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Paronychia

What is paronychia?

Paronychia is an infection of the skin that surrounds a fingernail. The infected tissue can be tender and painful with swelling.

What causes paronychia?

Staphylococci bacteria are the most common culprit in acute paronychia followed by Streptococcus. Chronic paronychia tends to be caused by a fungus rather than a bacterium.

How does paronychia occur?

Splitting or cracking a nail, aggressively trimming your nails, or a trauma to the nail (such as getting the nail trapped and squeezed between two surfaces, or smashed by a heavy object such as a hammer), can create a way for bacteria to enter and cause an infection. This type of paronychia is referred to as “acute paronychia.”

People who have jobs that frequently expose their hands to irritants, solvents, or acrylics, or require their hands to be immersed in water are at increased risk of chronic paronychia. Dishwasher, bartender, janitor, and gardener are such occupations. People with chronically dry skin, eczema or a history of contact dermatitis, and those who bite their nails are also at greater risk. Persons with diabetes are more prone to nail infection than those without diabetes. Diseases that compromise the immune system can also predispose persons to paronychia.

How can I tell if I have paronychia?

With acute paronychia, a crack in the nail fold or trauma to the nail is usually seen first. Then your finger may throb and redden, and the skin around the nail will swell. Sometimes pus will collect under the skin next to the affected nail.

With chronic paronychia, you may experience tenderness around the nail. The skin may redden and swell slightly. The area around the nail will be moist. Several nails on the same hand may be affected with chronic paronychia.

How is the diagnosis of paronychia made?

Most often, the diagnosis is made by the appearance of the nail and the skin around it. A culture of a sample of the tissue might be done if your doctor suspects that the cause is a fungus.

How is paronychia treated?

With acute paronychia, you can try soaking the affected finger (or toe) in warm water for about 15 minutes several times a day. If the infection persists or if pus develops, your doctor may drain the infected area through a small cut. He or she will instruct you to keep your finger or toe raised as much as possible. You will also need to soak it in warm water several times each day. Sometimes an oral antibiotic will be prescribed. Your symptoms should clear up within 2 weeks.

With chronic paronychia caused by a fungus, your doctor may prescribe an antifungal medication that can be applied directly on the nail. The medication will need to be applied daily, possibly for several weeks, and the nail and skin must be kept dry.

How can I prevent paronychia from occurring?

Taking proper care of your nails will greatly reduce the chance of an infection. Do not chew on your nails or pick at the skin around them. Trim your nails regularly with clippers or sharp manicure scissors, but don’t cut them too short. Fingernails should be trimmed with a rounded edge; toenails should be trimmed straight across. Cutting nails after bathing or showering may make them easier to trim.

Do not trim the cuticles (the skin at the base of the nail). Trimming them may create an entry for bacteria or fungi.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/31/2014…#15327

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