Paronychia

Paronychia is a skin infection around the fingernail or toenail by bacteria or fungi. It typically develops around the skin attaching edges of the nail (or the nail fold) and it does not affect the distal end of the nail. It causes redness, increased in local temperature, swelling, and pain or discomfort around the nailfold. You will avoid using that infected finger for pain and discomfort.

There are two types of paronychia:

• Acute paronychiaThis usually develops over hours or days with increasing pain and swelling around one fingernail or toenail. Abscess containing pus may form. Immediate surgical treatment can reduce symptoms and cure the disease relatively quicker.

• Chronic paronychiaThis occurs when symptoms last for more than few weeks. It develops more slowly and can become more serious with larger area of distal finger being affected. Chronic paronychia often affects several digits at once. Weeks of avoiding moisture with oral and local medication can cure the condition.

Causes

The infection occurs when the nail fold becomes damaged and germs enter.

Common causes of skin damage around the nailfold include:

• biting or chewing the nails
• clipping the nails too short
• manicures
• excessive exposure of the hands to moisture, including frequently sucking the finger
• ingrowing nails

Symptoms

Most symptoms of paronychia resemble those of different skin infections. Some symptoms directly affect the nail itself.

Paronychia symptoms include:

• pain, tenderness, redness and swelling around the nailfold
• abscess containing pus
• nail hardening
• nail hardening
• nail and nail bed separation

Diagnosis

In most cases, experienced doctors can easily diagnose paronychia with physical examination. Experienced doctors will also consider a person’s medical history and look for risk factors, such as diabetes, nail biting and prolonged water contact etc. Often pus is sent to the laboratory for bacterial culture and drug sensitivity testing. The result may guide subsequent antibacterial or antifungal medications.

Treatment

Acute paronychia required surgical treatment with incision and drainage of the pus containing abscess under local anesthesia or general anesthesia by surgeons. After daily wound cleansing with antiseptic solution, oral and local antibiotics, acute paronychia will usually resolve in one to two weeks time.

Incision and drainage of acute paronychia

Chronic paronychia is usually caused by a one or more fungi or bacteria. Doctors will prescribe antifungal medication and antibiotic medication. These drugs are taken orally and applied locally for a minimum of 2 – 4weeks. It is important to keep the hands dry and clean throughout. Avoid thumb sucking and nail biting. Wear single use gloves if possible. If a person’s job requires their hands to be wet, they may need to take time off.

Patients’ self care is the most important element in curing and preventing paronychia:

• Always keep your hands as warm, clean and dry. Moisturizing the nail fold after washing the hands.
• Wear water seal gloves for any tasks touching irritants and chemicals
• Avoiding submerging the hands in water for long periods of time
• Avoid biting your nails, manicuring your nail folds, and pushing back the cuticles.
• Do not use nail varnish or apply false nail until the condition is cured
• Occasionally a change of the work flow or occupation may be considered.