What are Paronychia ?
A paronychia is an infection which develops next to the fingernail. It may arise anywhere around the “U” shaped line where the fingernail doesn’t seem to have a protruding edge – where the edge of the nail is covered by skin. It may be a mild infection, but often is associated with a small abscess – a collection of pus beneath the skin. A paronychial infection may develop suddenly due to a bacterial infection, or may persist for months or more due to a fungal infection.
Alternative Names: Infection – skin around the nail
Signs and symptoms of Paronychia
Symptoms of bacterial paronychia usually come on rather abruptly. There is redness, swelling and pain in the tissues surrounding the fingernail. Occasionally, an abscess may develop, with a small, white lump forming filled with pus. In severe cases, the nail may become detached from the nail bed. The nail may appear distorted or deformed. Fungal paronychia usually develops over a longer time. Similar symptoms may occur, but there is generally not so much pain, swelling or redness. Secondary bacterial infections may develop in someone that has a fungal paronychia.
Causes of Paronychia
Both acute and chronic infections start with a break in the epidermis. An acute infection is associated with trauma to the skin such as a hangnail, ingrown nail, or nail-biting. The most common bacteria responsible is Staphylococcus aureus . Other bacteria that are less commonly involved are Streptococcus species and Pseudomonas species.
A chronic infection is associated with repeated irritation such as exposure to detergents and water. Most chronic infections are caused by Candida albicans or other fungi
Treatment OF Paronychia
- Warm soaks in a mixture of 50% warm water and 50% liquid antibacterial soap 3-4 times daily for about 15 minutes. This soaking should be done at the first sign of redness around the nail.
- In extreme cases, infection can move under the fingernail and need partial or complete nail removal. Unless there is an extensive cellulitis, antibiotics are usually not necessary.
- Fungal paronychia may be treated with topical or oral antifungals.
- Your doctor may prescribe some medications sych as thymol, mupirocin, Loprox or Lotrisone.
- Sometimes packing called a wick is placed in the abscess to allow it to continue to drain when you go home and to keep it from closing up and re-forming the abscess. The packing is usually left in for 24-48 hours.
Prevention of Paronychia
- Dry your hands thoroughly after washing
- Wear cotton – lined rubber gloves when your hands are in water.
- Do not bite nails or cuticles
- Do not suck fingers