Caleb Foster
Fingernail infections are a common problem that can affect people of all ages. These infections can be caused by bacteria or fungi entering the skin through broken skin near the cuticle and nail fold. In some cases, the infection can be a result of an underlying condition such as diabetes, poor blood circulation, or a compromised immune system. While fingernail infections usually respond well to treatment, they can cause pain and discomfort, and in severe cases, may require medical attention to prevent the spread of infection to other parts of the body.
| Characteristics | Values |
|---|---|
| Type of infection | Bacterial, fungal, or yeast-like |
| Symptoms | Redness, swelling, pain, discomfort, discolouration, thickening, curling, detachment, abnormal shape, foul smell, pus-filled blisters |
| Causes | Trauma, irritation, injury, biting nails, chewing nails, hangnails, cutting nails too short, diabetes, poor circulation, immunosuppression, frequent exposure to water or chemicals |
| Treatment | Antibiotics, antifungal creams, lotions, or oral medications, laser treatment, photodynamic therapy, incision and drainage, warm water soaks, lemon and salt |
| Prevention | Maintaining good hygiene, using gentle soaps, wearing waterproof gloves, keeping nails short and straight, using antifungal powder or spray, wearing moisture-wicking socks, changing socks frequently, avoiding walking barefoot in public spaces, disinfecting manicure tools |
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What You'll Learn
Paronychia, a skin infection around the nail
Paronychia is a common nail infection that affects the skin around a fingernail or toenail. It is characterised by pain, redness, and swelling around the nail, and can be caused by bacteria, fungi, or viruses. The condition usually occurs when the protective barrier between the nail and the nail fold (cuticle) is disrupted, allowing bacteria or other organisms to enter and cause an infection.
There are two types of paronychia: acute and chronic. Acute paronychia appears suddenly, with symptoms developing over a few hours or days. It is typically caused by a bacterial infection, particularly Staphylococcus aureus, and usually affects only one nail. Symptoms include pain, redness, and swelling around the nail, and it may be accompanied by fever, lymphangitis, and tender lymphadenopathy. Acute candida, a type of fungal infection, more commonly infects the proximal nail fold.
Chronic paronychia, on the other hand, develops more slowly and usually lasts six weeks or longer. It is often caused by mechanical or chemical factors, and sometimes by a fungal infection, particularly Candida species. Several fingers or toes can be infected at once. The affected nail fold is swollen and lifted off the nail plate, allowing the entry of organisms and irritants. The skin may be red and tender, and pus may be present under the cuticle. The nail plate may thicken and become distorted, with transverse ridges.
Treatment for paronychia aims to address the underlying infection and relieve symptoms. Acute paronychia is typically treated with antibiotics, while chronic paronychia may require antifungal medications. In some cases, drainage of pus or surgical incision may be necessary. It is important to maintain good nail hygiene and avoid biting or picking at the nails and cuticles to prevent paronychia.
Paronychia is usually not a serious condition, but it can cause discomfort and nail deformities. However, in severe cases, especially when left untreated, the infection can spread deeper into the finger or toe, and in rare cases, a finger or toe may need to be amputated to prevent the spread of the infection to the rest of the body.
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Bacterial and fungal infections
Fungal nail infections can affect any part of the body but occur more frequently in toenails than fingernails, likely because toes are confined to shoes, which provide a warm, moist environment that allows fungi to thrive. The same fungi that cause jock itch, athlete's foot, and ringworm can cause nail infections. Candida yeasts, which cause nail infections, can invade nails that have been damaged by a prior infection or injury. Candida infections more commonly affect the fingernails, especially in people who frequently soak their hands in water. These infections usually start around the cuticle, which becomes swollen, red, and tender to the touch. The nail may partially lift off the nail bed, or fall off completely.
Fungal nail infections are not usually serious but can be unpleasant and difficult to treat. They develop slowly and cause the nail to become discoloured, thickened, distorted, brittle, and crumbly. Toenails and fingernails can become thick, yellow, and brittle. In some cases, the nail may become distorted and difficult to trim.
Fungal nail infections are treated with antifungal medication, which comes in the form of tablets or a special paint that is applied directly to the nail. Treatment can take several months, and a small sample of the infected nail may need to be tested before treatment to confirm the presence of a fungal infection. Laser treatment is another option for stubborn infections, but it is expensive and not usually available through public healthcare services.
Nail infections (paronychia) happen when bacteria get under the skin around the nail, often through cuts in the cuticle and the nail fold (the skin around the nail). Paronychia can also develop when the protective barrier between the nail and the nail fold is disrupted, which can be caused by manicures and pedicures, artificial nails, and biting or picking at the nails or cuticles. Paronychia is usually treated with antibiotics and, in some cases, pus may need to be drained.
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Treatment and prevention
Paronychia is a skin infection around the nails, causing inflammation, swelling, pain and discomfort. It can be caused by biting or chewing nails, pulling hangnails, sucking fingers, or an ingrown toenail. It is usually treated with antibiotics to kill the infection.
If you have mild acute paronychia, you can try soaking the affected area in warm water several times a day. You can also try a home remedy of soaking your finger in a lemon sprinkled with salt for a few minutes, although there is no scientific evidence to support this. If symptoms do not improve, seek medical advice.
For more severe cases, a doctor may need to drain any pus from abscesses. They will use a local anaesthetic and insert gauze to help drain the pus. Oral antibiotics are usually only needed if the patient is immunocompromised or has a severe infection.
To prevent paronychia, avoid biting or chewing nails and hangnails, and do not pick at cuticles. Be careful not to cut your nails too short, and when trimming cuticles, avoid cutting too close to the nail fold. Wash your hands regularly and keep your nails clean, using gentle soaps that are not irritating to the skin. Use lotion on your nail folds and cuticles if your skin is dry. If your job involves working with chemicals or having wet hands for long periods, wear waterproof gloves.
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Risk factors
Fingernail infections, or paronychia, occur when bacteria enter broken skin near the cuticle and nail fold, causing an infection. The cuticle is the skin at the base of the nail, and the nail fold is where the skin and nail come together. Paronychia can develop following trauma, irritation, or infection.
Paronychia is more common in women than in men, with a female-to-male ratio of 3:1. Middle-aged women are at the highest risk of infection. It is also more likely to occur in manual labor workers or those in occupations that require their hands or feet to be submerged in water for long periods, such as dishwashers or bartenders.
Nail biting or picking at the cuticles can create tiny cracks in the nails or cuts in the skin, allowing bacteria to enter and cause an infection. Similarly, biting or chewing on hangnails can have the same effect. Cutting nails too short can also lead to paronychia, as it increases the risk of breaking the skin around the nail.
People with diabetes or conditions affecting their circulation are more prone to developing paronychia. Additionally, those with underlying skin conditions may be more susceptible to nail infections.
Occupational or environmental exposures to irritants, such as detergents and other chemicals, can irritate the skin and lead to a nail bed infection. Working with chemicals without wearing protective gloves increases the risk of developing paronychia.
Some medications have also been linked to paronychia, including retinoids, anti-cancer medications, HIV medications, and certain antibiotics.
Infrequent hand washing or a lack of proper nail hygiene can also increase the risk of developing fingernail infections.
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Symptoms
Fingernail infections, also known as paronychia, are usually caused by bacteria or a type of yeast called Candida. The infection can be acute or chronic. Acute paronychia symptoms appear over a few hours or days and go away with treatment, lasting less than six weeks. Chronic paronychia symptoms develop more slowly and usually last six weeks or longer.
The main symptom of paronychia is a painful, swollen, red area around the nail, often at the cuticle or at the site of a hangnail or other injury. The nail may look detached, abnormally shaped, or have an unusual colour. There may also be pus-filled blisters, especially with a bacterial infection. Bacterial paronychia usually appears suddenly, whereas fungal paronychia can take longer to notice and causes less obvious symptoms.
Chronic paronychia may cause the cuticle to break down, and the nail may eventually separate from the skin. The nail may become thick, hard, and deformed. Paronychia caused by bacteria can get worse quickly. It is important to note that chronic paronychia may be caused by irritant dermatitis, a condition that makes the skin red and itchy. Once the skin is irritated, germs can take hold and cause an infection.
Paronychia is usually diagnosed through a simple physical examination by a healthcare provider. Occasionally, they may take a sample of the tissue or pus and send it to a laboratory to test for specific infectious causes such as bacteria or fungi.
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