How to Stop Picking Your Nails and Fingers

Repeated picking may result in raw, bleeding skin

Medically reviewed by Aleesha Grier, PsyD

Nail picking, also known as onychotillomania, is the urge to pull at or pick the nails and surrounding skin. The condition is similar to the more commonly known onychophagia, which is when someone bites their nails and skin. Nail picking is often related to an underlying mental health condition.

Treatment involves identifying triggers, therapy, and treating the underlying mental health condition.

This article covers how to stop picking your nails, treatment options, and nail care.

How to Stop Picking Cuticles, Nails, and Surrounding Skin

Learning to stop picking cuticles, nails, and the surrounding skin can be difficult. It is often thought of as a dermatological concern when it is both that and a mental health concern. Below are ways that can help someone stop picking their nails.

Identify Triggers

Identifying what triggers someone to pick their nails, cuticles, or surrounding skin can help resolve the issue. Some triggers will be external sources, such as an activity or environmental concern that causes the desire to pick. Other triggers are internal, a thought, feeling, or sensory change that creates the need to pick.

Determining the triggers can help create awareness and teach the person to avoid those situations or learn to identify what is happening to begin the process of stopping. Some people may find it helpful to write in a journal or keep notes to determine what is leading up to the nail picking.

Cover With Band-Aids

An occlusive cover like a Band-Aid or other adhesive dressing will provide a physical barrier and a reminder to stop picking. Some people may not like the appearance of wearing Band-Aids over their fingers, so try clear adhesive bandages found at pharmacies.

Apply Super Glue

Cyanoacrylate adhesive, also known as Super Glue, is applied one or two times per week over the nails, cuticles, and skin to provide a temporary barrier. It acts as a reminder not to pick. One case report found cyanoacrylate adhesive applications stopped picking within three to six months.

Join a Support Group

Learning to stop picking your nails, cuticles, and surrounding skin is a process that does not happen overnight. Joining a support group with other people who pick or have similar habits can offer a reassuring environment where advice and previous experiences can be shared. Healthcare providers and social workers can help find support groups.

What to Do Instead of Picking Your Nails

During the process of learning how to stop picking your nails, it can be helpful to find replacement behaviors.

A replacement behavior is something that is done in place of picking. It can be squeezing a stress ball, sitting on your hands, or making a fist.

Learn More: 7 Positive Lifestyle Factors That Promote Good Health

Addressing Nail Picking and Mental Health

Nail picking is a condition that is both a skin and mental health concern.

The picking creates skin and nail destruction, which generally arises from a mental health condition. Nail picking is not classified as its mental health diagnosis in the guide that health providers use, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), but is placed under the body-focused repetitive behavior disorders (BFRB) in the subsection of "Other Specified Obsessive-Compulsive-Related Disorders."

It is often associated with other mental health conditions like anxiety, depression, and psychosis. It can also be associated with dissociation. This occurs when the person has little to no memory of picking their nails and skin.

Nail Picking and Infection

Infection is one of the risks when someone picks their nails or skin. The skin and nails form a barrier between the outside world and the inside of the body. When that is compromised with picking, an infection can develop.

To avoid an infection, clean any picked areas and try not to touch them. If you develop signs of an infection, contact a healthcare provider to determine the best course of treatment.

Onychotillomania Treatment

Treating nail picking is done through therapy and in some cases medication. Below is an overview of the two treatments.

Medication

There is limited research on treating nail picking with medications. Research does support the use of medications for nail biting.

Medications that have successfully treated nail picking include:

• N-acetylcysteine (NAC)

• Fluoxetine

• Selective serotonin reuptake inhibitors (SSRIs)

• Tricyclic antidepressants

• Antipsychotics

For some people, treating an underlying mental health condition can improve nail-picking symptoms as well.

Therapies

In addition to medication, behavior modification like cognitive behavioral therapy (CBT) can treat nail picking. CBT increases a person's awareness of nail picking.

Another therapy is habit reversal training (HRT). HRT uses three elements to provide treatment, as follows:

• Awareness training: People are encouraged to acknowledge their triggers by saying or writing down the triggers and their consequences.

• Competing response training: This teaches the use of replacement behaviors for nail picking.

• Social support: The person is kept accountable by family and friends or in group therapy.

Nail Care to Discourage Picking

Taking care of the nails and surrounding skin may help to discourage someone from picking. Nail care measures include keeping the nails and cuticles short and clean or getting a manicure. Keeping the nails and surrounding skin clean and healthy may decrease the urge to pick.

Summary

Onychotillomania, or the urge to pick at the nails and surrounding skin, is a behavior of an underlying mental health condition. There are several treatment options such as therapy, trigger identification, and medication. Contact a healthcare provider for an evaluation and treatment for nail picking.

Read the original article on Verywell Health.