Worst Nail Infections: Paronychia

paronychia video finger abscessVideo source: https://www.medicalvideos.com/video/13494/worst-nail-infection-paronychia

Paronychia is a skin infection that develops around the nail. It occurs when bacteria or fungi get under the skin.

Paronychia can result from biting or chewing the nails, but it is more common when working conditions require the hands to be frequently wet or exposed to chemicals.

Most cases of paronychia are not serious, and there are several effective treatments. This article will discuss the causes and treatments of the infection.

What is paronychia?

Fingernail bed inflammation, bacterial infection paronychia in child's hand.Paronychia is an infection that can occur around the nail.

Paronychia is an infection of the skin around the nail of at least one finger or toe. It typically develops around the edges of the nail at the bottom or sides.

This skin infection causes inflammation, swelling, and discomfort around the nail. Abscesses containing pus can also form.

There are two types of paronychia:

  • Acute paronychia. This develops over hours or days. The infection does not usually spread deep into the finger, and treatment can reduce symptoms relatively quickly.
  • Chronic paronychia. This occurs when symptoms last for at least 6 weeks. It develops more slowly and can become more serious. Chronic paronychia often affects several digits at once.

Paronychia can occur at any age and is easily treatable.

In rare cases, the infection can spread to the rest of the finger or toe. If this happens, a person should see their doctor.


Some symptoms of paronychia resemble those of different skin infections. Other symptoms directly affect the nail itself.

Paronychia symptoms include:

  • swelling, tenderness, and redness around the nail
  • puss-filled abscesses
  • hardening of the nail
  • deformation or damage to the nail
  • the nail separating from the nailbed
  • Causes

    fingernail bed inflammation paronychia image credit chris craig 2007

    Biting the nails or the skin around the nails can cause infection.
    Image credit: Chris Craig, 2007.

    The infection occurs when the skin around the nail becomes damaged, allowing germs to enter.

    Bacteria or fungi can cause paronychia, and common culprits are Staphylococcus aureusand Streptococcus pyogenes bacteria.

    Common causes of skin damage around the nail include:

    • biting or chewing the nails
    • clipping the nails too short
    • manicures
    • excessive exposure of the hands to moisture, including frequently sucking the finger
    • ingrown nails



    Treatments for paronychia will vary, depending on the severity and whether it is chronic or acute.

    A person with mild, acute paronychia can try soaking the affected finger or toe in warm water three to four times a day. If symptoms do not improve, seek further treatment.

    When a bacterial infection causes acute paronychia, a doctor may recommend an antibiotic, such as dicloxacillin or clindamycin.

    When a fungal infection causes chronic paronychia, a doctor will prescribe antifungal medication. These medications are topical and typically include clotrimazole or ketoconazole.

    Chronic paronychia may require weeks or months of treatment. It is important to keep the hands dry and clean throughout. If a person’s job requires their hands to be wet or exposed to germs, they may need to take time off.

    A doctor may also need to drain any pus from surrounding abscesses. To do this, they will provide a local anesthetic, then open the nail fold enough to insert gauze, which will help drain the pus.