Child Caring

Finger-picker, nail-biter, toe-biter. Yikes!

Hi Barbara,
Was hoping you could share some advice. I have a soon to be 4 year old happy- go- lucky boy who has one very bad habit - he is constantly picking his skin and nails.
Usually it's his finger and toenails, and occasionally his lips. It's serious enough that he has actually picked the nail off two of his toes. He is also constantly picking at the skin around his fingers and occasionally will do the same to his lip. It's not unusual to see he skin inflamed and sometimes, cut.

So our dilemma is we don't want to make a huge deal about it but are trying to find a way for him to stop.

He is a strong-willed child, so threats (like wearing gloves to bed, or withholding favorite items like a blanket) don't work. He also sometimes gets upset when he has picked to the point of pain ("I'm hurting ").

He is otherwise very typical - goes to pre-school, plays well with others. We just don't know how to deter this bad habit without creating a "thing". Any suggestions and why do you think he does this?

Many thanks
From: , Steve. Newburyport, MA

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Hi Steve,

This kind of habit typically begins as a soothing mechanism. Much as a baby finds his/her thumb is a source of comfort, finger or foot tapping typically starts as a way to expend unused energy, hair-pulling often begins as a way to concentrate. The genesis for nail biting is typically tactile: there's rough skin or a hang nail and you pick it to make it smooth again. A source of control? Maybe that, too. From there, it becomes habitual and sometimes a ritual. In other words, this is not necessarily the result of stress and is often wrongly labelled a "nervous habit."

Forget trying to be punitive. It rarely works with nail/cuticle pickers because it just makes them feel ashamed. Instead, offer a substitute object that feels good to the touch -- a smooth stone or seashell, a small squeezable ball -- that he can easily carry in all his pockets so they are handy when he feels the need. Because the worry of infection is real, matter-of-factly clip his finger and toenails and cuticles short and neat, on a daily basis. Rub some cream or Vaseline on them to keep them soft. Just make it part of his bedtime routine. If you see one that's been bleeding, pop a Band Aid on asap. Be firm, "My job is to keep you healthy. That means to make sure this doesn't get infected." That way, it's about you, not about his behavior. Natural consequences -- one infected toe that needs medical attention might -- or might not! -- be just the cure, but I'm not suggesting that! I would comfortably say that you should not waste your money on products that taste bad.

The truth is, habits like these are hard to break unless the child wants to stop. You can ask him if it bothers him or if kids tease him (Keep it impersonal: "When I was a kid, there was someone in my class who picked his lip and he got really badly teased....." See where that goes.) If he sort of wants to stop, suggest he mark a paper every time during the day that he picks. How many times would be ok? How many would be too many? Then let him count how often it happens so he can decide if it's too much. Star charts can sometimes help children this age. Set a goal together, for instance, any number less than X is worthy of special time with you.