It can also occur as a result of a fungal nail infection, referred to asonychomycosis.
Symptoms include redness, swelling, pain, and pus discharge.
Topical antibioticsmay be needed to scrub the bacteria infection.
South_agency / Getty Images
If a nail fungus is involved, atopical antifungalmay be prescribed.
It also describes ways to prevent nail infections and when to see a healthcare provider.
The nail plate and nail bed can also be collaterally damaged.
Reproduced with permission from © DermNet and © Raimo Suhonen dermnetnz.org 2023
Paronychia can beacute(sudden and severe) orchronic(persistent or recurrent).
Acute cases almost invariably involve bacteria, while chronic cases are typically associated with fungi or chemical irritants.
This photo contains content that some people may find graphic or disturbing.
With onychomycosis, the infection can sometimes spread and colonize the nail folds.
Because the infection is notoriously difficult to treat, the swelling can persist and become chronic.
As withStaphylococcus aureus, Candida albicansis found naturally in the human body.
This is a condition in which theimmune systemreacts to irritants that touch the skin.
What Does a Nail Infection Look Like?
Paronychia is easily recognized and something that most people will experience at one time or another.
It mainly affects the nail folds but can also affect the nail bed and nail plate.
The nail can become dry and brittle and crack or entirely detach from the nail bed.
Fingernails are affected more than toenails.
How Is a Nail Infection (Paronychia) Diagnosed?
Paronychia can be diagnosed by physical examination of the finger or toe.
Laboratory tests are generally not needed.
If there is an abscess, the skin overlying the abscess will blanch (whiten).
Only around 4% of these cultures can identify a single causal agent; most detect multiple bacterial types.
Chronic paronychia is treated differently based on its severity and underlying cause.
Home Remedies
Acute paronychia doesn’t always require medical treatment.
Prescription Medications
Prescription antibiotics may be prescribed if home and OTC remedies fail to provide relief.
Topical antibiotics are preferred over oral antibiotics, which have not proven more effective in treating uncomplicated paronychia.
If anything, oral antibiotics are associated with a greater risk ofantibiotic resistance.
Topical lidocaine can be used to help numb the skin, but this is generally not needed.
Once the pus is drained, oral antibiotics are not needed.
This is generally all that is needed to promote healing and prevent infection.
These measures are especially important if you’ve had nail infections in the past.
To reduce the risk of paronychia:
Whats the Outlook for People With Paronychia?
With appropriate treatment, most cases of acute paronychia will quickly resolve without complications.
Although chronic paronychia can take weeks to heal, the nail and surrounding skin usually return to normal.
Certain people may develop severe complications if the infection happens to spread.
People who are immunocompromised are most commonly affected, including those withadvanced untreated diabetes.
Bacteria cause acute infections, while chronic infections are most frequently associated with fungus.
Symptoms include redness, pain, warmth, and redness.
Left untreated, paronychia can an abscess, nail deformity, and nail loss.
Paronychia is diagnosed with a physical exam.
Acute cases may be treated with warm soaks and topical antibiotics.
Chronic cases may require topical steroids, antifungals, or tacrolimus.
Abscesses should be a healthcare provider to drain the accumulated pus safely.
Leggit JC.Acute and chronic paronychia.Am Fam Physician.2017;96(1):44-51.
2015;28(3):603-661. doi:10.1128/CMR.00134-14
Centers for Disease Control and Prevention.Group A strep infection.
Spernovasilis N, Psichogiou M, Poulakou G.Skin manifestations of Pseudomonas aeruginosa infections.Curr Opin Infect Dis.
Bryant A, Knox A.Ingrown toenails: the role of the GP.Austr Fam Physician.2015;44(3).
DailyMed.Neomycin and polymyxin B sulfates and bacitracin zinc ointment.
Centers for Disease Control and Prevention.Cellulitis: all you gotta know.
