Onychophagia (nail-biting) and onychotillomania (nail-picking) are psychodermatoses, or behavior disturbances classified within body-focused repetitive behavior disorders (BFRBDs), which have been more frequently described in literature associated with the COVID-19 pandemic.1-7 Onychophagia is a misnomer, while “onychodaxia” would be the more appropriate nomenclature; people with onychophagia often bite multiple nails, mainly of hands, and are cognizant of behavior. It is estimated to affect up to 20-30% of population and up to 45% of 10 years children to puberty.5 Nail pickers know that the nail dystrophy is due to tools to pick and pull, or excess in manicure them, whereas patients with habit-tic nail deformity are often unaware of their abnormal nails origin.2 Patients with onychophagia or onychotillomania can have repetitive behaviors involving skin or hair. Nail-biting and nailpicking are difficult to control, but tiny nail signs can favor early psychological and physical intervention that improve the outcome; besides pharmacotherapy, habit-reversal training stimulus control, cognitive behavioral aversion therapy, topical bitter ingredients, and the gloves.1,2 The BFRBs include hair pulling, skin picking, onychophagia, and onychotillomania, which are associated with psychiatric conditions, such as anxiety and obsessive-compulsive disorder (OCD).3 The COVID-19 pandemic, with the adoption of strict social isolation, increased the anxiety status among the nail pickers and biters who have developed a worsening of symptoms during this period
