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HELP! I Have A Nail Biter!

by Sue Hubbard, M.D.

Dear Dr. Sue: My daughter bites her fingernails and now it looks like her finger is infected. I have been trying to get her to stop biting and hoped this would not happen. Now what? Thanks! Monica.

Hi Monica: this is really a common problem among children who are nail biters and cuticle pickers. (FYI…I will admit I was a nail biter until I was a teenager and decided I had “ugly” nails. I stopped biting and my parents were thrilled!).

It’s also common to see similar infections of the toenails as some children bite their toe nails or pick and pull them off. In either case, you can develop an infection around the skin that hangs over the side of the nail, and this is called a paronychia.

A paronychia may start off with just a tender red swelling around the edge of the nail. In many cases, if caught early enough it may be treated simply by using warm soaks and applying a topical antibiotic such as polysporin (OTC) or even mupiricin (by script).

If the area continues to be inflamed and gets larger and more painful it will require a visit to the pediatrician. The infection is typically caused by staph, or strep and is then treated with an oral antibiotic that works against these “skin bacteria”. In most cases a culture of the area will not be needed.

The best way to prevent a paronychia? Keep those fingers and toes out of the mouth! I know this is easier said than done, and I have yet to find a fool proof way to stop the biting. If I had, I would not still be bugging my own boys about nail biting (but I will not say who is still an offender).

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