An Overview

Depending on the cause of the infection, paronychia may come on slowly and last for weeks or show up suddenly and last for only one or two days. The symptoms of paronychia are easy to spot and can usually be easily and successfully treated with little or no damage to your skin and nails. Your infection can become severe and even result in a partial or complete loss of your nail if it’s not treated. A paronychia is an infection of the skin that surrounds a toenail or fingernail. There are two different types of paronychia, acute and chronic:

• Acute paronychia. This usually appears as a sudden, very painful area of swelling, warmth and redness around a fingernail or toenail, usually after an injury to the area. An acute paronychia typically is caused by an infection with bacteria that invade the skin where it was injured. The injury can be caused by overaggressive manicuring (especially cutting or tearing the cuticle, which is the rim of paper-thin skin that outlines the outer margins of your nail). It can also result from biting the edges of the nails or the skin around the nails, picking at the skin near the nails or sucking on the fingers.
• Chronic paronychia. This is an infection that usually develops slowly, causing gradual swelling, tenderness and redness of the skin around the nails. It usually is caused by Candida or other species of yeast (fungus). It often affects several fingers on the same hand. People who are more likely to get this infection include those with diabetes or workers whose jobs constantly expose their hands to water or chemical solvents. Such jobs include bartending, house cleaning, janitorial work, dentistry, nursing, food service, dishwashing and hairdressing.

Symptoms paronychia

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 of paronychia

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. It may come as a surprise that the most infections originate from the human mouth; thus, bacteria isolated from paronychia often include all types of bacteria, both aerobic and anaerobic. Chief among these bugs are species of Staphylococcus aureus and Streptococcus species.
Paronychia is typically painful and can occur in healthy people. However, immunocompromised people (such as those with HIV) may experience hard-to-treat chronic paronychia. Furthermore, people with diabetes can get chronic paronychia caused by fungi like Candida albicans.
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

How paronychia is treated

• Home treatments are often very successful in treating mild cases. If you have a collection of pus under the skin, you can soak the infected area in warm water several times per day and dry it thoroughly afterward. The soaking will encourage the area to drain on its own.

• Your doctor may prescribe an antibiotic if the infection is more severe or if it isn’t responding to home treatments.

• You may also need to have blisters or abscesses drained of fluids to relieve discomfort and speed healing. This should be done by your doctor in order to avoid spreading the infection. When draining it, your doctor can also take a sample of pus from the wound to determine what is causing the infection and how best to treat it.

• 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.

What kind of antibiotics do you use for paronychia?

  • Paronychia is often treated with antibiotics, either topical or oral or both. Chronicparonychia is most often caused by a yeast infection of the soft tissues around the nail but can also be traced to a bacterial infectio


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
  • Sometimes paronychia can extend under part of the nail. In these cases, either part or all the nail needs to be removed. A paronychia that is left untreated can sometimes surround the entire nail margin and result in a “floating” nail
  • After a paronychia is drained of pus, there is usually no need for antibiotics. However, if the paronychia is accompanied by localizedcellulitis or skin infection, then antibiotics are needed to treat the skin infection.

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