Paronychia: Causes, Symptoms & Diagnosis
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Paronychia

Overview

Paronychia is an infection of the skin around the fingernails and toenails. Bacteria or a type of yeast called Candida cause this infection. Bacteria and yeast can even combine into one infection.

Depending on the cause of the infection, paronychia may come on slowly and last for weeks or show up suddenly and last for only one or two days. The symptoms of paronychia are easy to spot and can usually be easily and successfully treated with little or no damage to your skin and nails. Your infection can become severe and even result in a partial or complete loss of your nail if it’s not treated.

Acute and Chronic Paronychia

Paronychia can be either acute or chronic depending on the speed of onset, the duration, and the infecting agents.

Acute Paronychia

An acute infection almost always occurs around the fingernails and develops quickly. It’s usually the result of damage to the skin around the nails from biting, hangnails, manicures, or other physical trauma. Staphylococcus bacteria are the most likely infecting agent in the case of acute paronychia.

Chronic Paronychia

Chronic paronychia can occur on your fingers or toes, and it comes on slowly. It lasts for several weeks and often comes back. It’s typically caused by more than one infecting agent, often Candida yeast and a bacteria. It’s more common in people who are constantly exposed to a moist environment.

What Are the Symptoms of Paronychia?

The symptoms of both acute and chronic paronychia are very similar. They’re largely distinguished from each other by the speed of onset and the duration of the infection. Chronic infections come on slowly and last for many weeks. Acute infections develop quickly and don’t last long. Both infections have the following symptoms:

  • redness of the skin around the nail
  • tenderness of the skin around the nail
  • pus-filled blisters
  • changes in nail shape, color, or texture
  • detachment of the nail

What Causes Paronychia?

There are multiple causes of both acute and chronic paronychia. The underlying cause of each is bacteria, Candida yeast, or a combination of the two agents.

Acute Paronychia

A bacterial agent that’s introduced to the area around the nail by some type of trauma typically causes an acute infection. This can be from biting your nails or hangnails, being punctured by manicurist tools, pushing down your cuticles too aggressively, and other similar types of injuries.

Chronic Paronychia

The underlying agent of infection in chronic paronychia is most commonly Candida yeast, but it can also be a bacteria. Because yeasts grow well in moist environments, this infection is often caused by having your feet or hands in water too much of the time.

How Is Paronychia Diagnosed?

In most cases, a doctor can diagnose paronychia simply by observing it.

Your doctor may send a sample of the tissue from your infection to a lab if treatment doesn’t seem to be helping. This will determine the exact infecting agent and will allow your doctor to prescribe the best treatment.

How Is Paronychia Treated?

Home treatments are often very successful in treating mild cases. You can soak the infected area in hot water several times per day and apply antibiotic ointment. Your doctor may prescribe an antibiotic to take by mouth if the infection is more severe or if it isn’t responding to home treatments. You may also need to have blisters or abscesses cut and drained of fluids to relieve discomfort and speed healing.

Chronic paronychia is more difficult to treat. You’ll need to see your doctor because home treatment isn’t likely to work. Your doctor will probably prescribe an antifungal medication and advise you to keep the area dry. In severe cases, you may need surgery to remove part of the nail.

How Can Paronychia Be Prevented?

Good hygiene is important for preventing paronychia. Keep your hands and feet clean to prevent bacteria from getting between your nails and skin. Avoiding trauma caused by biting, manicures, or pedicures can also help you prevent acute infections.

To prevent a chronic infection, you can avoid exposure to water and wet environments and keep your hands and feet as dry as possible.

What Is the Long-Term Outlook?

The outlook is good if you have a mild case of acute paronychia. You can treat it successfully, and it’s unlikely to return. If you let it go untreated for too long, the outlook is still good if you get medical treatment.

Chronic infection is likely to last for weeks or months. Treatment should help it clear up.

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