Nail biting, also known as onychophagia, is a common habit that many people struggle to overcome. Approximately 20-30% of children, teenagers, and young adults bite their nails regularly. While nail biting may seem harmless, it can lead to infections, damaged teeth, and social stigma. Understanding the causes behind nail biting is the first step to breaking this frustrating habit.
What causes nail biting?
There are several potential causes of nail biting including:
- Stress and anxiety – Nail biting can be a coping mechanism for dealing with stress, anxiety, or boredom. The repetitive motion releases tension.
- Oral fixation – Some people have an instinctive need to keep their mouths occupied. Nail biting satisfies this urge for oral stimulation.
- Habit – Over time, nail biting can become an unconscious habit. People may bite their nails without being fully aware they are doing it.
- Perfectionism – An obsession with smooth, even nail edges can fuel the urge to bite ragged cuticles and nails.
- Learned behavior – Children may pick up the habit from parents or siblings who bite their nails.
Stress and anxiety
For many people, nail biting starts as a response to stress or anxiety. In tense situations, nail biting can act as a distraction from emotional discomfort. The physical sensation helps temporarily mute worried thoughts plaguing the mind. Unfortunately, any relief is short-lived. Nail biting tends to increase overall anxiety levels over time.
People may bite their nails to relieve the following types of stress:
- Generalized anxiety
- Social anxiety around others
- Perfectionism relating to high expectations of oneself
- Trauma or abuse
- Major life changes
- Pressure to succeed at school or work
Nail biting is an unhealthy coping mechanism. The temporary sense of relief it provides quickly shifts back to anxiety. This sets up a vicious cycle. As anxiety builds, the urge to bite nails intensifies again. The more someone bites their nails, the more anxious they feel. Breaking this cycle involves dealing with root causes of stress.
Oral fixation
Nail biting can also arise from an instinctive oral fixation. People with oral fixations feel a compulsive need to keep their mouths occupied. This may involve chewing on pencils, hair, lips, cheeks, or fingernails.
Oral fixations often form in childhood around ages 5-6 during the oral stage of psychosocial development. During this stage, children explore the world through tasting and mouthing objects. Most outgrow this tendency as other senses develop. However, some children remain orally fixated later in life.
Adults with oral fixations may bite their nails for stimulation and comfort. Having something in their mouth satisfies an ingrained urge. This urge may intensify during times of tension when the body craves self-soothing behaviors.
Habit
Nail biting starts as a conscious behavior. Over time, it can morph into an unconscious habit through reinforcement. At first, biting nails may provide temporary relief from stress or anxiety. This relief rewards the behavior and strengthens neural pathways in the brain associated with nail biting. Eventually, the habit becomes automatic.
People start biting their nails without being fully aware of it. The behavior occurs absentmindedly in response to triggers. Common triggers include boredom, reading, watching TV, driving, waiting in line, and doing repetitive tasks. Nail biters may place fingers in their mouths out of pure habit even when their nails are already bitten down to the quick.
Because nail biting becomes so deeply ingrained, most people have trouble quitting. Kicking a habit requires interrupting well-worn neural pathways in the brain. This takes time, patience, and conscious effort.
Perfectionism
Perfectionism is another common cause of nail biting. Those with perfectionistic tendencies have an acute sense of flaw detection. Even tiny imperfections become glaring. Hangnails, rough edges, or uneven nail lengths may feel intolerable.
To fix these perceived defects, perfectionists bite their nails down until smooth and even. However, this never lasts long. New flaws quickly appear, restarting the cycle. Perfectionists get caught in an endless loop of biting nails down and watching them grow back. This continues despite the harm caused to their nail beds.
Learned behavior
Children often mimic behaviors they see in parents, siblings, and peers. Those who grow up with nail biters in their close circle have a higher chance of developing the habit themselves. Monkey see, monkey do reflexes kick in. Children absorb behaviors modeled around them subconsciously.
Kids with anxiety may also pick up nail biting after observing it calms others around them. Seeing the habit soothes stressed adults can teach children this is an effective coping mechanism. Unfortunately, this passes on unhealthy behaviors to the next generation.
Potential risks of nail biting
While nail biting may seem harmless on the surface, it carries surprising risks:
- Infections – Biting nails creates openings for germs to enter. This can lead to bacterial, viral, and fungal nail infections.
- Parasites – Dirty nails may transfer tiny parasites like pinworms into the mouth.
- Dental damage – Using teeth to bite nails can chip teeth or harm tooth enamel.
- Gum injury – Jagged nail edges can cut and injure the gums.
- Social stigma – Bitten bloody nails are considered unsightly and embarrassing.
Infections
One of the top risks associated with nail biting is transmitting infections. Bacteria, viruses, and fungi live under and around nails. Transferring these microbes into your mouth with nibbled fingers can make you sick. Common nail biting risks include:
- Herpetic whitlow – A painful viral infection of the fingers caused by HSV-1 or HSV-2. Whitlow presents as red, swollen, blistered skin around the nail beds and cuticles. The virus enters through broken skin caused by nail biting. Putting infected fingers in your mouth can then transfer the virus to your lips, mouth, and face.
- Paronychia – A bacterial infection of the nail fold. It causes redness, swelling, and pus around the nails. Biting infected nails can spread the infection to the mouth.
- Onychomycosis – A fungal nail infection that turns nails yellow, brittle, and misshapen. It normally enters via tiny separations in the nail bed. Nail biting widens these separations, enabling the fungus to penetrate deeper. The fungus can then travel into the mouth.
- Warts – Biting warts transfers the human papillomavirus (HPV) into the mouth. This can lead to oral warts on the lips, tongue, and cheeks.
To prevent infections, it is important to keep nails short, clean, and dry. Avoid biting nails that look discolored or damaged. See a doctor at the first sign of pain, redness, or swelling around cuticles and nails.
Parasites
Parasites like pinworms can also hitchhike onto bitten fingernails. Children are especially prone to ingesting parasites through nail biting.
Pinworms are tiny parasitic worms that live in the intestines. Female pinworms crawl out of the anus at night to lay eggs externally around the perianal region. This causes itching. Fingers easily pick up pinworm eggs when scratching infected areas.
Children then transmit the pinworm eggs into their mouths through nail biting and thumb sucking. After being swallowed, the eggs hatch into worms that take up residence in the gut. Pinworm infections spread rapidly through child groups due to these oral-fecal routes.
Preventing parasites involves training children not to bite nails and to wash hands frequently. Keeping fingernails closely trimmed short also minimizes risks.
Dental damage
Using teeth to bite down hard nails can lead to dental trauma over time. This may include:
- Chipped or cracked teeth – Using incisors and canines to bite into nails can chip enamel. Cracks enlarge over time, causing further damage.
- Tooth wear – Nails over time can wear down biting surfaces of teeth, causing teeth to become loose, sensitive, or require crowns.
- Injury to gums – Gums can become irritated, cut, and injured from sharp nails continuously grinding against them.
Dental damage from nail biting often takes years to accumulate. Many people are unaware of the slow harm occurring inside their mouths. Protect teeth by keeping nails neatly trimmed. Use nail clippers or files instead of teeth to manage hangnails.
Social stigma
Unfortunately, nail biting carries social stigma due to aesthetics. Bloodied, scabbed, discolored chewed-up fingers appear unsightly from an outside perspective.
Judgments from others can cause anxiety and embarrassment in public situations:
- Reluctance to show hands during greetings or while gesturing when speaking
- Hiding nails in pockets or behind backs
- Avoiding touch, manicures, hand massages, or activities like painting that draw attention to fingers
The appearance of bitten nails can significantly detract from self-confidence. Some nail biters withdraw socially to avoid feeling judged about their nails. They may decline invitations or shy away from new acquaintances due to feeling self-conscious.
While social anxiety about nail biting is understandable, the judgments of others speak more about them than you. There are many discreet ways to manage the appearance of bitten nails in social settings. The ultimate priority should be overcoming the habit for your own health and well-being.
How to stop biting your nails
Kicking the nail biting habit requires patience and commitment. Avoid negative self-talk – slipping up during the process is normal. The following tips can help end nail biting for good:
- Identify your triggers – Notice times, places, and emotions causing you to bite your nails. Increase awareness before habitually putting fingers in your mouth.
- Address anxiety issues – Talk to a counselor if stress or anxiety are major triggers. Develop healthy coping skills to deal with emotions rather than biting nails.
- Fidget tools – Keep hands busy with objects like squishy stress balls, fidget spinners, or silly putty. This redirects the physical urge to bite.
- Oral substitutes – Swap nail biting for sugar-free gum, hard candy, carrot sticks, or sunflower seeds.
- Regular grooming – Keep nails neatly trimmed and filed to remove temptation. Consider weekly manicures.
- Moisturize – Use thick lotion around nails to discourage biting. Bandages can protect damaged nails while healing.
- Barrier methods – Paint nails with a foul-tasting commercial polish. Wear gloves or bandages over fingers to remind you not to bite.
- Set reminders – Use a visual cue like a rubber band on your wrist. Set phone alarms to remind yourself not to bite throughout the day.
- Notice progress – Celebrate and reward each successful day without biting. Track milestones using a calendar.
- Identify root causes – Reflect on when and why you reach for your nails. Adjust behaviors generating anxiety and tension.
Don’t lose hope if you stumble along the way. Bad habits take time to overcome. Enlist help from loved ones to hold you accountable. With consistent effort, your fingers will heal and the biting urge will fade.
When to seek help
Consider talking to your doctor or a therapist if:
- Nail biting causes significant anxiety or distress
- You regularly bite nails until they bleed or inflict pain
- Nail biting interferes with daily life
- You’ve sustained dental damage from nail biting
- You’ve attempted to quit repeatedly without success
- Nail biting accompanies other body-focused repetitive behaviors like skin picking or hair pulling
Mental health professionals can address the emotional side of nail biting through therapy. Behavioral treatment, cognitive behavioral therapy (CBT), and habit reversal training can help end lifelong nail biting struggles.
Medications and supplements
Doctors may prescribe medications or supplements to assist in curtailing nail biting, especially when anxiety is a factor:
- Anti-anxiety medication – Medicines like fluoxetine and clomipramine have proven successful in lessening nail biting linked to anxiety.
- Opioid antagonists – Naltrexone may help block the pleasurable sensations experienced while biting nails.
- Behavior-altering supplements – N-acetyl cysteine supplements have reduced nail biting frequency in some compulsive disorders.
- Over-the-counter bitter nail polishes – Applying a foul-tasting topical polish can deter the urge to bite. However, these should be used cautiously in children due to toxicity concerns if ingested.
Discuss pharmaceutical options with your physician to determine if medication may be appropriate alongside behavioral modification efforts.
Habit reversal training
Habit reversal training is a form of cognitive behavioral therapy often used to address nail biting. This psychological treatment approach aims to reverse ingrained physical habits.
The training normally follows four steps:
- Awareness – Patients monitor and record details surrounding nail biting urges such as timing, triggers, and frequency.
- Competing response – The next step is to perform an opposing action when nail biting feels compelled. This may involve making a fist, sitting on hands, snapping a rubber band on the wrist, or other unpleasant or impossible actions.
- Motivation – Patients give themselves rewards for resisting biting urges to stay motivated.
- Generalization – Over time, theCompeting response becomes a long-term habit that takes the place of nail biting.
Habit reversal training requires regular practice but can be highly effective for rewiring the brain. With a professional therapist’s guidance, ingrained nail biting behaviors can be replaced with healthier responses.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy is another therapeutic option for chronic nail biters. CBT aims to change harmful thought patterns contributing to behaviors.
In CBT, a therapist helps patients identify distorted thinking patterns surrounding nail biting, such as:
- “I’ll just bite one nail to make it even.”
- “My nails look awful. I have to fix them.”
- “I can’t stop myself from biting when I get anxious.”
- “My nails grow back so quickly I can keep biting them.”
The therapist challenges these thought distortions and teaches coping skills to short-circuit urges. Over time, CBT reframes thinking to support lasting change.
Conclusion
Nail biting stems from various root causes like anxiety, oral fixations, perfectionism, and social learning. Kicking the habit requires patience, commitment, and often professional support. With consistent effort to identify triggers, engage oral substitutes, and curb negative thinking patterns, nail biting can become a thing of the past.
