anymore, because of that nail-polish-looking stuff on your nails. It has the nice side-effect that it will, over time, actually harden your nails.

Additional Pictures

Chronic nail biting. On the right, a pyogenic granuloma has formed due to the repeated trauma.
Onychophagia or nail biting with a pyogenic granuloma

RegionalDerm

Homepage | FAQs | Use of Images | Contact Dr. White


It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.