Paronychia is an inflammation of the skin bordering a fingernail or toenail. This inflammation can be classified as acute or chronic, depending on your symptoms, the cause of the inflammation, and how long you have had it.

Acute paronychia

Acute paronychia is usually a painful condition that develops over one to 2 days. It is usually associated with problems which involve trauma to the skin, such as a hang-nail, ingrown nail or nail biting.

Acute paronychia is usually caused by a bacterial infection, and the bacteria called Staphylococcus aureus is the most common cause.

Treatment of acute paronychia

Acute paronychia may be treated by bathing the affected finger or toe in warm, salty water 2 or 3 times a day. If there is a collection of pus, your doctor may drain the pus by puncturing the overlying skin. Rarely, a portion of the nail might also need to be removed. Acute paronychia will occasionally need to be treated with antibiotics if it does not improve by draining the pus.

Chronic paronychia

Chronic paronychia differs from acute paronychia in that it is usually not painful and develops over a longer period. It arises because of damage to, or loss of, the nail cuticle, which performs an important role in creating a waterproof seal that protects the nail matrix, where the fingernail grows from. It commonly occurs in people who spend a lot of time with their hands in water, such as chefs, cleaners and hairdressers and children who suck their fingers regularly. Trimming back the cuticles too much when having a manicure is also a risk factor for developing chronic paronychia.

Treatment of chronic paronychia

Corticosteroid creams are helpful in treating chronic paronychia. Chronic paronychia is often complicated by a fungal infection, which can be treated with antifungal preparations that are applied directly to the affected area. The inflamed area can also become infected with bacteria, which may or may not require antibiotic treatment.

The mainstay of treatment for chronic paronychia is avoiding the irritant that is causing the inflammation. In most cases, this means keeping your hands dry and avoiding wet work wherever possible. Other irritants to be avoided include detergents, soap, grease and solvents. People with chronic paronychia should also avoid nail biting, manicuring or aggressively cleaning the cuticles. Regular moisturising also helps to waterproof and protect the area involved.

If your toes are affected, you should make sure that the irritation is not the result of poorly fitting shoes.

People at risk of paronychia complications

People with certain medical conditions are more prone to acute and chronic paronychia, and are more likely to have complications from the inflammation and any associated infection. People who are more at risk include those with:

  • diabetes;
  • poor blood circulation to their extremities; or
  • a suppressed immune system (e.g. people undergoing chemotherapy or people with AIDS).

If you have a condition that puts you at increased risk and you develop symptoms of paronychia, it’s important to seek medical help early so that complications can be avoided.

Last Reviewed: 12/12/2012

myDr



References

1. DermNet NZ. Paronychia. Last updated 29 June 2011. http://dermnetnz.org/fungal/paronychia.html (accessed Feb 2013).
2. eTherapeutic Guidelines. Paronychia. Revised Feb 2009. (accessed Feb 2013).