Onychophagia (Nail Biting) : Causes, Symptoms and Treatment

Onychophagia can be described as a type of compulsion to bite the nails and fingertips. Individual cases can differ in severity with the mild end of the spectrum involving occasional nail biting that may be temporary, while the more extreme end is usually a long-term problem that results in nail deformity and infections around the nail bed.

Although onychophagia is a common disorder in individuals of all ages, its causes are not completely understood. Research has produced theories about nail biting that includes it being a sign of self-hostility that results in self-mutilation or a result of a troubled relationship with the mother during childhood. The most widespread theory portrays nail biting as a symptom of anxiety or a nervous habit. This condition is believed to be induced by nervousness, stress, or boredom and can be tied to emotional or psychological issues.

Co-Occurring and Related Disorders

Nail biting has been compared to obsessive compulsive disorder (OCD) and is also said to be a form of OCD. People who engage in nail-biting behavior feel the physical pain, but they also experience feelings of stress relief and gratification, which may thwart their attempts to quit. Many children that act on the urge to bite their nails suffer from other disorders such as attention deficit hyperactivity disorder (ADHD), separation anxiety disorder, or enuresis. Adults may also have ADHD, anxiety, depression or other related disorders. More excessive cases of nail biting can be classified as a form of self-mutilation.

Symptoms of Onychophagia

  • Extremely short nails
  • Bleeding around the nails
  • Damaged skin around the nails and tips of fingers
  • Hard bumps or calluses
  • Uncontrolled nail biting
  • Hangnails
  • Pain around the nail bed

Motivation Behind Nail Biting

Reasons behind nail-biting are not completely known, but there are numerous factors that are thought to promote it.
  • Boredom: Nail biting can occur when a person is bored or listless and engaging in this behavior can help to stimulate them and keep them alert.
  • Pacification: Stress can prompt nail biting to provide a distraction and sense of relief.
  • Perfectionism: People who bite their nails may be provoked by the need to achieve a flawless appearance and will pick at any irregularity they find on their nails and fingers. This usually creates a self-perpetuating cycle because the nails tend to look worse after they are finished.

The emotional factors behind nail biting can create an ongoing pattern, which can become very difficult to break.  Any resulting shame or anxiety tends to further increase the need to continue nail-biting behavior.

Treatment Methods

Children and teenagers can sometimes grow out of this habit without intervention. However, if the condition persists, there are methods that have been effective for some people.

At-Home Methods

Create an Aversion: There are certain types of nail polish that were developed to help people stop biting their nails. The polish is produced to have a very unpleasant taste, which support efforts to quit nail biting. This technique can be used for children or adults and can also be effective with some other types of nail polish.

  • Maintain: This approach can help to hinder nail biting by removing the temptation caused by long or unkempt nails. By keeping nails short, there is less to bite. Getting manicures can also deter the urge to chew on nails.
  • Relieve Stress: Since stress can be a factor behind the urge to bite nails, attempting to alleviate some of it through other methods may be an effective way to stop. Incorporating activities such as meditation, yoga, or other forms of relaxation are good examples.
  • Conceal the Focus: If the above techniques fail, it may help to cover your hands or nails with gloves or bandages. This can also make the person conscious of their behavior and stop distracted nail biting.


Cognitive-behavior therapy is a common type of psychotherapy, which involves work with a mental health counselor in a structured setting. This is done to change behavior by becoming aware of negative emotions and related habits so that they can be dealt with in more effective ways. This type of therapy has been used as a way to treat onychophagia and may involve one of the following methods or a combination of them.

  • Competing Response: With this technique, the person is provided with an alternative to nail biting. This can include activities that involve the hands like toys or things that involve the mouth such as chewing gum to satisfy orally-motivated urges.
  • Habit Reversal Training: This four-step process teaches an individual how to breathe and feel grounded, achieve relaxation, and to complete muscle-response exercises. It also includes self-monitoring and stimulus control, which is described below, as well as support from family members and friends.
  • Stimulus Control:  A behavioral treatment that helps to identify, get rid of, or transform the environmental circumstances, or emotions that trigger nail-biting. The goal of this therapy is to control triggers through conscious behavior modification, and to channel the unhealthy urges into behaviors that are non-destructive. For example, if the person notices that they tend to bite their nails when they are watching television, they could be asked to wear gloves at those times. If they bit their nails when they are around a specific person, they should try to avoid this individual.
  • Self-Monitoring: Making the nail biter more aware of their actions is the goal with this therapy. Since this is often an unconscious act, taking notes can create more awareness of the behavior. Recording the behavior can also be an effective deterrent because it serves as an interruption and can be used to redirect the person to something different.

Whether home remedies or professional help are used, it will take time to overcome the urge to chew on nails. The longer the sufferer can go without biting their nails, the more their drive to do so will diminish. The length of time it takes to change the behavior depends on the individual and the severity of their onychophagia, but with a little determination, it can be done.

Deanna James is the Director of Media Relations at Monarch Cove Treatment Center. She loves to see patients overcome their individual disorders with the help of the professional, caring staff at Monarch Cove. Monarch Coves treats a variety of disorders from Anorexia Nervosa to Anxiety & OCD.

Leave a Comment

Your email address will not be published. Required fields are marked *