Paronychia (nail infection)
An infection that develops along the edge of the fingernail or toenail is called a paronychia. It is the most common hand infection and if left untreated can progress to a more severe infection of the entire finger or toe.
Pictures of paronychia nail infections
A moderate paronychia. Swelling and redness around the edge of the nail is caused by a large pus collection under the skin.
Another view of the same paronychia. The majority of the swelling and redness can be seen on the right side of this picture.
A scalpel (knife) is inserted under the skin at the edge of nail to open the pus pocket and drain it to relieve the pressure and treat the infection.
A closer view of the scalpel used to open the infected area.
The doctor pushes on the swollen area to get the pus out after the incision was made with the scalpel.
A paronychia is most often caused by common skin bacteria entering the skin around the nail that has been damaged by trauma, such as nail biting, finger sucking, dishwashing, or chemical irritants. Fungus can also be a cause of paronychia formation, especially in people with recurrent infection.
A paronychia may start as redness and swelling around the nail, called a cellulitis. It is most often very sore to the touch and, at times, may be a yellow-green colour, indicating that a collection of pus has formed under the skin (called an abscess).
The most common symptoms are the following:
- Pus collection
- Pain and tenderness to touch
When to seek medical care
You should seek medical advice if the redness extends beyond the skin around your nail or to the pad of the finger. This redness shows that the infection might be forming a more serious finger infection of the deep tissues of your fingertip.
You should also seek medical advice if an abscess is forming. An abscess usually requires drainage by a doctor. Opening (or incising) an abscess to drain the pus should not be attempted at home.
At the first sign of pus collection, you should seek medical attention for possible drainage. If you notice that the swelling and redness has extended down your finger or you are unable to move the joints of the affected finger, you need to go to a hospital's emergency department immediately. This condition may or may not be associated with fever or chills, indicating a serious infection.
Examinations and tests
A doctor will examine your finger and decide how severe the infection is and what treatment is needed.
Paronychia treatment - self-care at home
Care at home includes warm soaks in a mixture of 50% warm water and 50% liquid antibacterial soap three to four times a day for about 15 minutes. This soaking should be done at the first sign of redness around the nail.