Paronychia is an infection of the skin next to the nail base. The infection is caused by bacteria, wherein the infected skin around the nail is swollen and tender. This infection is often accompanied by severe redness or whitish swollen skin as a result of pus collection underneath. Paronychia may occur on the skin around the fingernails and toenails, and is triggered by the overgrowth of bacteria residing on the skin called Staphylococcus or yeast referred as Candida. Paronychia may occur in mild to chronic range, based on the caused pain and effects. However, even the mild stage of paronychia can be quite painful. To treat this infection properly and to promote faster healing, it is important to get everything about paronychia elaborated, as knowing the symptoms can determine the degree of severity and thus, required treatments or medications, if needed.

Why is paronychia very painful?

Paronychia is commonly caused by bacteria infestation, but may also be triggered by yeast overgrowth on the infected site. Most of the time paronychia is mild and becomes no big deal concerning the entire health. However, paronychia nail infection may also be very painful. The infection commonly occurs suddenly, although it may also develop gradually. With these two types of paronychia, red and swollen skin around the nail is always involved. Since paronychia causes infection on the folds of tissues surrounding the nail of a finger or toe, it is commonly painful. However, with proper treatments this pain should gradually subside and thus, if it elevates instead, you might need to have it examined, as the infection may spread into a wider area around the nail and cause more severe damages you might not visibly notice.

Risk factors of paronychia

The infection of the folds of the skin tissues surrounding the finger or toenails can be triggered by variety of risk factors. Some common ones include:

• Trauma to the skin around the nail. The most common cause that triggers trauma to the skin around the fingernails is nail biting. Frequent and excessive nail biting may cause tears to the skin around the nail cuticle, letting bacteria from outside to come into the wound site, causing infection developing as paronychia.
• Frequent sucking of the finger. In addition to nail biting, sucking the finger may also possibly trigger damages to the skin, which lets bacteria enter the skin, causing the infection.
• Improper nail trimming or cutting. This is the common cause of paronychia nail infection on the toenails. As the nail is cut too short, the nail bed is injured and becomes the entry point for bacteria in infesting the area. Improper nail trimming may also cause an ingrown nail that causes injuries to the skin around the nail, letting bacteria go beneath it.
• Getting manicures with bad hygiene practices. Manicures can be one of the most frequent risk factor causing paronychia nail infection. Unhygienic manicure instruments transfer causal bacteria into the skin and may end up in infection.
• Frequent hand washing. This causes the hand skin to be more fragile and thus, prone to injuries and wounds. As a result, bacteria can easily infest through the caused scratches or lesions.
• Having hands or feet in water for too long. Yeasts grow well in moist environment, including water. Thus, if you are having your hands or feet for too long in water, it is very likely for these yeasts to infest the skin, which is fragile and tender for the soaking. As a result, the infection of the skin around the nail plate occurs.

In addition, paronychia may also occur when some other possible triggering factors present. These include certain health conditions, such as diabetes, herpes, or psoriasis, as these health complications cause the skin to be more fragile and inhibits sufficient blood supply to the wound site.

How long does it take for paronychia to heal?

Most cases of paronychia are minor and will heal without any specific medical treatments and even medications. However, certain cases of paronychia might require longer healing time compared to some others. There are some factors influencing how much time you might need before having your infection go away completely. These include the severity of the injury, which put the swelling, pus collection, and resulted pain into account, the patient’s health condition, and the treatments performed. As to the resulted symptoms, paronychia is generally signed by some symptoms, such as:

• Redness of the skin around the fingernail or toenail.
• Tender skin of the infection site.
• Collection of pus beneath the affected skin.
• Painful sensation, which is accompanied by warmth on the site of infection.
• In more severe paronychia, the nail on the affected finger or toe may undergo discoloration.

Both types of paronychia develop in two common infection stages. The first stage starts with bacterial infection to the skin region around the nail plate, causing tenderness, swelling, and redness of the area. This is the stage where the infection of the cells occur, which is scientifically known as cellulitis. Furthermore, paronychia is continued with the second stage of development called as an abscess. This phase is started when the causal bacteria or yeast won against the body natural immune system, the white blood cells. When these cells lose in the battle, a pocket of pus filled with white blood cells fighting the bacteria start to form. This is what-so-called as the abscess, which is visible as a collection of pus discharge under the infected skin.

Proper and immediate treatments of paronychia will get rid of the causal bacteria or yeast infestation, so that the resulted symptoms will slowly go away. There are acute and chronic paronychia, which require quite distinguished length of healing time. While acute infections develop quickly and commonly do not last long, the chronic ones develops slowly and thus, may last for around four to six weeks. Chronic paronychia also has a higher chance of reoccurring when its main cause is triggered.

To make sure you have performed proper treatments to the infected skin around the nail, you may observe some signs of improvement within the next days or weeks, such as:

• The pain on the affected finger or toe decreases significantly, although it does not necessarily vanish.
• The redness of the affected fingertip decreases and changes from bright red color into softer, duller red. These two improvement symptoms commonly develop within 36 hours after the proper treatment is performed.
• If you are suffering from an abscess and it has been drained, the finger will continue to be swollen and dull red for some weeks before it fully heals. Hot water soaks and oral antibiotics can be taken to speed up the healing.

Does paronychia go away on its own?

In most cases, paronychia is minor and can be treated at home. Certain remedies are known to be able to bring down the inflammation caused by paronychia, reduce the resulted pain, and promote skin regeneration. If you are suffering from an acute paronychia, you are advised to perform initial home treatments that inhibit its development into the next, more severe level of paronychia. In addition to these performed treatments, it is really important for you to keep away from anything triggering the infection. This way, your symptoms will go away faster, you can prevent it from getting worse, and you will be able to prevent it from reoccurring in the future.

On the other hand, you should be really cautious when suffering from chronic paronychia, in which an abscess around the nail plate has formed and have probably interrupted your ability to do daily chores or activities you used to perform. In this stage, paronychia may require medications and other treatments before it improves and thus, should not be left to heal by itself.

If you are in the initial stage of paronychia infection, the most effective home remedy to perform is soaking your hand wherein the infection present in hot water. Hot soaks are work for cellulitis stage of paronychia in that it increases blood supply to the affected area. This nutrient-rich blood supply increases the body’s natural infection-fighting cells to the cells. Epsom salt can be added into the hot water—not hot enough to hurt the hand, but warm enough to promote blood circulation to the hand—especially because it helps kill the infesting bacteria. Do these hot soaks five times a day with 20-minute interval in each session.

Quite differently, paronychia that has reached the severe stage needs to be treated by medical professionals. They are going to numb up your infected finger before making a small cut required for draining the abscess. This might be required in order to let the accumulated pus drained out. Abscessed paronychia may not be able to treat with hot soaks, since the pus-filled infected skin does not have any blood vessels that are able to deliver any nutrient-rich blood supply to the infection site.

When does paronychia require antibiotics?

Early-stage paronychia does not usually need any medications to heal. Most of the time, hot soaks and keeping away from the causal factors are effective enough to bring some improvements to the infection site. Conversely, if you are having later-stage paronychia, in which a collection of pus is present under the skin, you might need to consider some oral medications, especially antibiotics. These antibiotics help your body’s immune system to fight against the causal bacteria or yeast, so that improvement is going to present.

Oral antibiotics are definitely required to take if you are having a drained abscess from severe paronychia. This is important, since any minor lacerations—lacerations are made to give the accumulated a way out of the infection site—are considered as an open wound, which can be prone to infection. Moreover, if your paronychia is severe, your nail plate might be infected as well, so that antibiotics are required. Topical antibiotics can be applied to an infected finger to help heal it faster. However, never apply topical antibiotic for paronychia in infants, as they might suck the finger and get themselves poisoned.

Do I need to see a doctor for paronychia?

Although paronychia may be minor, there are some conditions that require you to see a doctor for this. Paronychia can actually be observed quite easily. It is commonly signed by present infection on the fingertip that causes redness, inflammation, and possibly, pus collection. If you are suffering for diabetes and other health complications that cause deteriorated immune system, this is an infection you should watch for. Paronychia often develop suddenly, but in diabetic persons, this infection may not only stop at the initial stage of paronychia and may develop into more severe one without being noticed.

It is possible for a diabetic patient not to notice the occurrence of paronychia, since the disease causes damages to the nerves, making it is less responsive to pain sensation. As a result, there are a lot of diabetic people who do not realize that they are developing paronychia and once they do, it has reached the severe stage where the infection has spread and professional helps is required.

What if the paronychia is left untreated?

There are various complications that may be caused by untreated paronychia, in addition to elevated discomfort and pain it may cause. In diabetic patients, untreated paronychia may develop into more severe infection that can eventually be life-threatening. Untreated paronychia may also spread the infection to the fingertip and the nail plate of the affected region. The causal bacteria and yeast, moreover, may get into your blood, causing blood poisoning, which is really serious. Untreated paronychia also develop into severe inflammation, which limits your ability to do basic daily chores and activities.

How to prevent paronychia?

Although paronychia is relatively easy to treat, it may also develop into more severe stage and thus, causes various complications and discomforts. Thus, the most effective way of getting rid of paronychia nail infection is by preventing it from occurring at all. To prevent paronychia:

• Do not bite your nails and avoid picking at the cuticles around them. If you need to get rid of a hangnail, trim it with a nail clipper and avoid pulling it.
• Do not cut your nail too short and always buff the cut nails to prevent them from injuring the nail bed and the skin around the nail plates.
• Avoid washing your hands too frequently and wear gloves if you need to be in a lot of contact with water.
• If you have diabetes, make sure you watch it and keep it under control. If you are suffering from diabetes, do not wait to get any finger infection checked by a doctor.
• Always practice good hygiene.