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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Skin Disorders NailBiting

NailBiting

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Nail biting is a stereotypic movement type disorder a very common habit that mostly affects kids but it can be present in adults and older people too manifested by biting one's fingernails or toenails during periods of nervousness, stress or boredom. It can be a sign of mental or emotional disorder but is commonly seen in intellectuals. Often starting in childhood, nail biting can persist in some adults and become an irritating and unsightly nuisance. Some nail biters experience the habit with such severity that their nails are constantly bitten down to the maximum and bleeding, causing pain, baldness of nails and often embarrassment.

Causes

Possible theories show that it can be due to

  • Behavioural
  • Neurological
  • Genetic

Some of the causes are

Symptoms

The fact is that most childhood habits are benign and have no specific observable physical signs. However, when physical signs are present, they are typically non-pathologic and often previously unnoticed.


  • Extremely short fingernails
  • Paronychia
  • Oral herpes
  • Herpetic whitlow
  • Damaged dentition
  • Apical root resorption
  • Fractures to the incisors
  • Gingivitis.
  • Nail biting can worsen some existing conditions of the nail bed, such as:
  • Infection of the skin around the nail (paronychia)
  • Warts around the nail bed
  • Serious infections of the gums and lips.
  • Nail biting also has the negative side effect of restraining the use of the hands.

Treatment

The most common habits in children that require treatment can be significantly improved with behavioral interventions, without the use of medications. Sometimes however, in addition to behavioral treatments, medications may be required to attain optimal treatment outcomes.


Medications

Antidepressants

  • Clomipramine
  • Fluoxetine
  • Sertraline
  • Paroxetine

Anti-psychotics medications

  • Risperidone
  • Olazapine

Behavioral Therapy

Behavioral therapy cannot be that much helpful, but some patients have found behavioral therapy to be beneficial on its own or as a complement to medication.


1. Habit Reversal Training (HRT)

It teaches how to get aware of your habits, how to relax, how to breathe and focus yourself, and to perform a competing and opposing muscle response. It teaches you to replace the nail biting habit with a more constructive habit if possible.


2. Stimulus control (SC)

SC is a behavioral treatment that seeks to help sufferers identify, and then eliminate, avoid, or change the particular activities, environmental factors, mood states, or circumstances that have become associated with, and that trigger picking or pulling. The goal of this part of the therapy is to consciously control these triggers that lead to the undesirable behaviors, and to create new learned connections between the urges and new non-destructive behaviors.


3. Hypnotherapy

Hypnotherapy can help you to form positive new alternatives to nail biting and help you cope with anxious situations and stress triggers in a constructive way.A hypnotherapist can also work with your unconscious mind to stop this unconscious habit.


Other Treatments

Various forms of aversion therapy exist to help people stop biting their nails. These include:

  • Coating the nails with a bad-tasting substance
  • Wearing a rubber band on their wrist
  • Having friends and family members snap it when they see nail biting.
  • Keeping a record of when one bites may also be helpful in finding the root of the problem.
  • Orthodontic treatment - Some nail biters who undergo this kind of treatment find that wearing a bite plate makes it impossible for them to bite their nails with their teeth.
  • In emotional cases, resolving the underlying problem can help to lessen or eliminate the nail-biting habit.

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