PARONYCHIA

 Basic information

description

Paronychia is an inflammation of tissue folds that surround a nail. The inflammation can be from bacterial or fungal infection, and is not contagious. It usually occurs on the hands and less often on the feet.

FREQUENT SIGNS & SYMPTOMS

• Bacterial paronychia:
  • Pain or tenderness, redness, warmth, and swelling of tissue adjacent to the fingernail.
  • Central whitish area produced by pus.
• Fungal paronychia:
  • Redness and swelling around the fingernail.
  • No pain, warmth, itching, or pus.

causes

• Bacterial paronychia is preceded by injury, such as a torn hangnail. The infecting bacteria are usually Staphylococcus.
• Fungal paronychia is caused by a fungus or yeast infection.

risk increases with

• Injury around the fingernail.
• Hands are exposed to constant wetness (dishwashers, bartenders, housewives, or swimmers).
• Diabetes.
• Nail biting or finger sucking.
• Artificial nails.
• Ingrown toenail.
• Manicure procedures.
• Shoes that bind or pinch the toes.

PREVENTIVE MEASURES

• Protect hands from wetness.
• Leave hangnails alone.
• Avoid fingertip injury.
• Avoid tight shoes.
• Do not trim or push back nail cuticles.
• Use care when trimming nails.

expected outcomes

• Bacterial paronychia is usually curable with treatment in 2 weeks.
• Fungal paronychia is chronic and may require 6 months to heal.

possible complications

• If untreated, may permanently damage the fingernail and nail bed. Rarely, the infection may enter bone or bloodstream.
• Nail may separate from nailbed.

 diagnosis & treatment

general measures

• Your health care provider will do an exam of the affected nail. Medical studies, such as a culture of the discharge (pus), may be done to identify the germ.
• Treatment involves avoiding factors that may be the cause, self-care, drug therapy, or surgery.
• If an abscess (pus-filled area) occurs, it may require incision (cutting) and drainage. Other surgery may be needed if paronychia does not heal with drug therapy.
• Wear vinyl gloves with cotton lining to prevent contact with water, irritating substances, or foods.
• Wear cotton, leather, or heavy-duty fabric gloves for housework or gardening.
• Use warm-water soaks several times a day.
• Use mild soap or alcohol-based hand cleaner to clean hands. Use a cream, lotion, or gel for dry hands or feet.
• Avoid all nail products until healed.
• Protect hands from chapping in cold weather.

medications

• For minor pain, you may use nonprescription drugs, such as ibuprofen or acetaminophen.
• A topical antibiotic cream or lotion may be prescribed. An oral antibiotic may be needed for severe cases.
• Topical steroids may be prescribed.
• Topical antifungals may be prescribed for fungal infection. An oral antifungal may be needed for severe cases.

activity

No limits.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of paronychia.
• The disorder is not helped with treatment.

Special Notes: