PARONYCHIA

General Information

DEFINITION--Inflammation of tissue folds that surround the fingernail. The inflammation can be bacterial or fungal and is not contagious.

BODY PARTS INVOLVED--Fingernails.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Bacterial paronychia:

• Pain or tenderness, redness, warmth and swelling of tissue adjacent to the fingernail.
• Central whitish area produced by pus.

Fungal paronychia:

• Redness and swelling around the fingernail.
• No pain, warmth, itching or pus.

CAUSES

• Bacterial paronychia is preceded by injury, such as a torn hangnail. The infecting germ is usually Staphylococcus.
• Fungal paronychia is caused by a fungus or yeast infection.

RISK INCREASES WITH

• Injury around the fingernail.
• Occupational exposure to constant wetness (dishwashers, bartenders, housewives).
• Diabetes mellitus.

HOW TO PREVENT

• Protect hands from wetness.
• Leave hangnails alone.
• Avoid fingertip injury.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor (sometimes).
• Laboratory studies, such as culture of the discharge, to identify the germ (rare).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• If abscesses present, may require incision and drainage.

POSSIBLE COMPLICATIONS--If untreated, may permanently damage the fingernail and nail bed, and the infection may enter bone or bloodstream.

PROBABLE OUTCOME--

• Bacterial paronychia is curable with treatment in 2 weeks.
• Fungal paronychia is chronic and may require 6 months to heal.
• Recurrence is common with both forms.

How To Treat

GENERAL MEASURES--

• Wear heavy-duty vinyl gloves to prevent contact with irritating substances, such as water, soap, detergent, metal scrubbing pads, scouring pads, scouring powder and other chemicals.
• Dry the insides of gloves after use. Discard gloves if they develop a hole. A glove with a hole harms the hand more than not wearing a glove.
• Wear gloves when you peel or squeeze lemons, oranges, grapefruit, tomatoes or potatoes.
• Wear leather or heavy-duty fabric gloves for housework or gardening.
• Use a dishwashing machine or ask someone else to wash dishes.
• Avoid contact with irritating chemicals, such as paint, paint thinner, turpentine, and polish for cars, floors, shoes, furniture or metal.
• Use lukewarm water and very little mild soap to shower or bathe. All soaps are irritating. Expensive soaps offer no more protection against irritation than less-expensive ones.
• For bacterial paronychia, apply warm soaks.

MEDICATION--

• For minor pain, you may use non-prescription drugs, such as aspirin or acetaminophen.
• Your doctor may prescribe antibiotics or antifungal medicine (depending on the type of infection).

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of paronychia.
• Fever develops.
• Pain is not relieved by treatment.