Friday 23 March 2018

Dear Dr Jennifer: My teenage daughter has started biting her nails, how can I help her?

Dr Jennifer Grant, a GP with the Beacon HealthCheck screening programme at Beacon Hospital.
Dr Jennifer Grant, a GP with the Beacon HealthCheck screening programme at Beacon Hospital.

Dear Doctor,

My teenage daughter has got into the nasty habit of biting her nails. She's just started into fourth year in school and it seems that the thought of doing work experience seems to have kicked it off. She's frightened of her life about having to do this and literally started biting her nails as a result. Do you think I need to get her some counselling or help? This seems like a strange thing to just happen and I'm worried..

Answer: Nail biting, with the wonderfully medical moniker 'onychophagia', is a very common complaint in all age groups. Some feel it is an oral-compulsive habit, others feel it is a sign of anxiety and there is a third school of thought that believe it could in fact be a sign of perfectionism!

Nail biting typically begins during childhood, increases substantially during adolescence, and declines with age, although the habit may continue into adulthood. The considerable increase in onychophagia in teens may be explained by the difficulty of transitional phases in their life, and the feeling of instability associated with those phases.

You have very perceptively noted that the proposition of work experience for your daughter in fourth year has triggered her biting. I have no doubt that your analysis here is correct. Addressing this psychological trigger is key to management.

You should discuss her thoughts and feeling about transition year and try to work out solutions with her. It may be something very simple, such as a skewed perception of what work experience entails. Maybe an older student has spooked her with their bad experience. Perhaps working alongside a family member or family friend would be less threatening for her. Try not to make any dramatic decisions such as skipping the year and going straight to fifth year as this would not address the issue and possibly kick the can further down the road.

If she can recognise the cause, then nail biting becomes more a conscious habit that can be controlled. When she feels the craving to nail bite, she should make a tight fist for three minutes so that she can't get at her finger nails. Or once she allows her nails to grow out enough, you could reward her by paying for a professional manicure such as gel nails or shellac which would be very difficult to bite!

She needs to develop her own set of distraction techniques and coping mechanisms. I suspect that once work experience gets underway, she will see that it was not worth worrying about, she may even enjoy it and her habit may subside organically as a result.

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