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.
What is paronychia?
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.
What causes nail-fold infections?
- 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.
Why do nail-fold infections develop?
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.
What is the treatment for nail-fold infections?
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.
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.
The following may help to prevent a recurrence of nail-fold infections:
- 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.
Dr Tim Kenny
Dr Louise Newson
Dr John Cox