Onychophagia, commonly referred to as nail biting, is a chronic condition that is repetitive and compulsive in nature, and generally seen in children and young adults.

Nail biting almost always begins in childhood. It’s a behavior often associated with stress or anxiety, but it’s likely more complicated than that. Multiple factors play a role in the development of nail biting, ranging from genetic components to underlying psychiatric conditions.

Why do some people bite nails?

• Nail biting usually occurs as a result of boredom or working on difficult problems
• Bottle feeding for an extended period of time, along with pacifier use, are considered potential risk factors in children with nail biting habit
• Emotions such as excitement, nervousness and impatience can trigger nail biting as a distraction from these emotions.
• Studies also suggest genetic factors for a child to develop this habit.

Consequence of nail biting – 

1. Complications of chronic compulsive nail biting range from obvious distortion of the nail bed unit to ungual and oral infection.
2. Nail biting may damage the tissue around the nail and lead to infection and teeth root damage.
3. NB may damage the nail beds and cause the disappearing of nails.
4. The children or adults with NB might be laughed at or stigmatized by others.

How to stop the nail biting habit?

Some people are aware of the habit but are not able to stop themselves from biting while others subconsciously bite their nails. Either ways, following tips can help to manage this habit

1. Identify when you’re most prone to do it. Take a mental note of the times or places you’re most likely to bite your nails. Even if a trigger isn’t avoidable, knowing it exists can make it easier to fend off.

If stress is the trigger to get you to pick the habit up over and over again, take stress-alleviating steps such as exercising, doing breathing exercises or yoga, getting outdoors or confiding in a loved one, friend or counselor.

1. Family support – The home atmosphere should be a sympathetic and loving environment for the child or adolescent, with continuous words of encouragement to boost self-confidence. Any siblings should be on board with the treatment plan and avoid laughing at the behavior.

Others should not blame children with NB habits and increase their disappointments, instead they should encourage them, and give them support and confidence.

1. Application of edible yet distasteful coating over nails – Dermatologists may recommend a form of aversive therapy to patients by applying a distasteful coating over the nail to discourage patients from biting. 

This method has shown improvement in reducing impulsive nail-biting behavior; however, the method should be avoided for patients suffering from an underlying compulsive disorder.

In addition, olive oil has been shown to decrease biting behavior by making the nail feel softer without causing distress to the child

1. Habit reversal therapy – Instead of chewing your nails when you’re bored or stressed, try using a fidget spinner, squeezing a stress ball, taking a walk or some other activity that can help distract or calm you.

Gum chewing may be an effective alternative option to curb the compulsion to bite nails in socially stressful situations for an older child when other coping mechanisms cannot be utilized. This results in better oral hygiene as well.

Manicured nails may keep adolescents engaged in not biting their nails secondary to positive cosmetic appeal.

Mindfulness, support and proper counseling can help to gradually give up this habit of nail biting and lead a life without any social backlash over this habit.