What helps against nail biting?
The impulse can hardly be controlled: People who bite their nails usually do so unconsciously. Those affected nibble, pull and gnaw at every bump with their teeth until the nail bed swells, reddens or even bleeds. Whether stress-biter or boredom-nibbler, nail biting is a kind of «idle action» that is performed while watching TV, on the tram or during a maths test, for example, and has a relaxing effect. According to the American researcher Pierre Halteh, 20 to 30 per cent of the population are affected.
Nail biting often begins in childhood and stops on its own in adolescence. According to a Polish research group, almost every second child between the ages of six and twelve bites their nails from time to time. Numerous studies point to a genetic component. There are usually several nail biters in the family. Pierre Halteh: «However, diagnosis and treatment are often delayed because patients are ashamed and rarely seek help.»
According to Halte's research findings, onychophagia (from the Greek ónyx = nail and phagein = to eat) can «lead to psychosocial problems and have a negative impact on quality of life». First described in the medical literature in 1934, obsessive nail biting has recently been classified as a mental disorder.
Perfectionists quickly become bored or frustrated. They bite their nails to compensate.
People who bite their nails usually find their behaviour unpleasant themselves. However, nail biting only becomes a medical concern when the behaviour turns into «self-injurious and aggressive» biting that leads to damage to the nail or skin. Dermatologist Pierre Halteh even warns of complications: «Injured areas can become inflamed or lead to nail growth disorders».
When constant nail biting permanently destroys the nails, doctors speak of onychotillomania, the destruction of the nails and nail plates brought about by the patient themselves. This can be caused by a mental illness, such as psychosis.
Hidden causes
There are many reasons for nail biting. One cause is oral fixation in childhood. In schoolchildren, pressure to perform or bullying can be possible triggers. Nail biting is often also a distraction and pastime. Commonly associated with nervousness, Canadian researchers describe nail biters as less nervous and more perfectionistic.
Those affected quickly experience boredom, frustration and impatience and are unable to compensate for these feelings. Nail biting serves to reduce tension.
With artificial nails against chewing
Many strategies have been tried to break the vicious circle and stop nail biting: from bitter-tasting nail varnish, creams or tinctures to simply trying not to think about it. Paradoxically, the latter even intensifies the urge.
Cosmeticians recommend that affected customers have their nails coated with gel polish. The nails then lack the nooks and crannies that people like to nibble on. However, this method is only recommended from the age of 16.
Nail varnish, tinctures, artificial nails: there are many strategies for stopping nail biting. Not all of them are promising.
However, nail biting cannot usually be stopped with polish and gel alone. According to studies, it is important to recognise and address the underlying problems. Care and attention from parents can help. In some cases, however, support from a specialist in the form of psychotherapy or behavioural therapy is also required.
Tips for parents
- Do not scold! Mental pressure can reinforce the behaviour.
- Observe the behaviour: When, how often and in what situations does a child bite?
- Talk to the child about the nail-biting behaviour and ask about possible causes.
- If the nail biting does not stop by itself in adolescence, consult a paediatrician.
Strategies for weaning:
- Keep hands busy in other ways, for example with an anti-stress ball or fidget spinner
- Apply bitter tinctures or special varnishes. Wormwood herb is an alternative.
- Cut nails short and file edges. Nail care reduces the need to chew.
- Set goals with rewards.
- Draw attention to nail biting, but do not put pressure on them.
Neuropsychologist Steffen Moritz from the University Medical Centre Hamburg-Eppendorf believes that a gradual change of habits is advisable. As part of a specially developed therapy programme, chewing is gradually replaced by a new action. Although those affected still have the impulse, they can redirect it - for example by moving their fingers to their ear or nose instead of their mouth.
As part of a study, a working group led by Moritz randomly divided 72 notorious nail biters into two groups. One group underwent behavioural training using the decoupling method, the other a course in progressive muscle relaxation according to Jacobson.
As the follow-up survey of the participants showed, the four-week decoupling training reduced their tendency to bite their nails; the relaxation exercises had no effect. Accordingly, the test subjects in the first group were significantly more satisfied with the external appearance of their hands.
The decoupling method - how it works!
- Möglichst genau beobachten und notieren, in welchen Situationen das Nägelkauen auftritt.
- Sobald die Finger Richtung Mund gehen, stattdessen versuchen, diese zum Ohrläppchen, zur Nase oder zu einem anderen Punkt umzulenken. Die neue Zielbewegung dabei möglichst abrupt ausführen.
- Ausprobieren, welche Bewegung einem am ehesten liegt, aber nicht mehr als zwischen zwei wählen. Das Nägelkauen lässt sich gut unterbrechen, wenn ein ähnlich automatisiertes Verhalten an seine Stelle tritt.
- Vor und nach der «Umleitung» die Fingernägel am Handballen oder an anderen Fingern reiben.
- Das Bewegungsmuster nach etwa zwei Wochen wechseln und eine andere Ersatzhandlung einüben. Nach einer Weile wieder zu der alten Umleitungsbewegung zurückkehren.
Quelle: Steffen Moritz et al.: A Randomized Controlled Trial of a Novel Self-Help Technique for Impulse Control Disorders: A Study on Nail-Biting. In: Behavior Modification 35, 2011
