Ava Monroe
Nail biting and picking are common habits that can be painful and embarrassing. While most people occasionally bite their nails or pick at their skin, some people do it compulsively, and it can interfere with their lives. This could be a sign of an underlying mental health condition, such as anxiety or stress, or it could be a nervous habit. In some cases, it can be a sign of a more severe condition called clinical excoriation disorder or onychotillomania. Treatment options include keeping your hands busy with a fidget device or stress ball, painting your nails, or covering them with band-aids or tape to remind yourself not to bite or pick. If the habit is severe and causing distress, it may be helpful to speak to a doctor or psychologist.
Table: Characteristics and Values
| Characteristics | Values |
|---|---|
| Medical Term | Onychotillomania |
| Cause | Anxiety, Stress, Boredom, Embarrassment, Skin Conditions, Thyroid Disease, Iron Deficiency, Vitamin or Mineral Deficiency, etc. |
| Treatment | Painting Nails, Band-aids, Speaking to a GP or Psychologist, Cognitive Behavioral Therapy (CBT), Manicures, etc. |
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What You'll Learn
Nail biting and picking
Understanding the Habit
Potential Risks and Consequences
Strategies to Stop
- Identify your triggers: Understand what causes you to bite or pick your nails, whether it's physical factors like hangnails or emotional factors like stress or anxiety. Addressing these triggers can help you develop a plan to stop.
- Gradual approach: Focus on stopping nail biting or picking on one set of nails first, such as your thumbnails. Gradually work towards eliminating other nails until you no longer bite or pick any of them.
- Keep nails trimmed short: Having shorter nails provides less temptation to bite or pick and reduces the risk of catching on objects.
- Apply bitter-tasting substances: Use over-the-counter bitter nail polish or natural alternatives like jalapeño juice, garlic-infused olive oil, or neem oil. These unpleasant tastes can deter nail biting or picking.
- Enhance nail appearance: Invest in a manicure or paint your nails yourself. Having aesthetically pleasing nails may make you less likely to bite or pick at them.
- Seek support: Ask people around you to gently remind you not to bite or pick your nails. This accountability can help you become more aware of your habit and provide the support you need to stop.
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Underlying health conditions
Onycholysis, or nail separation, can be caused by external factors such as injury, irritation, or fungal infections. However, it can also be a sign of underlying health conditions. While rare, peeling nails could indicate an iron deficiency, which, if left untreated, can lead to anemia. Anemia is a condition where the body does not have enough healthy red blood cells or hemoglobin, which helps carry oxygen around the body.
Another possible underlying health condition is an underactive thyroid, which does not produce enough hormones. In addition to brittle nails, symptoms of an underactive thyroid include dry skin, low energy levels, increased urination, and muscle cramps. Treatment for an underactive thyroid involves taking a synthetic form of the T4 hormone, which is usually produced by a healthy thyroid.
Nail abnormalities may also be a sign of lung disease. According to the American Lung Association, symptoms of lung disease include nail peeling, yellowing, and discolouration. Chronic obstructive pulmonary disease (COPD) is one type of lung disease that can cause nail issues.
Additionally, kidney disease can cause changes in the nails. With approximately 37 million adults affected in the US alone, kidney disease often goes unnoticed. Dr. Nyanda of the National Kidney Foundation states that "any issues with the kidneys can eventually cause changes to the nail," including "peeling, yellowing, [and] discolouration." Other signs of kidney disease include dry skin, low energy levels, increased urination, and muscle cramps.
Finally, while not an underlying health condition per se, age-related changes in nail growth have been associated with blood circulation problems and extended exposure to UV rays.
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Trauma to the nail
Nail trauma can manifest in different forms, each requiring specific care. One common type of nail trauma is a bacterial or fungal toenail infection. This occurs when blood collects beneath the nail, resulting in a painful, dark blue or black discoloration. A deep cut or tear in the skin beneath the nail is known as a nail bed laceration, which can cause pain, bleeding, and potential damage to the nail matrix. When the nail breaks or cracks due to trauma, it can be quite painful. Fractures can occur horizontally or vertically and may involve a partial or complete separation of the nail.
Another type of nail trauma is onycholysis, which is when the nail separates from the nail bed. This can occur due to injury, irritation to the nail area, or an underlying condition. Repetitive trauma, such as repeatedly tapping the nails for a long time, can also cause onycholysis. Treatment for onycholysis involves managing the underlying cause, which may include trimming the nail, using antibacterial soaks, and avoiding activities or products that can irritate the nail.
It is important to seek appropriate medical attention for nail trauma to prevent or minimize structural changes and promote proper healing and nail regrowth. Podiatrists are trained to diagnose and treat nail conditions and can provide specialized care to ensure proper healing and prevent complications. For more severe cases of nail trauma, such as fragmentation or avulsion of the nail bed, exploration and repair may be necessary.
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Fungal infections
Onycholysis, or nail separation, can be caused by fungal infections. This occurs when a fungus gets between your nail and nail bed, usually through cracks or cuts in your fingers or toes. Fungal infections cause nails to become thick and yellow, and they may show white spots and streaks. They can also cause nails to become discoloured, thickened, and distorted.
Fungal nail infections can be spread to other people, so it is important to take steps to avoid this if you have an infection. Treatment may include cutting away the separated nail as it grows out, taking antifungal medications, or stopping the use of certain nail products. Antifungal treatments are thought to be effective in treating about 60 to 80% of fungal nail infections. The two most commonly prescribed medications are terbinafine and itraconazole, which are taken once or twice a day for several months. Laser treatment is also an option for stubborn infections, although it is not available on the NHS.
To prevent fungal nail infections, it is recommended to keep your nails short and clean. Be careful when cleaning underneath your nails, as tools like cuticle sticks or nail brushes can break the skin and cause infection. Avoid nail products that can irritate your nails, such as nail polish, nail gloss, nail hardener, nail polish remover, and fake nails. Wear gloves when doing activities that may damage your nails, such as washing dishes or playing sports.
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Treatment and prevention
Onycholysis, or nail separation, is a common condition that can affect both the fingernails and toenails. It is characterised by the nail lifting or peeling away from the nail bed, and it can have various underlying causes, including injury, infection, or certain skin conditions. Treatment and prevention of onycholysis involve several measures:
Treatment Options:
- Identify the underlying cause: The first step in treating onycholysis is to determine its underlying cause, which could be an injury, infection, skin condition, or other medical conditions. A dermatologist can help identify the cause, especially if multiple nails are affected.
- Address the root cause: Once the cause is identified, treating the underlying issue becomes crucial. This may involve medication or supplements to address conditions such as fungal infections, psoriasis, thyroid issues, or vitamin deficiencies.
- Manage nail length: Keeping nails short and trimmed helps prevent accidental pulling or catching on objects. However, aggressive clipping or manicuring should be avoided to prevent further damage to the nail bed.
- Avoid irritants and chemicals: Stay away from nail products, harsh soaps, and chemicals that can irritate the nails or the skin around them. This includes nail polish, nail gloss, nail hardeners, and nail polish removers.
- Protect nails: Wear gloves during activities that may damage nails, such as washing dishes, gardening, playing sports, or working outdoors. This prevents direct contact with potential irritants and keeps nails safe from injury.
- Practice good nail hygiene: Avoid the urge to bite nails or pick at cuticles. Be cautious when cleaning underneath nails to prevent breaking the skin and causing infection. Use diluted vinegar to prevent infections.
- Keep nails moisturised: Moisturising the nails and cuticles helps prevent dryness and the formation of hangnails, which can lead to infections.
- Medical treatments: In some cases, doctors may prescribe topical treatments, such as vitamin D or corticosteroids, to aid in nail recovery and relieve symptoms.
Prevention:
- Avoid nail salon injuries: Regular manicures can contribute to onycholysis due to the force applied during trimming, buffing, and polishing. Choose nail technicians who are gentle and avoid excessive force.
- Be cautious with footwear: Wearing shoes that are too small can cause trauma to the nails and lead to onycholysis. Ensure your footwear fits comfortably and doesn't put pressure on the nails.
- Limit water exposure: Prolonged exposure to water can contribute to onycholysis. Avoid keeping your nails submerged in water for extended periods.
- Maintain a healthy diet and hydration: Eating a well-balanced diet and staying hydrated can help prevent hangnails and promote overall nail health.
- Protect hands from harsh chemicals: When using harsh chemicals, such as cleaning products or hand sanitiser, wear gloves to minimise their impact on the nails and surrounding skin.
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Frequently asked questions
You may be experiencing onycholysis, a condition where the nail separates from the nail bed. This can be caused by injury, irritation, or an underlying condition such as a fungal infection or skin condition.
The most common symptom is the lifting or peeling of the nail from the nail bed. Other symptoms include nail thickening, discoloration, and deformation.
Treatment for onycholysis aims to address the underlying cause. General measures include keeping nails short and trimmed, avoiding activities that may harm the nails, and using antibacterial soaks. In some cases, antifungal medications or discontinuing certain nail products may be recommended.
While it is not always possible to prevent onycholysis, certain measures can help reduce the risk. These include wearing gloves during activities that may damage nails, avoiding nail-biting, and being cautious when cleaning underneath the nails.
If onycholysis is affecting multiple nails or is accompanied by other symptoms, it is advisable to consult a doctor or dermatologist. Onycholysis can sometimes indicate a more serious underlying condition, so early medical attention is recommended.
