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Onychotillomania affecting the left thumb

Onychotillomania is a compulsive behavior in which a person picks constantly at the nails or tries to tear them off.[1] It is not the same as onychophagia, where the nails are bitten or chewed, or dermatillomania, where skin is bitten or scratched. Onychotillomania can be categorized as a body-focused repetitive behavior in the DSM-5 and is a form of skin picking, also known as excorciation disorder.

It can be associated with psychiatric disorders such as depressive neurosis, delusions of infestation[2] and hypochondriasis.[3]

It was named by Jan Alkiewicz, a Polish dermatologist.[4]

The constant destruction of the nail bed leads to onychodystrophy, paronychia[5] and darkening of the nail.[6]

Some cases have been treated successfully with antipsychotics.[7]

One cheap solution suggested by researchers is to cover the proximal nail fold with a Cyanoacrylate glue. "The mechanism of action for improvement is probably related to the presence of an obstacle to picking."[8]

See also


  1. James WD, Berger T, Elston D (2006). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Philadelphia: Saunders Elsevier. ISBN 978-0-7216-2921-6.
  2. Ameen Sait M, Reddy BS, Garg BR (1985). "Onychotillomania. 2 case reports". Dermatologica. 171 (3): 200–2. doi:10.1159/000249420. PMID 4076493.
  3. Kim MH, Park HJ, Lee JY, Cho BK (July 2006). "Two Cases of Onychotillomania". Korean J Dermatol (in Korean). 44 (7): 855–857. ISSN 0494-4739.{{cite journal}}: CS1 maint: unrecognized language (link)
  4. Grzybowski A, Zaba R (2009). "Professor Jan Alkiewicz, MD, and his influence on 20th century dermatology and mycology". Clinics in Dermatology. 27 (3): 317–322. doi:10.1016/j.clindermatol.2008.10.009. PMID 19368061.
  5. Harth W, Gieler U, Kusnir D, Tausk F (2009). Clinical Management of Psychodermatology. Berlin: Springer. p. 21. ISBN 978-3-540-34718-7. Archived from the original on 2022-04-30. Retrieved 2022-03-20.
  6. Baran R (1990). "Nail biting and picking as a possible cause of longitudinal melanonychia. A study of 6 cases". Dermatologica. 181 (2): 126–8. doi:10.1159/000247900. PMID 2242780.
  7. Hamann K (1982). "Onychotillomania treated with pimozide (Orap)". Acta Derm. Venereol. 62 (4): 364–366. PMID 6183881.
  8. Ring DS (November 2010). "Inexpensive solution for habit-tic deformity". Archives of Dermatology. 146 (11): 1222–3. doi:10.1001/archdermatol.2010.287. PMID 21079056.

External links