Paronychia

Causes

Acute paronychia is often caused by bacteria. It enters through damaged skin such as torn cuticles, cuts, or cracks. Chronic paronychia may be caused by an allergen or irritant that a person comes in contact with often.

Risk Factors

Paronychia is more common in women. Other things that may raise the risk are:

• Diabetes
• A weak immune system
• Work that has contact with chemicals or water such as food service, cleaning, dentistry, bartending, hairdressing, and nursing
• Nail-biting or picking, and finger sucking
• Damage from aggressive trimming of nails or cuticles
• Ingrown nail

Symptoms

Symptoms of paronychia may be:

• Redness and swelling of the skin around the nail
• Pus near the nail
• Pain and tenderness to the touch
• Change in nail color or ridges on nail
• Loss of tissue at the nail bed (cuticle)

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor can see paronychia during the exam. A sample of the pus may be taken. It will help find the germ that is causing the problem.

The doctor may also ask about work or hobbies that may be linked to the problem.

Treatment

For Acute Paronychia

For Chronic Paronychia

The goal is to ease the inflammation and prevent or treat any infection. The person may need to change habits that have led to paronychia.

Minor swelling or redness may be treated by warm water soaks. Antibiotic creams or gels may be placed on the skin. This type of paronychia often heals within 5 to 10 days.

More severe infections may need extra care. Pus may build up in the area. It can cause a lot of pressure and pain. The doctor may need to drain the pus. A part of the nail may also be removed. Antibiotic pills may also be needed for some infections.

Inflammation is the main problem of chronic paronychia. Cortisone creams can help to ease inflammation.

Good skin care is also important. Contact with irritants will need to be avoided. Surgery may be needed if these steps are not effective.

Symptoms may go away with treatment. The nail or tissue around the nail may have some lasting damage.

Prevention

To help reduce the risk of paronychia:

• Keep hands and feet clean and dry. Use a moisturizer after hand washing.
• Wear rubber gloves if there is frequent contact with water or chemicals.
• Do not bite or pick nails.
• Do not cut, pull, or tear cuticles.
• Avoid artificial nails, vigorous manicures, or treatments that remove the cuticles.
• Practice proper hygiene. Do not share bathroom supplies.