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Paronychia

Paronychia is a common condition causing redness, swelling and tenderness of the skin around a finger or toe nail. Paronychia is divided into two main categories.

Acute Paronychia

This generally develops over days or even hours, with very prominent swelling, redness and pain. This can begin after trauma, and is usually due to infection with bacteria.

Treatment: Antibiotics are often required, and the area may need to be incised and drained in the office. Warm water soaks (3-4 times per day for 10 minutes) may help. The pain and swelling generally resolves promptly with treatment.

Chronic Paronychia

The onset is gradual over days to weeks, and tends to last longer as well. Chronic paronychia is generally caused by recurrent irritation, and can become secondarily infected with yeast.

Treatment: The area must be protected from further irritation. Common irritants include: soaps and shampoos, chemicals, raw foods, nail polish or nail polish remover. Prolonged exposure to water or moisture can also cause irritation. It is important to wear gloves if contact with irritants cannot be avoided. Hand washing should be minimized and the area should be thoroughly dried afterwards. It is also important to avoid pushing back or trimming the cuticle, as this normally helps protect the area between the nail and the surrounding skin from irritation and infection. Other trauma to the nail, including manicuring or finger sucking should be avoided. Anti-yeast medications may be needed, and occasionally a topical steroid is used to decrease inflammation. We often recommend soaking for 10minutes a day in Listerine, which contains thymol to help kill yeast and bacteria.

Deformity of the nail may result from either acute or chronic paronychia. This usually grows out along with the nail plate and returns to normal.