Definition
Paronychia refers to swelling and infection of the skin surrounding a fingernail or toenail.
What is going on in the body?
Paronychia may be caused by repeated injury that creates swelling. It may also be caused by an infection with bacteria or yeast organisms. Swelling lifts the wall of skin underlying the nail and makes the area more prone to future infection.
What are the signs and symptoms of the infection?
Paronychia may cause swelling, tenderness, and redness of the area around the nail. Nails may be discolored and may grow abnormally. Pus may leak from the cuticles, which are the thin layers of skin that cover the edges of a nail.
What are the causes and risks of the infection?
Following are some common causes of paronychia:
repeated injury of the cuticle skin, such as in vigorous manicures
repetitive soaking of hands in water at work or at home
excessive hand washing, especially when the hands are not dried properly
cutting nails too short
biting or other trauma
Paronychia is more common in a person who is prone to bacterial and yeast infections, such as an individual who has diabetes. Repeated bouts of paronychia are common.
What can be done to prevent the infection?
Paronychia can be minimized by avoiding prolonged soaking in water, by drying the hands well after hand washing, and by avoiding cutting the sides of the nails too short. Manicures should be gentle, to avoid trauma to the cuticles.
How is the infection diagnosed?
Paronychia can be diagnosed from the appearance of the nail and its surrounding skin. Sometimes a culture is done to identify the organism causing the infection. For a culture, a sample of the pus is collected and sent to the laboratory for examination under a microscope.
What are the long-term effects of the infection?
Paronychia can cause permanent nail damage. If paronychia is not treated effectively, the tissue and bone of the finger can become infected.
What are the risks to others?
The organisms that cause paronychia are not usually passed to other people. However, the use of manicure tools that have not been sterilized can transmit the infection.
What are the treatments for the infection?
Antifungal and corticosteroid creams can be applied directly to the infected area. Antifungal and antibiotic medications taken in pill form may be needed to treat some infections.
What are the side effects of the treatments?
Antifungal or antibiotic medications may cause headaches, stomach upset, or allergic reactions.
What happens after treatment for the infection?
Paronychia should clear up completely with appropriate treatment but may recur periodically.
How is the infection monitored?
Any new or worsening symptoms should be reported to the healthcare professional.
Author: Lynn West, MD Date Written: 10/01/99 Medical Review: David McDaniel, MD Date Written: 1/6/2007 Reviewer: Reginald Finger, MD Date Reviewed: 1/15/2007
Contributors
Potential conflict of interest information for reviewers available on request
