Onychophagy — severe nail biting — is considered a sub-group of OCD.

Onychophagy — severe nail biting — is considered a sub-group of OCD.

onychophagy (also onychophagia) (än-i-’käf--je) n: severe biting of the nails on the fingers and/or toes

As nail techs, we see people regularly who have bitten their nails so badly the nails even look painful. Clients feel embarrassed and sometimes hopeless, but because nail biting is so common, it’s easy to dismiss it as just a nasty habit instead of the nail disorder that it is. However, depending on the cause, clients who suffer from chronic onychophagy may need not only the attention of a good nail tech, but also an appointment with a professional who can help with behavior modification.

Dr. Kevin Kennedy, a psychotherapist at Harvard Vanguard Medical Associates in Braintree, Mass., says 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 imperfections on their skin. Onychophagy can begin because of severe stress, tension, or anxiety, but it can develop into a habit, which remains even when the stress or anxiety is gone.

The habit of nail biting can become so familiar to sufferers that they are unaware they are picking at or biting their nails until they feel pain. 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. This can have a number of psychological effects, including frustration and self-loathing.

Treatment Options

The treatment for onychophagy varies 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 a rubber band on the wrist. (Every time you bite your nails you snap the rubber band. Your brain associates nail biting with pain, and you quit. The effectiveness isn’t universal.)

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 will power. Nail enhancements, manicures, or topical treatments may help the client stop biting her nails, but ultimately, it’s her own determination that allows her to finally stop biting her nails. In this way, nail biting is simply a bad habit. As with most bad habits, it’s easier to break if you replace the habit with something positive. That’s why manicures or enhancements are effective: Clients care for their nails instead of abusing them.

Alain-Raymond van Abbe has found a creative solution to the problem of onychophagy. Van Abbe, a Dutchman whose background is in the health and beauty industry, is the founder of the Institute for Pathological Onychophagia (IPO) in Venlo, Netherlands. His system for the treatment of onychophagy is unique. Clients’ nails are maintained through manicures and pedicures, and clients are educated on how to care for their nails at home. But the treatment goes a step further and includes a mouth guard created from a mold supplied by the client’s dentist. The client wears the guard, which can be removed to eat, for a month. Between care at the clinic, home care, and the mouth guard, IPO reports a 97% success rate in patients.

What’s a Tech to Do?

A tech can do a lot to aid a client who suffers from onychophagy, and it all begins with education. 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, you may need to expand your salon’s supplies. The products used during a treatment manicure will be different than those used during a regular manicure, because they are chosen to repair skin and nails, not just beautify them. 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, not one that simply smells nice. The point is for the product to seep into the skin and make the skin supple to prevent hangnails.

If a person doesn’t respond to manicures, topical treatments, or behavior modification techniques, she may need to seek a professional.

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 as often as possible, even if that means carrying it to and from work to apply multiple times during the day. Take before and after pictures to add incentive and to celebrate the client’s achievement.

There will be times 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. At this point, nail biting isn’t a habit, it’s a compulsion. If a person doesn’t respond to manicures, topical treatments, or behavior modification techniques, she may need to seek a professional. A counselor or psychologist will likely be more beneficial than a dermatologist since nail biting is seen as a form of self-mutilation, and the client may need to uncover deep-rooted, subconscious stress or anxiety.



For reprint and licensing requests for this article, Click here.