Paronychia

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

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What is paronychia?

Paronychia is an infection of your nail fold caused by bacteria or a fungus. The nail fold is the skin around your nail. Paronychia may happen suddenly and last for 6 weeks or longer. You may have paronychia on more than 1 finger or toe.

What increases my risk for paronychia?

• Trauma: Any injury that causes your skin to tear can lead to infection. Your risk is increased if you have ingrown nails, bite your nails, or wear acrylic nails.
• Frequent contact with water: Jobs that require you to soak your hands in water often may increase your risk for paronychia. Common examples are nurses, cooks, and bartenders. Swimmers also have increased risk.
• Medical conditions: Diabetes and other conditions that cause a weak immune system can increase your risk. Some examples are skin cancer, psoriasis, HIV, and lupus.
• Chemicals: Contact with soaps, detergents, and other chemicals can cause inflammation and lead to paronychia.
• Allergies: Allergies to certain foods, nail polish, or latex can cause inflammation and increase your risk.

What are the signs and symptoms of paronychia?

• Red, hot, swollen, painful nail fold
• Pus coming out of your nail fold when you press on it
• Nail that pulls away from your nail fold and may fall off
• Changes in nail color, such as green nails
• Fever
• Thick, rough nail, or ridges in the nail

How is paronychia diagnosed?

Your healthcare provider will examine your nails and ask about your symptoms. Your provider may press on your infected nail to see if pus drains from it. Your provider will send any pus to a lab for tests to learn what germ is causing your infection. This is called a fluid culture.

How is paronychia treated?

• Medicine:
  • Td vaccine is a booster shot used to help prevent tetanus and diphtheria. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.
  • Antibiotics: This medicine will help fight or prevent an infection caused by bacteria. It may be given as a pill, cream, or ointment.
  • Steroids: This medicine will help decrease inflammation. It may be given as a pill, cream, or ointment.
  • Antifungal medicine: This medicine helps kill fungus that may be causing your infection. It may be given as a cream or ointment.
  • NSAIDs: These medicines decrease pain and swelling. NSAIDs are available without a doctor's order. Ask your healthcare provider which medicine is right for you. Ask how much to take and when to take it. Take as directed. NSAIDs can cause stomach bleeding and kidney problems if not taken correctly.
• Procedures: You may need surgery to drain an abscess (pus pocket) in your finger or toe. Your nail may need to be removed. Infected tissue around your nail may also need to be removed.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• nystatin
• mupirocin
• clotrimazole
• econazole
• bacitracin/neomycin/polymyxin b

View more treatment options

What are the risks of paronychia?

Your nail may become loose, deformed, or fall off. The infection may form a large abscess on your nail. The infection may spread to nearby tissue and bone.

How can paronychia be prevented?

• Avoid chemicals and allergens that may harm your skin and nails. This includes soaps, laundry detergents, and nail products.
• Keep your nails clean and dry. Do not soak your nails in water. Use cotton-lined rubber gloves or wear 2 rubber gloves if you work with food or water. The gloves will help protect your nail folds.
• Keep your nails short. Do not bite your nails, pick at your hangnails, suck your fingers, or wear fake nails. Bring your own nail tools when you go to the nail salon.

How can I manage my symptoms?

• Soak your nail: Soak your nail in a mixture of equal parts vinegar and water 3 or 4 times each day. This will help decrease inflammation.
• Apply a warm compress: Soak a washcloth in warm water and place it on your nail. This will help decrease inflammation.
• Elevate: Raise your nail above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your nail on pillows or blankets to keep it elevated comfortably.
• Use lotion: Apply lotion after you wash your hands. This will prevent the skin from becoming too dry.

When should I seek immediate care?

• You have severe nail pain.
• The inflammation spreads to your hand or arm.

When should I call my doctor?

• Your nail becomes loose, deformed, or falls off.
• You have a large abscess on your nail.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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