What is paronychia? Paronychia, also called perionychia, is an infection and inflammation (redness, pain, and swelling) of your nail fold. The nail fold is the skin around your fingernails and toenails. Paronychia may be acute (sudden) or chronic (happen repeatedly over six weeks or longer). You may have paronychia in one or more fingers or toes. Treatment for paronychia may decrease the pain and swelling in your finger or toe. Treatment may also prevent the infection from spreading to nearby tissue.
What causes paronychia? Paronychia occurs when germs such as bacteria or fungi enter through broken skin in your nail fold. The germs may then cause an infection and inflammation. The following may increase your risk of having paronychia:
Allergies: Skin allergies to nail polish or latex may increase your chances of having paronychia. Having allergies to certain foods may cause inflammation in your skin leading to infections. This may happen to people who handle food often.
Certain medicines: Certain medicines used to treat HIV and cancer may increase your risk. Ask your caregiver for more information about these conditions and medicines.
Chemicals: Using certain soaps, detergents, and other chemicals often may cause your skin to become inflamed. This may lead to chronic paronychia.
Diseases: Some autoimmune diseases may cause your immune system to attack its own cells and cause inflammation. Autoimmune skin diseases include psoriasis, pemphigus vulgaris, or lupus erythematosus. Skin cancer and diabetes may also increase your chance of having paronychia. Ask your caregiver for more information about these diseases.
Ingrown nails: This is when your nail edge grows into your skin. An ingrown nail may cause a tear in your nail fold and lead to an infection. Ask your caregiver for more information about ingrown nails.
Injury: An injury to your nail fold may cause a break (tear) in your skin. Injuries may happen if you get a splinter in your finger or toe, or when you pick at a hangnail. A hangnail is a piece of loose skin in the area of your nail fold. Injury may also happen if you suck your fingers or bite your nails. Having manicures and wearing fake nails may also cause injury to your nail folds.
Repeated water soaking: Jobs that require you to soak your hands in water often may increase your risk for paronychia. Swimming often may also increase your risk.
What are the signs and symptoms of paronychia? With paronychia, you may have any of the following:
Changes in nail color, such as greenish nails.
Fever (high body temperature).
Nail that pulls away from your nail fold and may fall off.
Pus coming out from your nail fold when you press against it.
Redness, pain, and swelling of your nail fold.
Thick, rough nails, or ridges (lines) in one or more of your nails.
How is paronychia diagnosed? Your caregiver will look at your nails and nail folds. He will ask about your symptoms and when they started. He will also ask if you have had recent injuries to your fingers or toes. Tell your caregiver if your fingers or toes are soaked in water often. Your caregiver may also ask about soaps or chemicals you use. Tell your caregiver if you are taking any medicine, or if you have any medical conditions.
Digital pressure test: Your caregiver may ask you to press against your infected finger using your thumb. You may use your thumb from the same hand as your infected finger. This will help your caregiver check for an abscess (pus pocket) in your finger. If pus or fluid drains from your finger, it may be sent to a lab for tests. This will help your caregiver learn about the germ causing your infection.
How is paronychia treated? Treatment for paronychia may take many weeks. Chronic paronychia treatment may be slower and longer than treatment for acute paronychia. You may need any of the following:
Home treatments:
Warm compress: Apply a warm compress on your infected finger or toe to decrease pain and swelling. Ask your caregiver for more information about using a warm compress.
Soak solution: This is a solution with vinegar or medicine to decrease redness and swelling and to prevent infection. You may also soak your finger or toe in warm water. Ask your caregiver for more information about soak treatments.
Moisturizing lotion: Rub lotion into your nail folds, hands, and feet.
Medicine:
Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
Antifungal medicine: This medicine helps kill fungus that may be causing your infection.
Pain medicine: You may be given medicine to decrease your pain. Your caregiver will tell you how much, and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well if you wait too long to take it. Tell your caregiver if the pain medicine does not help, or if your pain comes back too soon.
Steroids: Steroid medicine may be given to decrease redness, pain, and swelling.
Topical medicine: This medicine is put on the skin around your nails. This may come as a cream or ointment. Topical medicine may help decrease pain and swelling, and may also prevent infection.
Surgery: You may need surgery to drain an abscess in your finger or toe. With chronic paronychia, you may need surgery to remove your nail or infected tissue around your nail. Ask your caregiver for more information about fingernail or toenail removal.
How can I prevent paronychia?
Rub moisturizing lotion into your hands after washing them.
Avoid chemicals that may harm your skin and nails. These may include soaps, laundry detergents, cuticle removers, primers, nail hardeners, or nail products containing acetone. Ask your caregiver for more information about other chemicals that may cause paronychia.
Avoid cutting or removing your nail fold when cleaning your fingernails or toenails.
Bring your own nail tools when having your fingernails or toenails cared for in nail salons.
If you have diabetes, keep your blood sugar at the level your caregiver suggests. Your infected nail fold may take longer to heal if you have diabetes. Ask your caregiver for more information about diabetes, and ways to control your blood sugar level.
Keep your nails short. Do not bite your nails, pick at your hangnails, suck your fingers, or wear fake nails.
Use cotton-lined rubber gloves or wear two rubber gloves when working with food or water. The gloves will help protect your nail folds.
Where can I find more information? Contact the following:
American Academy of Family Physicians 11400 Tomahawk Creek Parkway Leawood, KS 66211-2680 Phone: 1-913-906-6000 Phone: 1-800-274-2237 Web Address: http://www.aafp.org
When should I call my caregiver? Call your caregiver if:
You have a fever.
You have pus draining from around your infected finger or toe.
You have questions or concerns about your condition, treatment, or care.
When should I seek immediate help? Seek care immediately or call 911 if:
Your swelling and pain worsens in your finger or toe.
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. 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.
