How to treat paronychia (an infected nail)

Paronychia is a skin infection that develops around the nail. It occurs when bacteria or fungi get under the skin.

Paronychia can result from biting or chewing the nails, but it is more common when working conditions require the hands to be frequently wet or exposed to chemicals.

Most cases of paronychia are not serious, and there are several effective treatments. This article will discuss the causes and treatments of the infection.

What is paronychia?

Paronychia is an infection that can occur around the nail.

Paronychia is an infection of the skin around the nail of at least one finger or toe. It typically develops around the edges of the nail at the bottom or sides.

This skin infection causes inflammation, swelling, and discomfort around the nail. Abscesses containing pus can also form.

There are two types of paronychia:

Acute paronychia. This develops over hours or days. The infection does not usually spread deep into the finger, and treatment can reduce symptoms relatively quickly.

Chronic paronychia. This occurs when symptoms last for at least 6 weeks. It develops more slowly and can become more serious. Chronic paronychia often affects several digits at once.

Paronychia can occur at any age and is easily treatable.

In rare cases, the infection can spread to the rest of the finger or toe. If this happens, a person should see their doctor.

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Symptoms

Some symptoms of paronychia resemble those of different skin infections. Other symptoms directly affect the nail itself.

Paronychia symptoms include:

swelling, tenderness, and redness around the nail

puss-filled abscesses

hardening of the nail

deformation or damage to the nail

the nail separating from the nailbed

Causes

Biting the nails or the skin around the nails can cause infection. Image credit: Chris Craig, 2007.

The infection occurs when the skin around the nail becomes damaged, allowing germs to enter.

Bacteria or fungi can cause paronychia, and common culprits are Staphylococcus aureus and Streptococcus pyogenes bacteria.

Common causes of skin damage around the nail include:

biting or chewing the nails

clipping the nails too short

manicures

excessive exposure of the hands to moisture, including frequently sucking the finger

ingrown nails

Treatment

Treatments for paronychia will vary, depending on the severity and whether it is chronic or acute.

A person with mild, acute paronychia can try soaking the affected finger or toe in warm water three to four times a day. If symptoms do not improve, seek further treatment.

When a bacterial infection causes acute paronychia, a doctor may recommend an antibiotic, such as dicloxacillin or clindamycin.

When a fungal infection causes chronic paronychia, a doctor will prescribe antifungal medication. These medications are topical and typically include clotrimazole or ketoconazole.

Chronic paronychia may require weeks or months of treatment. It is important to keep the hands dry and clean throughout. If a person’s job requires their hands to be wet or exposed to germs, they may need to take time off.

A doctor may also need to drain any pus from surrounding abscesses. To do this, they will provide a local anesthetic, then open the nail fold enough to insert gauze, which will help drain the pus.

When to see a doctor

People can treat paronychia at home if symptoms are mild and the infection has not spread beyond the fingernail.

However, if symptoms do not improve after a few days or the infection has spread further than the nail, it is important to see a doctor.

If the symptoms are severe, contact a doctor immediately.

Preventing nail infections

Regularly moisturizing the hands, especially after washing, can help prevent nail infections.

People can reduce their risk of developing nail infections by using the following methods:

moisturizing after washing the hands

avoiding biting or chewing the nails

taking care when cutting the nails

keeping the hands and nails clean

avoiding submerging the hands in water for long periods

avoiding contact with irritants

keeping the nails short

Risk factors

Some people have a higher risk of paronychia, such as:

women

people with diabetes

people whose hands are frequently wet, including cleaners

people with other skin conditions, such as dermatitis

people with weakened immune systems

Diagnosis

In most cases, a doctor can easily diagnose paronychia with a physical examination. They will also consider a person’s medical history and look for risk factors, such as diabetes.

In some cases, a doctor may require a sample of any pus that is present. They can send this to a laboratory for analysis to check whether bacteria or fungi are causing the infection.

Summary

Paronychia is a skin infection around a fingernail or toenail. Symptoms include inflammation, swelling, pain, and discomfort. Biting or chewing the nails is a common cause.

Acute paronychia develops quickly, and treatment can reduce symptoms rapidly. People can treat mild cases at home. Chronic paronychia has a slower onset and can take weeks for treatment to effectively reduce symptoms.

Taking good care of the hands and nails is the best way to prevent paronychia.

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1 Comment

  1. nail fungal infection treatmentJanuary 15, 2019

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    Reply

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