Skin Infection Around a Fingernail or Toenail (Paronychia)

What is paronychia?

Paronychia is an infection of the skin next to a fingernail or toenail.

What is the cause?

The cutting or tearing of a hangnail or cuticle, nail biting, a splinter, or a thorn prick can cause a break in the skin near the nail. Bacteria or a fungus can then get into the skin and cause an infection.

A sudden painful infection is usually caused by bacteria commonly found on the skin. Infection that develops slowly is called chronic. It is usually caused by a fungus. You have a higher risk of having a chronic nail infection if:

  • Your job involves a lot of exposure to water or chemical solvents. Examples of such jobs are housecleaning, nursing, food service, and dishwashing.
  • You bite or tear your nails and cuticles.

These infections are more common and may be harder to treat in people who have diabetes or poor circulation, and in people whose immune systems are weakened by HIV, cancer, or other health problems.

What are the symptoms?

Symptoms may include:

  • Painful, red, swollen skin around the nail
  • Pus-filled blisters around the nail

If you have the infection for a long time, your nail may become thick and hard.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may also have blood tests or a swab of the fluid from the sore to see what is causing the infection.

How is it treated?

For an infection caused by bacteria your healthcare provider may prescribe an antibiotic. For a fungal infection, your provider may prescribe an antifungal cream.

If you have pus-filled blisters, your healthcare provider may numb your finger or toe and then cut the pocket open to drain the pus. If the infection is beneath the nail, your provider may remove a section of the nail. Your provider may pack the wound with gauze to allow it to drain and heal.

Usually it takes about a week for a bacterial infection to heal. You may need to treat a fungal infection for several weeks with antifungal medicine before it heals.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. The best time to take care of an infection around your nails is as soon as it starts to develop.

  • Wash the infected area with antibacterial soap and water and rinse it thoroughly.
  • Soak your finger or toe in warm water or put a washcloth that has been soaked with hot water on the infected area.
  • Put an antibiotic ointment on the area and cover it with a bandage.
  • Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
    • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
    • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

Ask your healthcare provider:

  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent paronychia?

  • Do not pick at your nails or cut the cuticles.
  • Don’t bite your nails.
  • If you want to push the cuticles of your nails back, use clean instruments and be careful not to push too hard.
  • Wear gloves if your work or daily activities put your hands at risk for getting scratched, poked, or irritated.
  • If you have infections around your nails often, talk to your provider.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-10-21
Last reviewed: 2014-07-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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