What is Paronychia

Paronychia is an infection of the skin that surrounds a nail. It usually affects the skin around a fingernail, but it may also occur near a toenail. It often causes pain and swelling around the nail. In some cases, a collection of pus (abscess) can form near or under the nail.

This condition may develop suddenly, or it may develop gradually over a longer period. In most cases, paronychia is not serious, and it will clear up with treatment.

What are the causes?

This condition may be caused by bacteria or a fungus. These germs can enter the body through an opening in the skin, such as a cut or a hangnail.

What increases the risk?

This condition is more likely to develop in people who:

• Get their hands wet often, such as those who work as dishwashers, bartenders, or nurses.
• Bite their fingernails or suck their thumbs.
• Trim their nails very short.
• Have hangnails or injured fingertips.
• Get manicures.
• Have diabetes.

What are the signs or symptoms?

Symptoms of this condition include:

• Redness and swelling of the skin near the nail.
• Tenderness around the nail when you touch the area.
• Pus-filled bumps under the skin at the base and sides of the nail (cuticle).
• Fluid or pus under the nail.
• Throbbing pain in the area.

How is this diagnosed?

This condition is diagnosed with a physical exam. In some cases, a sample of pus may be tested to determine what type of bacteria or fungus is causing the condition.

How is this treated?

Treatment depends on the cause and severity of your condition. If your condition is mild, it may clear up on its own in a few days or after soaking in warm water. If needed, treatment may include:

• Antibiotic medicine, if your infection is caused by bacteria.
• Antifungal medicine, if your infection is caused by a fungus.
• A procedure to drain pus from an abscess.
• Anti-inflammatory medicine (corticosteroids).

Follow these instructions at home:

Wound care

• Keep the affected area clean.
• Soak the affected area in warm water, if told to do so by your health care provider. You may be told to do this for 20 minutes, 2–3 times a day.
• Keep the area dry when you are not soaking it.
• Do not try to drain an abscess yourself.
• Follow instructions from your health care provider about how to take care of the affected area. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
• If you had an abscess drained, check the area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

General instructions

• Avoid contact with harsh chemicals.
• Do not pick at the affected area.

Prevention

• To prevent this condition from happening again:
  • Wear rubber gloves when washing dishes or doing other tasks that require your hands to get wet.
  • Wear gloves if your hands might come in contact with cleaners or other chemicals.
  • Avoid injuring your nails or fingertips.
  • Do not bite your nails or tear hangnails.
  • Do not cut your nails very short. 
  • Do not cut your cuticles.
  • Use clean nail clippers or scissors when trimming nails.

Contact a health care provider if:

• Your symptoms get worse or do not improve with treatment.
• You have continued or increased fluid, blood, or pus coming from the affected area.
• Your finger or knuckle becomes swollen or difficult to move.

Get help right away if you have:

• A fever or chills.
• Redness spreading away from the affected area.
• Joint or muscle pain.

Summary

• Paronychia is an infection of the skin that surrounds a nail. It often causes pain and swelling around the nail. In some cases, a collection of pus (abscess) can form near or under the nail.
• This condition may be caused by bacteria or a fungus. These germs can enter the body through an opening in the skin, such as a cut or a hangnail.
• If your condition is mild, it may clear up on its own in a few days. If needed, treatment may include medicine or a procedure to drain pus from an abscess.
• To prevent this condition from happening again, wear gloves if doing tasks that require your hands to get wet or to come in contact with chemicals. Also avoid injuring your nails or fingertips.