Table of ContentsView AllTable of ContentsCausesAppearanceDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Causes
Appearance
Diagnosis
Treatment
Prevention
Paronychiais an infection of the layer of skin surrounding the nail (known as theperionychium). It can develop when bacteria enters broken skin near the cuticle at the base of the nail or when an irritation damages the skin around the fingernails or toenails and allows fungus to grow. Treatments depend on the type of infection.
Paronychia is one of the most common hand infections and is seen frequently in children as a result of nail biting and finger sucking.
This article explores the appearance of paronychia, its causes and treatments, and what you can do to prevent an infection.
This photo contains content that some people may find graphic or disturbing.See PhotoParonychia hand infection.kckate16 / Getty Images
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Paronychia can have different causes that may vary based on the amount of time the infection has been present. It is a condition classified as either:
Both acute and chronic paronychia start with the penetration of the outer layer of skin called the epidermis.
Acute paronychia is usually the result of a direct trauma to the skin, such as a cut, hangnail, oringrown nail. Bacteria are the most common cause of the infection, predominantlyStaphylococcus aureus,but also certain strains of theStreptococcusandPseudomonasbacteria.
Treating Ingrown Nails
Acute paronychia starts as a red, warm, painful swelling of the skin around the nail. Over time, the accumulation of pus may separate the skin from the nail. In more severe cases, thelymph nodesin your elbow and armpit may swell and your nail may become discolored.
In chronic paronychia,redness and tenderness are usually less noticeable. The skin around the nail often looks baggy, and the cuticle may separate from the nail bed. The nail often becomes thickened and discolored with pronounced horizontal grooves on the surface. Green discoloration can occur in cases ofPseudomonasinfection.
8 Causes of White Spots on Your Nails
Acute paronychia is typically diagnosed based on a review of the clinical symptoms. If pus is oozing, your healthcare provider may make an incision to drain it.
In severe cases, they may culture bacteria from the drained pus to make a definitive diagnosis. This usually isn’t necessary because the bacteria is usuallyStaphylococcusorStreptococcustype, both of which are treated similarly.
Chronic paronychia tends to be more difficult to diagnose. A potassium hydroxide (KOH) test, using a smear is extracted from the nail fold, sometimes confirms a fungal infection.If pus is involved, a culture can confirm the presence of fungus or other, less common infectious agents.
Types of Bacterial Skin Infections and How to Treat Them
For an acute infection, soaking the nail in warm water three to four times a day can promote drainage and relieve some of the pain. Some healthcare providers suggest an acetic acid soak, using one part warm water and one part vinegar.
If you have pus or an abscess, the infection may need to be drained. In some cases, a portion of the nail may need to be removed.
Bacteria-associatedparonychia is most commonly treated with antibiotics such as cephalexin or dicloxacillin.Topical antibiotics or anti-bacterial ointments are not considered an effective treatment.
Chronic paronychia is typically treated with a topical antifungal medication such as ketoconazole cream.In addition, a mildtopical steroidmay be used to help reduce inflammation. (Steroids should never be used on their own as they don’t treat the underlying infection.)
Some people tend to have more extensive paronychial infections and may need to be treated with a prolonged course of antibiotics, including those with:A compromised immune system, such as from HIVLong-term corticosteroid useDiabetesAutoimmune disease, including psoriasis and lupusPoor circulation in the arms or legs
Some people tend to have more extensive paronychial infections and may need to be treated with a prolonged course of antibiotics, including those with:
You have several options for reducing the risk or severity of a paronychial infection.
Beau’s Lines and Their Causes
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Family Physicians.Paronychia.
Leggit JC.Acute and chronic paronychia.Am Fam Physician. 2017;96(1):44-51.
American Family Physician.Acute and chronic paronychia.
Allouni A, Yousif A, Akhtar S.Chronic paronychia in a hairdresser.Occupational Medicine. 2014;64(6):468-469. doi.org/10.1093/occmed/kqu075
Centers for Disease Control and Prevention.Candidiasis.
Chiriac A, Brzezinski P, Marincu I, Foia L.Chloronychia: green nail syndrome causedPseudomonas aeruginosain elderly persons.CIA. 2015:2015(10):265-267. doi:10.2147/CIA.S75525
MedlinePlus.Skin lesion KOH Exam.
Relhan V, Goel K, Bansal S, Garg VK.Management of chronic paronychia.Indian J Dermatol. 2014;59(1):15-20. doi:10.4103/0019-5154.123482
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
