Paronychia

Overview

Definition

Paronychia is inflammation or infection of the skin around a fingernail or toenail.

It may be acute, which means it just started. Chronic is one that causes problems for 6 weeks or more.

Infection Surrounding the Nail
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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 you come in contact with often.

Risk Factors

Things that may increase your chance of paronychia include:

  • Diabetes
  • Suppressed 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

SymptomsandDiagnosis

Symptoms

Paronychia may cause:

  • 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 the cuticle

Diagnosis

The doctor will ask about your 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.

Treatments

Treatment

Acute Paronychia

Minor swelling or redness may be treated by warm water soaks. Antibiotic creams or gels may be given as well. It can 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.

Chronic Paronychia

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 permanent damage.

Prevention

To help reduce your chances of paronychia:

  • Keep your hands and feet clean and dry. Use a moisturizer after hand washing.
  • Wear rubber gloves if you often come in contact with water or chemicals.
  • Avoid biting or picking your nails.
  • Avoid cutting, pulling, or tearing your cuticles.
  • Avoid artificial nails, vigorous manicures, or treatments that remove the cuticles.
  • Practice proper hygiene. Do not share bathroom supplies.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

American Academy of Dermatology https://www.aad.org 

National Institute of Arthritis and Musculoskeletal and Skin Diseases https://www.niams.nih.gov 

CANADIAN RESOURCES

Canadian Dermatology Association https://dermatology.ca 

Health Canada https://www.canada.ca 

References

Paronychia. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/paronychia.html. Updated January 2015. Accessed December 31, 2019.

Paronychia. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115236/Paronychia  . Updated August 11, 2017. Accessed December 31, 2019.

Leggit J. Acute and chronic paronychia. Am Fam Physician. 2017;96(1):44-51.