Paronychia is an infection of the tissue adjacent to a nail, generally at the edge of a fingernail on the side or at the bottom of it. It occurs when bacteria or fungi get under the skin.
The painful lesion usually occurs on one side of the nail but, if left untreated, can spread around the whole nail. It can develop around toenails as well as fingernails, though it is less often found around toenails than around fingernails.
It is fairly common. It can produce swelling, redness, and pain in the affected area. Over time, the infection could result in fluid-filled blisters. It is possible to have both bacterial and fungal infections at the same time
The skin infection causes inflammation, swelling and discomfort around or next to the nail. An abscess, which is a blister containing pus, may form.
It is caused by injury or irritation such as a hangnail, cuticle damage or continually wet hands.
There are two types of paronychia, namely acute and chronic paronychia. Acute paronychia develops over hours or days. The infection does not usually spread deep into the finger and treatment can reduce symptoms relatively quickly.
Chronic paronychia on the other hand occurs when symptoms last for at least six weeks. It develops more slowly and can become more serious.
Most cases of paronychia are not serious. Paronychia can occur at any age and is easily treatable.
Causes
Paronychia can result from biting or chewing the nails or pulling off a hangnail, which is a bit of skin hanging near the root of the nail The infection occurs when the skin around the nail becomes damaged, allowing germs to enter.
It is common when working conditions require the hands to be frequently wet or exposed to chemicals
Common causes of skin damage around the nail include biting or chewing the nails, clipping the nails too short, manicures, excessive exposure of the hands to moisture, including frequently sucking the finger, and ingrown nails.
Children do not normally develop paronychia in their toes, unless they have an ingrown toenail.
Symptoms
The tissue adjacent to the nail is painful, red and swollen. Symptoms include swelling, tenderness and redness around the nail. There may be pus filled abscesses. With the chronic condition there may be hardening of the nail, deformation or damage to the nail and the nail separating from the nailbed.
Some symptoms of paronychia resemble those of other skin infections. Some directly affect the nail itself.
If the redness extends beyond the skin around the nail or to the pad of the finger, seek medical attention. This redness indicates that a nail infection may be developing into a more serious finger infection, called a felon, with pus development in the deep tissues of the fingertip.
Risk Factors
Diabetics are more susceptible to skin infections in general and more likely to develop paronychia. Diabetics take longer to recover from infections than non-diabetics. Paronychia is also common in people who have medical conditions that cause poor blood circulation.
Paronychia is more common in people with certain jobs, such as fishermen, dairy farmers, bartenders, and cleaners. This is due to the fact that their profession exposes them to bacteria as well as the danger of skin cuts.
Women, particularly homemakers, are more likely to be affected than males.
Treatment
Treatment for paronychia will vary depending on its severity and whether it is chronic or acute.
If symptoms are mild and the infection has not spread beyond the fingernail it is possible to treat paronychia at home. Try soaking the affected finger or toe in warm water with salt three to four times a day.
If symptoms do not improve after a few days or the infection has spread further than the nail it is important to see a doctor. If the symptoms are severe contact a doctor immediately.
When a bacterial infection causes acute paronychia a doctor may recommend an antibiotic. When a fungal infection causes chronic paronychia, the doctor may prescribe antifungal medication.
If there is an abscess pus may need to be drained. This is best done by the doctor or other healthcare professional. It is not advisable to try to drain the pus on your own at home.
The doctor may provide a local anaesthetic then open the nail fold enough to insert gauze which will help drain the pus.
Your doctor may send a sample of the pus from your infection to a laboratory if treatment does not seem to be helping. This will determine the exact infecting agent and allow your doctor to prescribe the best treatment.
Chronic paronychia may require weeks or months of treatment. It is important to keep your hands dry and clean throughout. If your job requires your hands to be wet or exposed to germs consider taking some time off.
Preventing nail infections
You can reduce your risk of developing nail infections by moisturising your hands after washing them; avoiding biting or chewing your nails; taking care when cutting your nails and keeping your hands and nails clean. Also avoid submerging your hands in water for long periods and avoid contact with irritants.
It helps to keep your nails short and hands dry and clear of chemicals that will help you avoid chronic paronychia. When working with water or severe chemicals, wear gloves.
