Infection - skin around the nail
Paronychia is a skin infection that occurs around the nails.
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:
A bacterial and fungal infection can occur at the same time.
Fungal paronychia may occur in people who:
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 causes 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:
The health care provider can usually diagnose this condition by simply looking at the sore skin.
Pus or fluid may be drained and sent to a laboratory to determine what type of bacteria or fungus is causing the infection.
If you have bacterial paronychia, soaking your nail in hot 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 fungal paronychia, your provider may prescribe antifungal medicine. Keep your hands dry and apply a skin-drying substance, such as Castellani paint (phenol).
Paronychia usually responds well to treatment. But, fungal infections may last for several months.
Complications are rare, but may include:
Call your health care provider if:
To prevent paronychia:
To minimize the risk of damage to the nails:
Habif TP. Nail diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier Mosby; 2016:chap 25.
Mallet RB. Paronychia. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 174.
Last reviewed on: 4/14/2015
Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.