Paronychia is a skin infection that develops around the nail. It occurs when bacteria or fungi get under the skin.
Paronychia can result from biting or chewing the nails, but it is more common when working conditions require the hands to be frequently wet or exposed to chemicals.
Most cases of paronychia are not serious, and there are several effective treatments. This article will discuss the causes and treatments of this infection.
What is paronychia?
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Paronychia is an infection of the surrounding tissue where the nail meets the skin. Onychia is an infection of the nail itself, which causes inflammation of the nail and swelling of the surrounding tissue.
Doctors may also refer to paronychia as candidal paronychias. There is usually a disruption in the barrier between the nail plate and nail fold. This results in infection from the yeast Candida albicans.
Both paronychia and an ingrown toenail can cause pain in the toe area. While they can occur at the same time, they are two distinct issues.
An ingrown toenail is when the nail plate grows into the surrounding skin, causing inflammation and infection. It can cause pain and discomfort, especially if left untreated.
Because the nail breaks the skin, it frequently causes infections, including paronychia.
Ingrown toenails mayTrusted Source result from:
- improper nail cutting
- poor foot hygiene
- wearing shoes that are too small and cause pressure on the corners of the toenail
- foot injury
- medications that affect the skin
Symptoms
Some symptoms of paronychia resemble those of different skin infections. Other symptoms directly affect the nail itself.
Paronychia symptoms include:
- swelling, tenderness, and redness around the nail
- pus-filled abscesses
- hardening of the nail
- deformation or damage to the nail
- separation of the nail from the nailbed
Causes
Paronychia occurs when the skin around the nail becomes damaged, allowing germs to enter.
Bacteria or fungi can cause the infection, such as Staphylococcus aureus and Streptococcus pyogenes bacteria.
Common causes of skin damage around the nail include:
- biting or chewing the nails
- picking at nails
- manicures
- excessive exposure of the hands to moisture, including frequently sucking the finger
- ingrown nails
Diagnosis
Doctors diagnose paronychia by identifying the type of bacteria or fungi causing the infection.
They will obtain a clipping of the nail or take a swab of the infected area and test for the presence of specific bacteria or fungi. Having done this, they can make a diagnosis.
Treatment
Treatments for paronychia will vary according to the severity and whether it is acute or chronic. Both at-home treatments and medical treatments may help, depending on the diagnosis and severity of the condition.
At-home treatment
A person with mild, acute paronychia can try soaking the affected finger or toe in warm water several times a day. If symptoms do not improve, they should seek further treatment.
Mild paronychia may be treatable with just a lemon and salt.
Individuals claim that a person can cure the infection by cutting a slit in a lemon and sprinkling salt into the hole before placing the affected finger in the lemon for a few minutes. They advise repeating this until the infection goes away. However, there seems to be no scientific evidence to support the idea that this can cure paronychia.
Another home remedy is applying magnesium sulfate paste to the infected area. Individuals claim that this helps with pain management and can ward off the infection. However, there doesn’t appear to be scientific evidence to support this claim either.
Chronic paronychia may require weeks or months of treatment. It is important to keep the hands dry and clean throughout. If a person’s job requires their hands to be wet or exposed to germs, they may need to take time off.
Medical treatment
When a bacterial infection causes acute paronychia, a doctor may recommend an antibiotic, such as dicloxacillin or clindamycin.
If a fungal infection causes chronic paronychia, a doctor will prescribe antifungal medication. These topical medications typically include clotrimazole or ketoconazole.
A doctor may also need to drain any pus from surrounding abscesses. To do this, they perform a procedure referred to as the incision and drainage method. They will provide a local anesthetic, then open the nail fold enough to insert gauze to help drain the pus.
Because many at-home remedies lack scientific support, it is best to consult a medical professional for guidance if you think you have paronychia or another type of toe or toenail infection.
When to contact a doctor
People can treat paronychia at home by minimizing germ exposure and frequently washing the infected area. However, they should only do this if symptoms are mild and the infection has not spread beyond the fingernail.
If symptoms do not improve after a few days or the infection has spread further than the nail, it is important to speak with a doctor.
For severe symptoms, contact a doctor immediately.
Preventing nail infections
People can reduce their risk of developing nail infections by:
- moisturizing after washing the hands
- avoiding biting or chewing the nails
- taking care when cutting the nails
- keeping the hands and nails clean
- avoiding submerging the hands in water for long periods
- avoiding contact with irritants
- keeping the nails short
Risk factors
Some people have a higher risk of developing paronychia, such as:
- people with jobs that require them to have wet hands frequently, including cleaners, fishers, dairy farmers, and bartenders
- people with poor circulation
- people with diabetes
- people with other skin conditions, such as dermatitis
- people with weakened immune systems
Diagnosis
In most cases, a doctor can easily diagnose paronychia with a physical examination. They will also consider a person’s medical history and look for risk factors, such as diabetes.
In some cases, a doctor may require a sample of any pus that is present. They can send this to a laboratory for analysis to check whether bacteria or fungi are causing the infection.
Summary
Paronychia is a skin infection around a fingernail or toenail. Symptoms include inflammation, swelling, pain, and discomfort. Biting or chewing the nails is a common cause.
Acute paronychia develops quickly and treatment can reduce symptoms rapidly. People can treat mild cases at home. Chronic paronychia has a slower onset, and it can take weeks for treatment to effectively reduce symptoms.
Taking good care of the hands and nails is the best way to prevent paronychia.
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