Paronychia
Symptoms
Paronychia presents as redness, swelling, and tenderness around the fingernail or toenail. The area may become warm and painful, especially when pressure is applied. In some cases, pus accumulates, creating an abscess. The nail fold may appear lifted or distorted. Chronic cases can lead to nail thickening or ridging. It may affect one or multiple digits. Pain can interfere with everyday tasks such as typing or gripping. In chronic cases, symptoms persist for weeks or longer with intermittent flare-ups.
Cause
Paronychia is typically caused by bacterial infection, most commonly Staphylococcus aureus, introduced through minor trauma like nail biting, manicures, or hangnails. Chronic cases are often due to yeast (Candida) or repeated exposure to moisture and irritants. People with jobs involving water or frequent hand washing are at higher risk. Diabetics and immunocompromised individuals are also more susceptible. The infection begins in the nail fold and can spread deeper if untreated. Recurrent trauma weakens the skin barrier, facilitating infection. It is not usually contagious.
Treatment
Acute bacterial paronychia is treated with warm soaks and topical or oral antibiotics. If pus is present, drainage may be needed. Chronic cases may require antifungal treatment and strategies to minimize moisture exposure. Protective gloves can help prevent recurrence. Keeping hands dry and avoiding nail trauma is essential. In persistent cases, dermatologists may prescribe anti-inflammatory creams. Surgery is rarely needed but may be considered for severe or recurrent infections. Proper nail care and avoiding cuticle cutting can help prevent paronychia.
Dr. Beth Schulz-Butulis
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