From the Research
Chronic onychophagia (nail biting) on both hands can lead to several health risks, and the most effective treatment approach is a combination of behavioral modifications and addressing underlying anxiety or stress triggers, as suggested by the most recent study 1.
Health Risks
The health risks associated with chronic onychophagia include:
- Bacterial and viral infections
- Dental problems, such as malocclusion or chipped teeth
- Tissue damage around the nails, including paronychia (infection of the skin around the nail) and damage to the nail bed
- Temporomandibular joint disorders from repetitive jaw movements
Treatment Options
Treatment options for chronic onychophagia include:
- Behavioral approaches, such as habit reversal training, stimulus control, and competing response training
- Bitter-tasting nail polishes, like Mavala Stop or Control-It, to create aversion to biting
- Physical barriers, such as bandages, gloves, or press-on nails, to prevent access to nails
- Cognitive-behavioral therapy to address underlying anxiety or stress triggers
- N-acetylcysteine at 1200-2400mg daily (divided doses) to reduce nail biting by modulating glutamate in the brain, as suggested by previous studies 2, 3
- Addressing underlying conditions, such as anxiety or ADHD, which often contribute to the habit
- Self-monitoring through journaling nail-biting episodes to identify triggers
- Maintaining proper nail hygiene and regular trimming to reduce the urge to bite
Importance of Persistence
Most people require a combination of approaches rather than a single treatment, and persistence is key as habit reversal typically takes 2-3 months of consistent effort to show significant improvement, as noted in the study 1. It is essential to prioritize the single most recent and highest quality study, which in this case is 1, to ensure the best possible outcome in terms of morbidity, mortality, and quality of life.