nailbiting

Nailbiting, or onychophagia, is a repetitive behavior characterized by biting, chewing, or picking at nails and the surrounding cuticles. It is considered a body-focused repetitive behavior and is common in children and adolescents, with many individuals carrying the habit into adulthood. The behavior is often triggered by stress, anxiety, boredom, or concentration, and may become a habitual response over time.

Prevalence and presentation vary. Nailbiting can involve only one or several nails, may affect the entire nail unit, and is sometimes accompanied by skin picking at the fingers or around the nails. It is typically incidental unless it causes functional or cosmetic problems, infections, or dental issues.

Causes and risk factors are multifactorial. Psychological stress, anxiety disorders, attention problems, and perfectionistic traits have been linked to nailbiting. It can occur as part of broader conditions such as obsessive-compulsive spectrum disorders or tic disorders, but it can also be a standalone habit without other clinical conditions.

Health effects can include damaged nails and cuticles, nail deformities, paronychia or other infections, dental wear or chipping, and ingestion of nail material, which may upset the digestive tract. In some individuals, the habit can contribute to negative social or cosmetic consequences.

Diagnosis is usually clinical, based on observation and patient history. Treatment focuses on reducing the behavior and addressing any underlying factors. This may involve habit reversal training, cognitive-behavioral therapy, stress management, and behavioral deterrents such as bitter-tasting nail polishes. Practical strategies include keeping nails short, applying nail hardeners, and using fidget tools to occupy hands. Pharmacotherapy is not routinely used, but may be considered for coexisting anxiety or mood disorders. Prognosis varies; many cases improve with age or intervention, though relapse can occur.