Learn About Paronychia

What is the definition of Paronychia?

Paronychia is a skin infection that occurs around the nails.

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What are the alternative names for Paronychia?

Infection - skin around the nail

What are the causes of Paronychia?

Paronychia is common. It is from injury to the area, such as biting off or picking a hangnail or from trimming or pushing back the cuticle.

The infection is caused by:

  • Bacteria
  • Candida, a type of yeast
  • Other types of fungi

A bacterial and fungal infection can occur at the same time.

Fungal paronychia may occur in people who:

  • Have a fungal nail infection
  • Have diabetes
  • Expose their hands to water a lot
What are the symptoms of Paronychia?

Main symptom is a painful, red, swollen area around the nail, often at the cuticle or at the site of a hangnail or other injury. There may be pus-filled blisters, especially with a bacterial infection.

Bacteria cause the condition to come on suddenly. If all or part of the infection is due to a fungus, it tends to occur more slowly.

Nail changes may occur. For example, the nail may look detached, abnormally shaped, or have an unusual color.

If the infection spreads to the rest of the body, symptoms may include:

  • Fever, chills
  • Development of red streaks along the skin
  • General ill feeling
  • Joint pain
  • Muscle pain
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What are the current treatments for Paronychia?

If you have bacterial paronychia, soaking your nail in warm water 2 or 3 times a day helps reduce swelling and pain.

Your provider may prescribe oral antibiotics. In severe cases, your provider may cut and drain the sore with a sharp instrument. Part of the nail may need to be removed.

If you have chronic fungal paronychia, your provider may prescribe antifungal medicine.

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What is the outlook (prognosis) for Paronychia?

Paronychia often responds well to treatment. But, fungal infections may last for several months.

What are the possible complications of Paronychia?

Complications are rare, but may include:

  • Abscess
  • Permanent changes in the shape of the nail
  • Spread of infection to tendons, bones, or bloodstream
When should I contact a medical professional for Paronychia?

Call your provider if:

  • Paronychia symptoms continue despite treatment
  • Symptoms worsen or new symptoms develop
How do I prevent Paronychia?

To prevent paronychia:

  • Care for the nails and the skin around the nails properly.
  • Avoid damaging the nails or fingertips. Because the nails grow slowly, an injury can last for months.
  • Do not bite or pick the nails.
  • Protect the nails from exposure to detergents and chemicals by using rubber or plastic gloves. Gloves with cotton liners are best.
  • Bring your own manicure tools to nail salons. Do not allow the manicurist to work on your cuticles.

To minimize the risk for damage to the nails:

  • Keep fingernails smooth and trim them weekly.
  • Trim toenails about once a month.
  • Use sharp manicure scissors or clippers for trimming fingernails and toenails, and an emery board for smoothing the edges.
  • Trim nails after bathing, when they are softer.
  • Trim fingernails with a slightly rounded edge. Trim toenails straight across and do not cut them too short.
  • Do not trim cuticles or use cuticle removers. Cuticle removers can damage the skin around the nail. The cuticle is needed to seal the space between the nail and skin. Trimming the cuticle weakens this seal, which can allow germs to enter the skin and lead to infection.
Paronychia - candidial
Nail infection - candidal
What are the latest Paronychia Clinical Trials?
A Clinical Study on the Treatment of Paronychia Caused by Afatinib With Zanthoxylum Nitidum Tincture
Summary: This is a randomized control trial evaluating the efficacy of zanthoxylum nitidum tincture on preventing progression of paronychia caused by afatinib from grade 1 to grade 2/3. Enrolled participates will randomly receive original treatment or original treatment plus zanthoxylum nitidum tincture immersion of the sick nail(s).
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Double-blind, Phase II Study to Assess the Effectiveness of Lycopene vs Placebo to Reduce Skin Toxicity in Patients With Colorectal Carcinoma Treated With Panitumumab
Summary: Background and rationale: EGFR represents the main and more studied signal activation pathway in the development of colorectal carcinoma. KRAS, NRAS, BRAF and PI3KA mutations and ERBB2 and MET amplification are responsible for most of the cases of primary resistance to anti-EGFR antibody treatments. Despite the identification of these resistance mechanisms, a primary resistance to the therapy was ...
What are the Latest Advances for Paronychia?
Analysis of the Effcacy and Safety of Amivantamab in Non-small Cell Lung Cancer 
Patients with EGFR/MET Gene Abnormalities: A Single Center's Experience.
Summary: Analysis of the Effcacy and Safety of Amivantamab in Non-small Cell Lung Cancer 
Patients with EGFR/MET Gene Abnormalities: A Single Center's Experience.
A phase 1b/2 study of PF-06747775 as monotherapy or in combination with Palbociclib in patients with epidermal growth factor receptor mutant advanced non-small cell lung cancer.
Summary: A phase 1b/2 study of PF-06747775 as monotherapy or in combination with Palbociclib in patients with epidermal growth factor receptor mutant advanced non-small cell lung cancer.
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Acrometastasis of Laryngeal Carcinoma to the Finger.
Summary: Acrometastasis of Laryngeal Carcinoma to the Finger.
Who are the sources who wrote this article ?

Published Date: April 14, 2021
Published By: Elika Hoss, MD, Senior Associate Consultant, Mayo Clinic, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Andre J, Sass U, Theunis A. Diseases of the nails. In: Calonje E, Brenn T, Lazar AJ, Billings SD, eds. McKee's Pathology of the Skin. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 23.

Dinulos JGH. Nail diseases. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 25.

Leggit JC. Acute and chronic paronychia. Am Fam Physician. 2017;96(1):44-51. PMID: 28671378 pubmed.ncbi.nlm.nih.gov/28671378/.

Mallett RB, Banfield CC. Paronychia. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 182.