A friend of mine has a dirty little secret that's actually fairly obvious: Ever since childhood, she has bitten her nails to the quick, often until the cuticles bleed. This successful 43-year-old marketing executive can't seem to stop, no matter how many foul-tasting potions she paints on her fingernails or how many disapproving stares and lectures she receives.
The irony, she says, is that she knows how bad it looks and how unhygienic it is.
Chronic nail biting, or onychophagia, usually begins in childhood and peaks in adolescence. Studies have found the habit in 28 percent to 33 percent of children ages 7 to 10, 44 percent of adolescents, and 19 to 29 percent of young adults.
"It's a lot more common than one might think," Maryland psychiatrist Carol Watkins says. "The incidence gradually declines into adulthood, but we're still talking about 10 to 20 percent of grown men and women who continue to bite their nails." While it may seem like a fairly innocuous habit, there can be ramifications, Washington dermatologist Ella Toombs says.
"It is definitely unsanitary, facilitating germ transfer from the hands and nails to the mouth," she says. "There are no real, serious, long-term medical problems caused by biting your nails, but it can be unattractive, (leading to) cosmetically unacceptable fingernail beds, with lots of redness of tissue and swelling and even scarring, in the worst cases. This type of broken skin is also more susceptible to infections."
Cause? Opinions vary
Many people bite their nails at various points, but it's unclear why.
"Initially people thought it had to do with an oral fixation — the Freudian view — but that's no longer popular opinion," Watkins says. "Older studies tend to talk about psychological reasons, while newer ones look at behavioral and biochemical kinds of things, such as whether (nail biting) is caused by a relative of obsessive-compulsive disorder." Some experts think there's a genetic link, while others believe it's an exaggerated grooming behavior.
There is a stress-relief aspect for many, Watkins says. The cause "may be different in different people. You really have to look at the individual. For some people it's associated with anxiety, for example, but other studies have shown that people who bite their nails aren't that anxious."
Awareness is key
Most people can stop with simple behavioral techniques.
The key is to become aware of when and where you're biting your nails, says Watkins, who suggests keeping a journal.
Reminders such as wearing a bracelet that jingles when your hand gets close to your mouth can increase awareness. "Once you actually realize you're doing it, then you can avoid triggers and set up competing behaviors," Watkins explains, recommending needlepoint, a stress ball or sitting on your hands. Keeping nails short and treating yourself to a regular manicure or wearing gloves can help.
If all else fails, you can turn to the Internet's favorite cure: bitter liquids painted on the nails. Prozac and other OCD treatments are typically a last resort, say experts, and only for the most severe cases.
For another friend of mine, the turning point came at 39. He made a New Year's resolution to stop in 2009. He stuck a Post-it on his bathroom mirror. He'd repeat a short mantra 10 times and then head to his laptop, which contained another Post-it that he'd see while he worked.
He said that all worked for him because he needed to be constantly reminded of his habit so he could catch himself in the act.