Nail & Skin Disorders

Under the Microscope: Onychophagy

Clients who suffer from chronic onychophagy — or severe nail biting — may benefit from the attention of a good nail tech.

What is it? Because nail biting is so common, it’s easy to dismiss it as just a bad habit instead of the nail disorder that it is. Onychophagy is a sub-group of OCD (obsessive-compulsive disorder). The sub-group also includes people who chronically pull or pick their hair, bite the inside of their cheek, or pick at the imperfections they see on their face or skin. Some patients with chronic onychophagy bite their toenails, fingernails, and the skin surrounding their nails until they bleed. Others bite and pick until they have literally removed an entire nail.

How do you get it? Onychophagy can begin because of severe stress, tension, or anxiety, but it can soon develop into a habit, which remains even when the stress or anxiety is gone. When a client doesn’t have the ability to muster the inner strength and discipline to stop biting her nails regardless of the products you choose, nail biting isn’t a habit, it’s a compulsion.

How is it treated? The treatment for onychophagy varies depending on the severity of the problem. Some patients respond to consistent nail maintenance, such as manicures, and topical applications on their nails, such as nail polish that tastes bitter, creams, or even hot sauce. Other treatments include behavior modification techniques such as snapping a rubber band on the wrist every time they bite their nails. Many nail biters reach a point in their lives where they are so sick of the embarrassment and pain of nail biting, they stop biting by sheer willpower.

What can a tech do? First, talk honestly with your client about the frustration and embarrassment nail biting causes her. Discuss her preference for treatment — does she want enhancements or does she prefer to grow her own nails? If she chooses enhancements, be sure to apply them very short at the first appointment. Schedule a follow-up appointment for no later than one week. As her natural nails grow underneath, the enhancements will look more natural. If the client chooses to grow her natural nails, talk with her about the need to commit to a weekly treatment schedule. During the manicure, groom her cuticles, removing frayed skin. Apply a nail polish formulated for nail biters, such as “No-Bite” from Barielle or “Stop” from Mavala. Let the client know you’re applying a foul-tasting polish so she isn’t shocked when she puts her nails in her mouth. Apply a cream to the nail and cuticles that heals the damaged skin and makes the skin supple to prevent hangnails.

What else? Educate clients on how to care for their nails at home. Provide them with an at-home treatment package to purchase. The kit should include a file, a bottle of the polish you chose to prevent biting, and cuticle cream. Recommend the client apply the polish every other day. The cream should be applied multiple times during the day. Take before and after pictures to add incentive and to celebrate the client’s achievement.

 Dr. Kevin Kennedy contributed to this article.

Keywords:   nail biting     onychophagy     Under the Microscope  

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