Nail Trauma: Washboard Nails, Nail Biting…

There are many manifestations that may occur with nail trauma to include subungual hematomas, onycholysis and a linear ridge going from the base of the nail to the distal edge, to name a few.  One of the most commonly seen is what is called a “washboard nail.”  This is directly related to repetitive trauma or impacts at the base of the nail, over the soft matrix of the nail.   With many patients this is due to regular hand use and tends to be related to manual labor.  In other cases it is related to a tic or habit of picking or pushing of the cuticle back.

Another nail dystrophy that may occur is related to nail biting and this is also referred to as onychophagia.  This is a compulsive act most frequently observed in adolescents, but may continue into adulthood.  It is spurred by anxiety and stress.

TREATMENT:  Treatment is often related to making the patient aware of the causes.  Patients with washboard nails are encourage to protect their hands when doing work and to avoid manipulating their cuticles.  Treating nail biting is more involved, since it is a compulsive disorder.  There are intraoral appliances that can be worn at night.  Management may also involve stress management and medications directed at treating anxiety and compulsive obsessive disorders.  To read more about these conditions click HERE, HERE and HERE.