Onychophagia describes chronic, habitual nail biting [1] and is classified as a body-focused repetitive behavior (BFRB) [2]. Biting may involve the nail plate, nail bed, nail matrix, and periungual skin [3] with varying clinical presentations dictated by the extent and severity of biting [4]. It is estimated that onychophagia affects between 20% and 30% of the general population [4–10]. Due to its association with psychiatric comorbidities, negative social implications, and embarrassment, onychophagia is often underrecognized in clinical practice, which may impact prevalence estimates [4, 11].