Rebecca Byrne was passing a nail salon in the local mall when an idea popped into her head. Stopping, she gathered the courage and went in to ask the nail technician if she could put acrylics on her bitten-down nails to help her grow them out.
Rebecca Byrne was passing a nail salon in the local mall when an idea popped into her head. Stopping, she gathered the courage and went in to ask the nail technician if she could put acrylics on her bitten-down nails to help her grow them out. The nail technician’s response after eyeing Byrne’s stubby fingernail tips and red, puffy cuticles? “No, you will have to stop biting them first before we can help you!” she exclaimed loudly. Embarrassed in front of both customers and the other nail technicians, Byrne left.
Now, nine years later, Byrne, a reformed nail biter, owns At Your Fingertips in San Mateo, Calif., and treats her female and male nail biting clients with respect, giving them tips to break their habit. Her theory about why people bite their nails comes from her own experience. “If I had a hangnail, fray, or tear, in one of my nails, I would use my teeth to try and fix it—make it smooth. The next thing I knew, a chunk of skin was missing from my fingertip,” Byrne remembers. “I was subconsciously trying to fix the problem, a rough area on a nail, without using the right tools or methods.”
Byrne was able to break the habit with the help of a good nail technician. “I finally found a manicurist who was willing to work with me,” she explains, adding that the nail technician applied acrylics and encouraged her to keep regular appointments.
Byrne’s experience of rejection is pretty common because a social stigma is attached to nail biting and picking. Many biters have been turned away from salons, ashamed of their habit and no closer to a solution to their problem. In fact, says Theresa Lopez, a nail technician at La Sage Beauty Salon in Bapple Mountain, Nev., many of her present clients came to her with complaints that other nail technicians refused to work on their bitten-down nails. Rebuffed, they sought her help.
While the nail biting and picking seems to be such a common problem, the psychological and medical research does not agree on the exact motivation for the action. However, it suggests that nail biting can be the result of stress, various medical disorders, learned behaviors, or just plain habit. Treatment depends on the individual, but regular grooming and care is a big part of successfully kicking nail biting or picking.
Taking a Bite Out of Stress
Psychologists have postulated many reasons for chronic onychophagia, the clinical name for habitual nail biting. It is estimated that 28% to 33% of children ages 7-10 years old, 44% of adolescents, 19% to 29% of young adults, and 5% of later adults are nail biters, according to Terry M. McClanahan, author of “Operant Learning Principles Applied to Nail Biting,” a 1995 study published in Psychological Reports. (See the Nail Biter Profile above for more details.)
The most common instigator of the disorder seems to be stress or anxiety. As far back as the 1930s and 1940s, studies have shown that nail or cuticle/skin biting may even be an outlet for pent-up emotion, reducing tension for the individual. “Nail biting is a habitual condition,” says Ronald Bronow, M.D., a dermatologist in private practice and assistant clinical professor of medicine at the University of California, Los Angeles. “It is a common reaction to stress and boredom. Nail biters could also suffer from a poor self-image or could be punishing themselves for deeper-rooted problems or anxieties. Basically, nail biting is a rational substitution of one problem for another,” he notes.
McClanahan’s 1995 study of one 32-year-old woman showed that anytime she felt overwhelmed, apprehensive, nervous, or worried because of her performance in graduate school or in relation to future goals, she bit her nails. Similar studies show that anytime a stressful situation rears its ugly head, nail biting is used as a tension reliever. Any kind of disharmony as a result of friends, family, work, or school can trigger the habit.
Dr. Bronow explains that often our skin and hands will reflect whatever emotional or psychological turmoil we may be experiencing. For instance, an individual’s face and neck may break out in acne or hives during a stressful situation or she may turn to nail biting for release. “Our skin and nails are a mirror of our emotions,” Dr. Bronow emphasizes.
Habit vs. Hang-Up
Racy psychoanalytic theories view nail biting as a symptom of repressed or destructive sexual impulses; possible as self-punishment for them. Dr. Bronow guesses that few individuals who bite their nails have deep-seated problems such as these. “About 99% of nail biters have minor problems or a fixed nail biting habit,” he notes. “Fewer have a deep emotional problem of which nail biting is a symptom.”
Rob Dahmes, M.D., an adult and child psychiatrist in private practice at New Orleans Psychotherapy Associates (New Orleans, La.), agrees, adding that nail biters with a compulsive habit may be harder to cure, but those who bite due to an underlying disorder may be more treatable. “As the old saying foes, ‘Bad habits are hard to break,’” he says. Individuals with a psychological problem can be treated with specific medication. As a result, the nail-biting symptom will eventually subside. However, there is no drug or cure for habitual nail biting.
Children may pick up nail biting from family or friends as a learned behavior or as a function of genetics, according to medical studies. It was also determined that twins born from one single egg (monozygotic) had a higher incidence of nail biting vs. twins born from two eggs but at the same time (dizygotic). The studies indicated that the closer the genetic relationship, the moiré likely that nail biting would result in both individuals.
Attention-seeking, need for oral gratification, sociopathy, lack of self-monitoring or self-esteem, obsessive-compulsive disorder, and even poorly manicured nails have all been named as possible nail-biting triggers by psychological and medical studies. Again, there is also the possibility that the act is simply a habit that has no deep psychological meaning at all.
So how can a nail professional tell the difference between a casual habit and a symptom of a deep-seated problem? With some nail biters, the problem is clear from the condition of their hands, nails, and cuticles, but with other individuals the problem may manifest itself in other ways.
Dr. Dahmes says that nail technicians and other observers of nail biters can tell the difference between someone who has a bad habit and someone who has a behavioral disorder by observing certain behaviors or listening to clients complain of certain symptoms. “Gastrointestinal problems, irritability, muscle tension, excessive sweating, cardiovascular problems, respiratory problems, and other signs may point to the fact that a nail biter is suffering from an anxiety disorder or some other deep-rooted problem,” he notes.
For instance, Dr. Bronow says that during medical school, when he visited the psychological ward for research, he noticed that most of the patients with deep-rooted psychological disorders had severe nail-biting tendencies.
To Bite or Not to Bite
Whatever the cause, nail biting causes damage to the cuticles, roughness on the free edge, bleeding at the grooves or cuticle, and nail deformities. However, fingernail growth may be accelerated by as much as 20%, according to a 1980 clinical study by W.B. Bean, who observed nail growth patterns over many years. Lopez has noticed that the nails of her nail-biting clients seem to grow faster than usual—a fact that she regularly shares with them for encouragement. “I tell them that if they can just not bite them for one month and call me as soon as one of their acrylic nails pops off so I can fix it before they bite their natural nail underneath, then they can eventually break the habit and have a beautiful set of nails,” she says.
The hand-to-mouth, oral action of biting and picking leaves some individuals open to medical problems. “Nail biters are mire susceptible to yeast infections of the nail due to the prolonged and increased wetting of the area during the repeated biting,” explains Dr. Bronow. “Damage to the nail matrix from nail biting causes more extreme problems, such as infection, ridging, or even permanent nail loss.”
Nail technicians should remind clients that nail biting can spread bacterial infections and can be responsible for severe dental problems, including gingivitis. Oral diseases can also be spread via nail biting because of the constant contact of fingers with the mouth of the individual. For instance, oral herpes can actually begin to grow on the fingers due to the constant contact, according to medical journalists.
In fact, 80% of patients requiring surgical treatment for acute paronychia (inflammation or infection of the nail folds) are also nail biters or pickers, according to a 1984 medical study. “I warn my nail-biting clients to stop as soon as they can because they can do permanent damage to their nail matrix or lose their nail completely,” says Lopez.
Several techniques with varying results have been developed to help extreme nail biters: mild aversion, therapy, self-monitoring, habit reversal, and medication. Mild aversion therapy is a “physically observable deterrent” and can be described as something as simple as snapping a rubber band on the inside of the wrist each time nail biting occurs, using a bitter-tasting coating on the nails, or wearing gloves.
Self-monitoring requires the nail biter to keep a written record of all incidences in hopes that awareness of the problem will stimulate self-control. While self-monitoring seems to be a favored form of therapy for nail biting, some journals decry its ability to change behavior permanently when prescribed without any additional treatment.
Habit reversal is perhaps the most “successful” and “valid” therapy for nail biting, using a step-by-step program that seeks to make the individual aware of her behavior and then provide a physically competing response to interfere with it. It combines self-monitoring (record behavior), relaxation training (yoga and similar deep muscle relaxation exercises), and response competition (performing a physical action when the desire to bite occurs).