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Paronychia is a common infection of the skin just next to a nail. Treatment involves antibiotic medicines for germ (bacterial) infections or antifungal medicine for infection caused by a yeast (candida) or a fungus.

Paronychia is an infection of the skin just next to a nail (the nail fold). The infected nail fold looks swollen, inflamed and may be tender.

There may also be a small collection of pus in the swelling. The nail itself may become infected or damaged if a nail-fold infection is left untreated.

  • Germs (bacteria). These tend to cause sudden-onset (acute) nail-fold infections which are painful.
  • Candida. This is a yeast (a type of fungus) and is another common cause. Nail-fold infections with candida tend to develop slowly and cause persistent (chronic) infection. They do not cause pus to appear.
  • Other germs (microbes). These include viruses and other fungi. They are less common causes.

Many nail-fold infections occur for no apparent reason. However, the following can increase the risk of germs (bacteria) and other germs getting into the nail-fold skin and causing infection:

  • Water. You are more likely to develop a nail-fold infection if your hands are in water for long periods, particularly with detergents. Cleaners, bartenders, beauticians, dish washers, etc, are prone to nail-fold infections. Constant washing may damage the nail fold and allow infection to develop.
  • Injury. For example, nail biting, poor manicure, damaged or diseased nails or nail folds, etc.
  • Covering. For example, if you use gloves for long periods, or use artificial nails, it can cause a moist, airless condition around your fingernails. This is good for some germs to thrive and cause infection.

Germ (bacterial) infections

If your infection is caused by bacteria then an antibiotic for seven days may be prescribed. Sometimes pus from a bacterial infection has to be drained by a very small cut if it collects next to the nail.

It may also help to soak the affected finger in warm salted water four times a day. Painkillers, such as paracetamol or ibuprofen, often work well to ease any pain.

If the antibiotic prescribed is not improving your infection after you have been taking it for a few days, you should see your doctor. Your doctor may take a sample (swab) of the infected area (to determine the actual bacteria causing your symptoms). He or she may also change the antibiotic to a different one.

Yeast (candidal) and fungal infections

These are usually treated with an antifungal cream. Treatment is usually needed for 3-6 months before the infection goes completely and a new healthy nail fold has formed.

Sometimes, a course of antifungal tablets for a week or so is given if the cream does not help. If the fungal infection has spread to your fingernails then treatment is needed for a longer period of time, usually 6-12 months. This is either by taking antifungal tablets or by using antifungal nail paint.

  • Do not bite your nails or pick at the skin next to nails.
  • Keep your hands and feet dry as much as possible. Dry well after washing.
  • Wear rubber gloves (preferably cotton-lined) if you work a lot with water.
  • Do not wear gloves or artificial nails for long periods.
Original Author:
Dr Tim Kenny
Current Version:
Peer Reviewer:
Dr John Cox
Document ID:
4457 (v39)
Last Checked:
Next Review:
The Information Standard - certified member
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