Onychophagia, commonly referred to as nail biting, is a chronic condition that is repetitive and compulsive in nature, and generally seen in children and young adults. Multiple factors play a role in the development of nail biting, ranging from genetic components to underlying psychiatric conditions. Complications of chronic, compulsive nail biting range from obvious distortion of the nail bed unit to ungual and oral infection. Dental hygiene is typically less well-maintained in patients with nail-biting disorders, and teeth may become chipped or notched and gums many become inflamed. Treatment of nail biting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care. Treatment ranges from psychotherapy modalities to medication trials of selective serotonin reuptake inhibitors and N-acetylcysteine. Proper nail hygiene remains a mainstay in the prevention of the complications of chronic nail biting. Additional supportive measures include the support of self-motivational novels and television episodes that help children learn coping mechanisms.
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