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.


Nail-Saving Treatments

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).


Recently, an oral medication has been used to successfully treat chronic nail biters, according to Jim Broge, spokesperson for the Obsessive-Compulsive Foundation in Milford, Conn. However, only sever cases would benefit from Anafranil, a brand name for a drug called clomipramine. Anafranil is one of five medications used to treat patients with obsessive-compulsive disorders, although doctors and researchers have not been able to conclusively classify nail biting as such a disorder. However, they do agree that some of the same treatments used for patients with obsessive compulsive disorders work on nail biters, hair pullers, and other patients with “impulse control” disorders, according t a spokesperson at the Obsessive-Compulsive Information Center in Madison, Wis.


How Nail Technicians Can Help

In addition to any medical treatment prescribed by a doctor, regular nail grooming is an important part of reforming a nail biter, according to both doctors and journals. “If I can put artificial nails on my clients that are smooth and tight, they will usually not bite the artificial nail,” explains Byrne, who says that if the nails are ridgeless, there is nothing for the clients to “fix,” so she leaves her nails alone.


It may also be the alpha hydroxyl lotions that both Byrne and Lopez recommend and retail to their clients for between-service maintenance that helps their nail biting clientele. “The lotion will slough off all the dead skin around the nails and keep it smooth,” says Byrne. “That way, there will be nothing to bite or tear.” She also recommends that her clients keep a file with them to smooth any hangnails, tears, or ridges that may occur.


Nadine Galli, Southern California regional manager for OPI Products (N. Hollywood, Calif.), recommends that mire nail technicians take advantage of this common nail ailment instead of turning nail biters away. “If you start nail biting-clients on a salon-care program, they can become your best customers,” she says. “If you can show them that they can have 10 beautiful nails, then you will probably have a good client for life.”


The first step is to get the client to commit to an extended nail care program by having her pay for future services up front. Chances are that financial commitment will also provide encouragement for the client to break her of the habit.


Galli says that if the clients wants nail extensions, set up an eight-week program and charge her accordingly for you time and the services. Explain to her that she is entitled to a certain number of weekly visits and can call in should she have a nail emergency.


Don’t extend the tips of the nails beyond the edge of her fingertips; by the eighth week, the nails should be long enough to attach longer tips or grow on their own. (See “Give Nail Biters a New Lease on Nails,” on page 40 in April 1996.)


Galli recommends following the same type of program for clients who prefer manicures; a six-week program for these individuals for, say, $10 an appointment. She emphasizes that the program is successful only if the nail technician is willing to serve clients who may require extra attention. “The program will only work of the client makes a full commitment to you and the services, and you make a full commitment to help the client.”


Nail technicians who do not (or will not) treat nail-biting clients are missing a big opportunity. “Nail biters become profitable, loyal clients,” Galli explains, adding that they appreciate the fact that the nail technician can make their problem hands beautiful with treatment. “Any nail biter who will go in regularly to a nail technician will see a marked difference in her nails.”


A common problem that is largely dismissed as a minor nuisance, nail biting can be anything from a bad habit to an outward symptom of a medical or emotional disorder.


Nail Biter Profile

Nail biters are more often male than female after age 10 (10% fewer bite their nails than boys), and individuals with a higher rate of intelligence tend to bite their nails more than those of less intelligence. (Studies seem to suggest this is because people with a higher rate of intelligence have more responsibility, which may provide more anxiety.) Studies show that some relationship between nail biting and low self-esteem may exist. In general though, nail biting was not shown to lower a biter’s self-esteem.


While no studies revealed an overall success rate for curing nail biters, Rob Dahmes, M.D., suggests that those with a habit may be harder to cure than those who bite their nails in relationship to a psychiatric problem. Nail biting that manifests itself due to emotional trauma can possibly be cured with medicine and/or counseling. Unfortunately, no treatment exists for bad habits.


Drastic Measures

Nail Biting Client: Gina, 38. While most people would agree that nail biting is not a large enough problem to cause a job change, a well-timed switch from one sales position to another helped this professional get a handle on her habit. “I bite my nails when my anxiety level rises,” Gina admits, recalling her extremely short, ragged nails and dry cuticles. “But I recently switched positions, so I feel that I am under a lot less stress. I haven’t bitten my nails for two weeks.”


Embarrassed in front of clients, Gina used to let her thumb nails grow (while biting the rest of her fingernails) because they were the ones she thought were the most directly exposed to clients when she handed them paperwork.


When asked if she thinks she’s kicked her bad habit permanently, Gina jokes, “Well, take a look at the cap of my ballpoint pen…”


How to Spot a Nail Biter

Look for these possible signs if the individual is a habitual biter or picker:

1.Rough free edge or no free edge

2. Extremely short nails or nail beds

3. Rough, red, cracked, and/or bleeding cuticles

4. Puffy skin around the nail

5. Ridged with calcium deposits

6. Transmission of oral diseases


Look for these possible signs (in addition to those mentioned above) in nail biters with emotional or psychological problems:

1. Gastrointestinal problems (stomach cramps, aches, etc.)

2. Mood swings/erratic disposition

3. Sociopathy (antisocial behavior)

4. Lack of self-monitoring or self-esteem (may manifest itself as poor hygiene)

5. Muscle tension (hard to get client to relax fingers)

6. Excessive perspiration

7. Cardiovascular and respiratory problems (heavy breathing or complaints of difficult breathing)


Nail Technician’s Nightmare

Nail Biting Client: Yumio, 23. This sailmaker admits that he has chewed his nails and cuticles until they bleed, ever since his baby teeth came in. “I don’t remember starting,” he says, adding that boredom keeps his habit alive. The urge to bite or chew sometimes comes when he is waiting for his computer to process large amounts of information.


Yumio’s hands are constantly exposed to saltwater and so his cuticles are always dried out. “In many cases it is just easier to bite off the dead skin than to find a file or a nail clipper,” he explains. He is a nail technician’s nightmare as he views going to a salon as a major inconvenience.


Because he feels that his nail biting bothers no one but his girlfriend, Yumio admits he has no inducement to rid himself of his habit.


Biting Complications

Nail Biting Client: Judy, 51. As an art director and graphic designer, Judy’s career rests in her own hands, one with badly bitten nails tat also have splits in them. She says that her nail-biting habit stems from on-the-job stress and sometimes boredom.


Her habit is so inborn, that Judy may not even know she is biting until pain warns her that damage was done. “I will be watching an exciting movie and before I know it, I feel a sharp, stinging pain and then I realize that my hands have been in my mouth,” she explains.


Judy’s nails have always been naturally thin, except for when she was pregnant and taking pre-natal vitamins. With the exception of a five-month period, and during her pregnancy, Judy’s nails have never been longer than the tips of her fingers. She is allergic to artificial nails so enhancements have not been a viable solution.


Judy owns beautiful rings, which she refuses to wear because they might call attention to her hands. “I am the same way in a professional situation, such as a meeting,” Judy says. “I will hide my hands under the table or fold them to keep people from seeing them.”


Nail Biting Articles Available

For more information on nail biting, the Obsessive-Compulsive Information Center has 127 articles on file. Many are medical studies related to various types of treatments available. The center can be reached by mail or by phone: Obsessive-Compulsive Information Center Dean Foundation 8000 Excelsior Drive Madison, WI 53717-1914 (608) 836-8070

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