Written by: Rhett Brown, MD
It starts with babies: Hands go directly to the mouth. As soon as teeth poke through and childhood stressors surface, a nail-biting habit can emerge. Approximately half of children between ages 10 and 18 bite their nails; and according to recent research, the incidence is greater in boys after the age of 10.
Chronic nail biting, or onychophagia, ranks as one of the most common nervous habits, and may occur with other repetitive body-focused behaviors, such as hair pulling and picking at the skin or face. Pay attention to children's behaviors because, in rare cases, nail biting can be an outward sign of an underlying mental health condition, such as obsessive compulsive disorder, impulse control disorder or other anxiety issues. If you're ever concerned about your child's habits or behaviors, talk with your family practitioner.
The nail-biting question most often heard from parents is, "How can I nix this nasty habit?" The good news is most nail biters will kick the tendency on their own by the time they're 30 years old, whether or not intervention is exercised. The bad news is this is an extremely difficult habit to break if the child is not ready and willing. I advise parents to pick their battles carefully, and in my opinion, nail biting is one annoying nuisance to ignore. Here's why: I've never seen a parent successfully nag or talk their child into halting a nail-biting habit. On the other hand, I have seen children naturally mature and decide to focus on more impressive styling and profiling techniques.
If an abnormal surge of nail biting develops, it may be a sign of trouble at school or with friends. Take a one-on-one moment to talk with your child and find out what underlying stress may be causing the nail biting. Creating an action plan together to resolve the issue will aid your child's coping skills, and may take you one step closer to nixing that nail-biting habit.
For parents having a hard time waiting it out, here are some tactics to try:
Engage in new stress management strategies. Stress often fans the flame of nail biting, so provide opportunities for your child to learn a variety of coping skills.Keep hands and mouths busy. If the habit arises out of boredom, anxiety or excitement, have alternative activities for fingers to fiddle with and mouths to munch on. Most nail biters nibble without even realizing it; try to keep mouths moving with snacks or gum, and let fingers handle silly putty or play dough during the next movie or long drive. It just might help.Teach good grooming. Show children how to neatly trim and file their nails. In addition to healthy hygiene, treating youths to a manicure may encourage them to maintain their attractive nails. Artificial nails can deter females by creating an extra layer to gnaw through, and a coat of clear polish may be just the trick for males.Make it bitter. Pungent polishlike products can be purchased over the counter and painted on nails for a mouth-puckering effect.
There's an old wives tale that chomping on nails will lead to perforated stomachs, but in reality the most common ramifications include redness and soreness on the fingers and along the fingernail beds, and broken skin where the soft tissue surrounds the nails. As long as the biter's nail bed stays intact, there should not be long-term physical damage regarding future fingernail growth.
A risk that can arise is an infection around the cuticle or nail edge, called paronychia. Occasionally, an infection will become contaminated enough that a physician will need to drain the area, and the patient will receive oral antibiotics. Also, with the unsanitary nature of the habit, any form of infection on the fingers, along with everyday germs residing on objects your child comes in contact with, are planted straight in the mouth. It's safe to say that a nail-biting habit increases a child's risks for colds, flu and viral infections.
Other nail-related reasons to contact a physician include an unusual appearance of the fingernail. Fingernails are composed of laminated layers of protein called keratin. Healthy nails appear smooth, with uniformity in color and consistency. Consult a doctor if nails become yellow, white or opaque; or if they separate from the nail bed, curl, pit or indent horizontally across the nail. Vertical lines, ridges or indents are harmless; so are white spots or lines that develop due to injury.
Dr. Rhett Brown is a family medicine physician at Presbyterian Family Medicine Midtown.