Paronychia is a common and sometimes painful condition that affects the skin around the fingernails or toenails. It happens when this skin becomes inflamed, often due to an infection. Although it’s usually not a serious medical issue, it can cause discomfort and sometimes complications if left untreated.

What Is Paronychia?

Paronychia is an infection of the nail folds, which are the areas of skin that frame and support the nail. It can be either acute or chronic, depending on how quickly it develops and how long it lasts. Acute paronychia usually starts suddenly and doesn’t last long, while chronic paronychia develops over time and can persist for weeks or even months (Bolognia et al., 2018).

Causes of Paronychia

Paronychia is usually caused by bacteria, especially in acute cases. A common culprit is Staphylococcus aureus, a type of bacteria found on the skin. Sometimes, Streptococcus or other bacteria may also be involved. In chronic cases, fungi such as Candida albicans are more commonly the cause, especially when the area stays moist for long periods (Ruben et al., 2022).

The infection often starts when the skin around the nail is broken, which can happen due to:

  • Nail biting or picking
  • Frequent exposure to water or chemicals (e.g., in dishwashing or hairdressing jobs)
  • Improper nail trimming
  • Injuries or trauma to the nail area
  • Artificial nails or nail treatments that damage the cuticle

Symptoms of Paronychia

The symptoms of paronychia can vary depending on whether the infection is acute or chronic:

Acute Paronychia:

  • Redness and swelling around the nail
  • Pain or tenderness
  • Pus-filled blisters near the nail
  • Warmth in the affected area

Chronic Paronychia:

  • Swelling that comes and goes
  • Redness around the nail fold
  • Discoloration or changes in the shape of the nail
  • Nail thickening or separation from the nail bed

Chronic cases tend to affect more than one finger or toe and often occur in people who frequently have wet hands or underlying skin conditions like eczema (Goh et al., 2020).

Diagnosing Paronychia

Doctors usually diagnose paronychia based on how the nail area looks and a person’s history of symptoms. Sometimes, if pus is present, they may take a sample to identify the bacteria or fungi causing the infection. This helps in choosing the most effective treatment (Habif, 2015).

Treatment Options

Treatment for paronychia depends on whether it’s acute or chronic and how severe the symptoms are.

For Acute Paronychia:

  • Warm Soaks: Soaking the affected finger or toe in warm water several times a day can reduce swelling and promote drainage.
  • Topical Antibiotics: These are used if the infection is mild.
  • Oral Antibiotics: For more severe infections or if pus is present.
  • Incision and Drainage: If an abscess forms, a doctor may need to drain the pus to relieve pain and promote healing.

For Chronic Paronychia:

  • Avoiding Irritants: Keeping hands dry and avoiding contact with harsh chemicals is crucial.
  • Topical Steroids: These may help reduce inflammation.
  • Antifungal Creams: If a yeast infection is suspected, antifungal medications are used.
  • Lifestyle Changes: Using gloves while working in wet conditions and moisturizing regularly can prevent recurrence.

Preventing Paronychia

Here are some simple steps to help prevent paronychia:

  • Avoid biting or picking at nails and cuticles.
  • Trim nails properly without cutting into the skin.
  • Keep hands and feet clean and dry.
  • Use gloves when working with water or harsh chemicals.
  • Moisturize hands regularly, especially around the nail beds.

When to See a Doctor

While mild paronychia often goes away on its own, medical attention is needed if:

  • The infection doesn’t improve with home treatment
  • Pus or abscess forms
  • The pain becomes severe
  • There is spreading redness or fever, which could indicate a more serious infection

Paronychia is a common but manageable infection of the nail area. With proper care and treatment, most people recover quickly and without complications. Recognizing early symptoms and taking preventive measures can help avoid the condition altogether. If symptoms worsen or don’t improve, it’s important to consult a healthcare provider.

References

  1. Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (2018). Dermatology (4th ed.). Elsevier.
  2. Goh, M. S. Y., Leong, K. P., & Tan, H. H. (2020). Chronic paronychia: A review of current management. Dermatology Reports, 12(1), 8791. https://doi.org/10.4081/dr.2020.8791
  3. Habif, T. P. (2015). Clinical Dermatology: A Color Guide to Diagnosis and Therapy (6th ed.). Elsevier.
  4. Ruben, B. S., Abbas, O., & Andea, A. A. (2022). Paronychia. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470271/

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