Sunday 25 September 2016

Ask the GP: Nail-bitingly embarrassing conditions

Nina Byrnes

Published 09/06/2015 | 02:30

Nail biting is a form of obsessive compulsive disorder according to psychiatrists
Nail biting is a form of obsessive compulsive disorder according to psychiatrists

Our GP, Dr Nina Byrnes, advises on how to stop biting your nails and what to do about testicle pain.

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Question: I am 20 years old and I still bite my nails. I started when I was  really small. I try all the time to stop  without success.  Have you any advice?

Dr Nina replies: Most people have bitten their nails occasionally. The most common reason is to get rid of an annoying hangnail when you are far from a scissors or clippers.

The habit of nail biting usually starts in childhood. Studies suggest that 60pc of children and 45pc of teenagers may regularly bite their nails. The percentage decreases in those over the age of 18 but it does continue into adulthood for some.

Psychiatrists have suggested that nail biting belongs to a group of behaviours called grooming disorders which are a form of obsessive compulsive disorder.

Nail biting isn't dangerous in its own right but it does have some health issues associated with it.

The skin around the nail beds may become damaged and inflamed making infection more likely.

The continuous introduction of the nails to the mouth makes it very easy for germs and dirt located on the hands and under nails to enter the mouth, possibly leading to increased incidence of other infections and viruses.

Nail biting can damage teeth over time and affect dental alignment.

If you want to quit start by being aware of your triggers for biting.

Nail biting is more common in times of boredom or anxiety or tension in many people.

Keeping your hands busy can be a start. Try using a stress ball and squeezing it when you want to bite. Chewing gum may help stop you putting your hands in your mouth.

If anxiety or stress are triggers consider taking up activities such as meditation or yoga to help ease this. Some have tried hypnotherapy but the efficacy of this treatment is not guaranteed.

Most people have tried applying the bitter nail coat that is supposed to help. I have met many nail biters who just bite on through this but the taste can at least act as a reminder that you are biting and need to stop.

A more extreme measure is to apply plasters to the tips of all your fingers. Biting through these may stop you biting your nails.

It is important to remember that nail biting is a habit and most habits can be broken. The most important thing is to remain motivated. Don't give up if you fail just try again.

Each time you quit your chance of stopping forever increases.

Question: I have developed a pain in my right testicle over the last few days. It isn't severe but is uncomfortable and not going away. I'm too embarrassed to go to my doctor. Do I need treatment? What do I do?

Dr Nina replies: The testicles are very sensitive and even minor trauma here can cause significant discomfort and pain.

Mild pain in the scrotum may be caused by an enlarged vein called a varicocele or fluid surrounding the testes which is called a hydrocoele. A hernia can be another cause of a mild dragging ache into the testes. Testicular cancer is nearly always painless.

One of the most common causes of testicular pain is epididymitis. This most commonly causes pain and swelling on one side that may come on over hours and days. There may be associated swelling of the testes (orchitis). This is most commonly due to an infection which may be sexually transmitted and antibiotics will be required. Viruses such as mumps may also cause testicular pain.

Sudden severe pain that comes on over minutes to hours can be a severe condition called testicular torsion. This is when the testicle and associate tubing have become twisted in the scrotum. This is most common in males aged 10 to 20. It is a medical emergency. If you have mild testicular pain, wear loose pants. Take simple painkillers such as paracetamol or ibuprofen. Lying down and applying ice may also help. If the pain lasts longer or is increasing you should see your GP.

If you experience sudden severe testicular pain, seek medical attention straight away. In order to prevent testicular pain wear the appropriate protective gear when playing sports. Adhere to safe sexual practice to avoid STIs.

Lastly, make sure you are immune to mumps or have an MMR vaccine.

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