Onychotillomania, commonly known as nail picking, is a body-focused repetitive behavior (BFRB) characterized by compulsive and repetitive picking, biting, or tearing of the nails. It falls under the broader category of Other Obsessive Compulsive and Related Disorders and is most similar to dermatillomania or excoriation disorder. The category of BFRBs encompasses various repetitive self-grooming behaviors.
Nail Picking
Onychotillomania, commonly known as nail picking, is a body-focused repetitive behavior (BFRB) characterized by compulsive and repetitive picking, biting, or tearing of the nails. It falls under the broader category of Other Obsessive Compulsive and Related Disorders and is most similar to dermatillomania or excoriation disorder. The category of BFRBs encompasses various repetitive self-grooming behaviors.
Signs and Symptoms
The signs and symptoms of onychotillomania may vary from person to person, but several common indicators help identify the presence of the condition:
Individuals with onychotillomania spend a considerable amount of time engaging in nail picking behavior. This repetitive action may occur consciously or unconsciously, and the person may find it challenging to resist the urge to pick their nails.
Frequent nail picking can result in noticeable damage to the nails, such as irregular shape, thinning, or uneven growth. Additionally, the skin around the nails, known as the cuticles, may become inflamed, red, or swollen due to the continuous picking.
Compulsive behavior: Individuals with onychotillomania experience an overwhelming urge to pick their nails and find it challenging to resist the impulse, especially if there is a trigger such as a rough or jagged nail, nails that appear longer than the others, or nails that fell or look somehow different than the others.
Emotional distress: Feelings of anxiety, tension, or stress often precede or accompany episodes of nail picking, and individuals may experience a temporary relief or gratification from the behavior.
Sensory Stimulation: Some individuals engage in nail picking to seek sensory stimulation or to get rid of a sensation that feels different, such as a rough nail edge, a sharp feeling nail, or some other aberration that attracts the person to that area. In addition, nail picking is also movement and can satisfy the need to move when one is in a sedentary situation.
Preoccupation and avoidance: Onychotillomania can consume a significant amount of an individual's thoughts and time, leading to avoidance of social situations or activities that may expose their skin.
Impacts and Effects
Persistent nail picking can cause physical harm, including infections, bleeding, and tissue damage. Repeatedly picking at the nails and surrounding skin increases the risk of bacterial or fungal infections, which can further exacerbate the condition.
Individuals with onychotillomania may also experience social isolation and avoidance due to embarrassment or shame about the appearance of their nails. The condition can also contribute to low self-esteem, anxiety, and depression, as the constant urge to engage in nail picking can be distressing and difficult to control.
Nail picking can interfere with daily activities, such as work, school, and personal relationships. The time spent engaging in nail picking can be a significant distraction and may lead to decreased productivity and difficulty concentrating.
Nail picking can lead to significant emotional distress, including feelings of shame, embarrassment, and guilt. The compulsive behavior may interfere with daily activities, relationships, and self-esteem.
Treatment
Joining support groups or engaging in peer support can be helpful for individuals with onychotillomania. Connecting with others who understand the challenges and experiences associated with BFRBs can provide a sense of validation, encouragement, and practical advice for managing the condition.
Choosing a therapeutic provider to support your BFRB journey is a process that takes time. Patience and persistence are key to finding your own level of success.
Medications used for OCD and other anxiety disorders have been tested on subjects with BFRBs with limited success. There has not yet been any single medication or combined medications approved by the Food and Drug Administration (FDA) for the treatment of BFRBs.
