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stopbitingnails.com

By Dr. Dana Stern   Onychophagia (nail-biting) is a common disorder affecting 20%–30% of the general population. However, its prevalence is likely underestimated, as patients are often embarrassed to seek help from physicians. It is not difficult to spot a nail-biter. Clinically, the nail will appear abnormally short and uneven. Cuticles may be absent or ragged and nail folds may be in varying stages of healing. Splinter hemorrhages (longitudinal thin black lines that look like splinters) are often present within the nail plate. Although the exact cause of onychophagia is currently unknown, there are studies that show a possible genetic relationship. There is also a possible association between nail-biting and certain psychiatric disorders — such as anxiety and obsessive-compulsive disorder — however these studies have shown conflicting results. Nail-biting has also been associated with boredom or a lull in activity. Beyond resulting in unattractive nails, nail-biting can also lead to a host of health-related concerns and complications.   Complications Related to Nail-Biting Longitudinal melanonychia (lengthwise pigmented bands in the nail) can occur from inadvertent stimulation of the melanocytes (melanin-producing cells) that reside in the lunula (half-moon region) of the nail. Those who bite or tear at hangnails near the cuticle are at risk for this clinical scenario. These pigmented stripes are almost always benign and do not pose a risk for nail melanoma; however, they are often cosmetically concerning to those who develop them. Paronychia is another concern associated with nail-biting. Paronychia is an infection of the nail fold that occurs when the cuticle is compromised. Disruption of the cuticle barrier can create an entry point for organisms to penetrate the nail unit. If bacteria enter, there will be pain, swelling, and purulent buildup that needs to be expressed, cultured, and treated by a physician. Alternatively, yeast organisms that are easily transfe