Nail Biting, Lip Picking, and Skin Picking: BFRBs Explained Including Onychophagia and Cuticle Picking

Nail Biting, Lip Picking, and Skin Picking: BFRBs Explained Including Onychophagia and Cuticle Picking

By: Ellen Crupi, HabitAware Director of Awareness 

Trichotillomania (hair pulling disorder) and Dermatillomania (skin picking disorder) are not the only BFRBs.  Did you know that nail biting, lip picking, finger picking, and cheek biting are also BFRBs?  

And they have some hard-to-pronounce medical names too:

Onychophagia:  Compulsive nail biting
Excoriation Disorder:  Compulsive Lip, Finger, and Skin Picking
Morsicatio Buccarum:  Compulsive Cheek Biting 

What is Onychophagia? The Truth About Nail Biting and Nail Picking

Onychophagia or compulsive nail biting is a pathological oral habit and grooming disorder characterized by chronic, seemingly uncontrollable nail biting that is destructive to fingernails and the surrounding tissue. Onychophagia might be considered more “socially acceptable” as compared to hair pulling or skin picking disorders, even seeping into our daily language - "That ball game was a nail biter!"

But the emotional and physical side effects can be just as damaging. Nail biting has terrible side effects of damage and infections to the nails and surrounding tissue, pain and physical discomfort, as well as feelings of shame and guilt for not being able to control our own hands.  

What is Compulsive Lip Picking?

Lip picking is another form of Skin Picking Disorder (Excoriation Disorder/Dermatillomania) that targets the lips or inside of the mouth, picking the skin with one’s own fingers. While most people might occasionally pick or pull at their dry lips, those with Lip Picking Disorder find it impossible to resist pulling or biting off a bit of peeled skin on their lips.  Lips feel as if they can never be smooth or soft without the picking which fuels the vicious picking cycle.  Compulsive Lip Picking can result in damage, bleeding, infections, scarring as well as disruption to ordinary activities, such as eating or kissing, and can cause discomfort and pain, plus emotional distress from the shame and guilt of not being able to control the behavior.

Lip Picking Dangers

Lip picking, a subset of Dermatillomania, involves the constant urge to pick at the lips or inside the mouth. While many may occasionally pick at dry lips, those with Lip Picking Disorder find it impossible to resist the urge to pull or bite peeled skin on their lips. This behavior often leads to damage, bleeding, infections, and scarring. It can disrupt everyday activities such as eating and kissing, causing discomfort and pain. Furthermore, individuals often grapple with emotional distress, feeling ashamed and guilty about their inability to control the habit.

The consequences of lip picking dangers can extend beyond physical harm. Chronic lip picking can impact one's self-esteem and overall well-being. The visible effects of this habit can make individuals feel self-conscious, leading to social anxiety and withdrawal from social situations.

What is Compulsive Finger Picking?

Finger, or nail picking is another form of Skin Picking Disorder (Excoriation Disorder/Dermatillomania) that targets the nail, cuticle and surrounding tissue. There is some crossover among people with nail biting urges (using teeth) and those with nail picking urges (using fingers), but not always.  This disorder can result in nail and tissue damage, scarring, infections and the emotional guilt, shame and fear of being judged.  

What is Morsicatio Buccarum?

Cheek biting is a behavior where the person bites or chews the inside of their mouth or tongue. Some favor a certain portion of the inner cheek, causing a concentrate on one area. This can result in areas that are raw and feel jagged. The broken skin can trigger an added compulsion to smooth the damaged area, creating a cycle of continuing biting behavior and worsening injury. Dentists often discourage this behavior because it can result in infection and mouth sores. 

What do these four BFRBs have in common?

They are chronic medical disorders.  Nail biting, finger picking, lip picking and cheek biting are all chronic mental disorders that involve recurrent, irresistible urges to bite, pull or pick at one's body, despite trying to stop resulting in physical wounds to the site (fingers, lips, nails, inside cheek) and significant distress, feelings of guilt, shame, fear, isolation, fear of being judged, depression, and anxiety.

They serve a purpose.  They are coping mechanisms, helping us through uncomfortable situations, from anxiety to boredom. They do an excellent job of self-soothing, in the moment. Those favorable side effects are temporary, like the eye of the storm. Once the calm, trance-like feeling fades, the terrible long term side effects set in and leave in its wake the physical and mental scars.

They fall into two types:

  • Focused means a person is goal-oriented and aware of the picking, pulling or biting.  i.e., picking fingers with or without tools, such as cuticle nippers.  
  • Automatic means the person is unaware of the picking, biting or pulling; and the behavior typically occurs while doing other activities, such as watching TV, reading, studying, and driving.  

While a person with a BFRB might lean towards one type over the other, typically the person engages in both types of behavior. For anyone who suffers with or knows someone who suffers from nail biting, lip picking, finger picking or cheek biting know that:

This is not your fault 

You did not choose to have a chronic condition

While there is no cure

Control is possible! 

Can Keen2 help in Taking Control of Nail Biting, Finger Picking and Lip Picking?  

YES! With the right mindset, Keen2 is a holistic system on your wrist and can help you take control of BFRBs that you do with your hands: Chronic Nail Biting, Compulsive Finger Picking, and Compulsive Lip Picking. You train Keen2 to sense your wrist movement…. 

- the way your wrists moves when you bite your nails
- the way your wrists moves when you pick your lips
- the way your wrists moves when your hands are picking at your fingers


Keen2 gesture detection senses the subtle wrist movement and sends a gentle vibration to build awareness.  Once aware, Keen2 coaches you through healthier strategies and Retrains Your Brain. In fact, we helped Deena crush a 70-year nail biting habit!...and Sarah stopped nail biting with Keen too! 

Note:  Keen2 cannot sense one-handed finger picking, as the gesture is too subtle on the wrist, mostly in the fingers. Check back with us though, as we are always working to improve our technology.

Can Keen2 help with Cheek Biting?

This one is more nuanced.  If you cheek bite by putting your finger to your cheek, pressing and then biting, Keen2 might work for you.  It will depend on your specific wrist movement.  However, if your behavior is teeth to the inside cheek, Keen2 is not the right tool AND there still is hope!

For people with nail biting, lip biting or cheek chewing, here are a few strategies to try to satisfy the oral behavior.  

  • Chewing gum
  • Wearing a mouth guard
  • Drinking water
  • Write “lips together teeth apart” on a piece of paper as a reminder
  • Suck on sugar free candies
  • Cut up a bunch of carrots, celery, apples into tiny pieces for snacking
  • Snack on sunflower seeds 
  • Play with dental floss, tooth picks

Add some for finger picking:

  • Fidgets
  • Liquid bandaid around skin
  • Finger gloves 
  • Gloves
  • Cuticle serum and hand cream
  • Pop bubble wrap
  • Coloring, painting, drawing 

Continue to practice through a lens of self care, and focus on what is possible, not what is perfect.  

Taking Control of BFRBs Begins with Keen Awareness.

Taking control is possible. Tens of thousands of people all over the globe have taken control of BFRBs with HabitAware Keen Awareness. Keen2 is a smart bracelet - your awareness and response coach - helping YOU take control.  It's a holistic system on your wrist, and in your pocket. 

Now you know there is hope. You can take control with the right mindset and with Keen2 Awareness and Response Coach!



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