By Casey Clark, writer, content strategist and BFRB advocate
You may know someone who bites their nails, or maybe you even do it sometimes without even realizing it. If that sounds familiar, and it results in significant emotional distress, including anxiety, shame, and social withdrawal, then you might have onychophagia, or nail biting disorder.
Compared to other Body-Focused Repetitive Behaviors (BFRBs), onychophagia is a lot more prevalent and common. According to the International Journal of Dermatology, onychophagia is a mental health disorder that affects 20% to 30% of the general population.
Ahead, we've gathered some information about onychophagia so you can understand more about this common issue. We summarize what causes nail biting, how to treat nail biting and the next steps you can take to better manage your nail biting symptoms now and in the future.
What is Onychophagia?
Onychophagia is the medical term for nail biting - a Body-Focused Repetitive Behavior (BFRB) that involves an individual biting their fingernails or toenails often, but not always, in response to stressful situations or stimuli.
According to UCLA Health, a majority of people who bite their nails likely developed the behavior after the ages of three and four years old. That said, some people may find that they picked it up during adolescence or early adulthood. It is these same people who may have sucked their thumb or fingers as kids and started biting nails later on as a replacement behavior.
Although nail biting might appear to be a seemingly harmless behavior, it can actually be quite debilitating emotionally, mentally, and physically.
From a physical standpoint, putting one's hands near the mouth area can expose one to germs and possibly lead to infections, mouth pain, tissue damage and other dental issues. In terms of mental and emotional health, nail biting can be a source of shame and embarrassment for people who engage in this behavior. As a result, they may have a tendency to isolate themselves or disengage from social situations.
What causes onychophagia?
The cause of onychophagia is unclear, however, there are some theories as to why people may bite their nails.
Stress
For starters, similar to other BFRB's such as trichotillomania or dermatillomania, nail biting may be brought on by stressful situations and environments.
Some people find the action of biting nails to be soothing and thus relieve temporary feelings of stress and anxiety. "Although some people are more likely to bite their fingernails genetically, it's the environment that typically triggers the behavior," says Libby Gordon, LCSW, therapist and founder of The BFRB Space.
Stressful environments whether that's crowded supermarkets or busy office spaces may lead one to bite their fingernails.
It's also worth noting that nail biting is also strongly associated with other mental health conditions including anxiety, ADHD, separation anxiety, tic disorder and oppositional defiant disorder (ODD). That said, not everyone with these conditions bites their nails and vice versa.
Boredom
People who bite their nails may also find they engage in the behavior when they are bored. For example, one might start biting their nails during a meeting at work, a lecture in school, or while in line at the grocery store.
Genetics
According to the International Journal of Women's Dermatology, more than 30% of people who bite their nails have a family member who also bites their nails.
It is well believed that there's a genetic component which comes into play for those who bite their nails although what exactly it is remains unknown.
How do you treat onychophagia?
There are a few treatment options for those with onychophagia from lifestyle changes to more therapeutic approaches.
Starter Strategies to Stop Nail Biting
From a practical standpoint, there are changes that one can make to help stop biting their nails. "One can try wearing nail polish, getting manicures and wearing gloves," says Gordon. These strategies are from the Comprehensive Behavioral Model (ComB) for BFRB treatment and are focused on the physical nail biting behavior. These temporary suggestions all work to try to preempt the physical nail biting behavior, but do not fulfill the self-soothing need.
Aside from the suggestions above, other ideas may include using a fidget toy and keeping hands busy by means of crocheting, painting or sculpting.
Habit Reversal Training for Nail Biting
For individuals who can't stop biting their nails, then they might benefit from Habit Reversal Training (HRT.)
"The first component in HRT is developing awareness of the behavior, triggers, and the consequences," says Gordon. "In the second phase of HRT, it's about finding strategies to make recovery easier, and eventually making choices to get relief in other ways."
HRT is also used in the treatment of trichotillomania, dermatillomania and other body focused repetitive behaviors.
Other mental health treatments for nail biting
If HRT doesn't work or you're interested in more integrative approaches, there are other evidence-based treatments for nail biting.
"Popular therapies like Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, motivational work, psychodynamic therapy and mindfulness strategies that can help people with onychophagia," says Gordon.
Cognitive behavioral therapy (CBT) can particularly be helpful for helping people recognize the thoughts that may be associated with the nail biting and then finding alternative behaviors that are healthier and more productive.
Find Support for Excessive Nail Biting
For many people, onychophagia is a lifelong condition they deal with and it can be even more difficult without adequate social support. Having people in your corner who can relate to what you're going through and support you during those hard times can be very helpful.
The BFRB Change Collective is a safe space for individuals to speak with each other, have access to resources, and even the chance to speak with a peer coach for support and guidance on how to manage their nail biting.
About the author
Casey Clark is a writer and content strategist from New York City who specializes in mental health, beauty and travel. Her work has appeared in The Wall Street Journal, HuffPost, National Geographic and more.
