What is the definition of Paronychia?

Paronychia is a skin infection that occurs around the nails.

What are the alternative names for Paronychia?

Infection - skin around the nail

What are the causes for 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 for 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

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.

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 for 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
Nail

REFERENCES

Habif TP. Nail diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 25.

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

  • Condition: Paronychia and Granulation with Chronic Lymphocytic Leukemia
  • Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology
  • Treatment Used: Silver Nitrate Chemical Cauterization with Ibrutinib Therapy
  • Number of Patients: 1
  • Published —
This case report describes a patient with paronychia and granulation that is undergoing ibrutinib therapy for chronic lymphocytic leukemia.
  • Condition: Plexiform Neurofibroma
  • Journal: BMC pediatrics
  • Treatment Used: Selumetinib
  • Number of Patients: 3
  • Published —
This case report describes 3 children with plexiform neurofibroma that were treated using selumetinib.
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Drug
  • Participants: 110
  • Start Date: June 12, 2019
A Clinical Study on the Treatment of Paronychia Caused by Afatinib With Zanthoxylum Nitidum Tincture
Clinical Trial
  • Status: Recruiting
  • Phase: Phase 2
  • Intervention Type: Other, Drug
  • Participants: 100
  • Start Date: August 3, 2016
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