Habit Tic Deformity

A young woman attended the Primary Care clinic to have the bilateral nail bed deformities on her thumbs evaluated. The woman admitted to regular nail picking. The nail abnormalities were diagnosed as habit tic deformity, a traumatic injury to the nail that occurs as a result of a picking or biting tic. The thumbnail is most commonly affected as it is picked by the index finger of the same hand. Habit tic deformity is associated with anxiety and obsessive-compulsive disorder. If the picking behavior ceases, the nail bed generally normalizes as it grows out. Physical barriers such as tape can aid in extinguishing the picking behavior. Individuals may be referred to a mental health specialist if the tic is associated with an underlying psychological condition.