Sophia Delgado
Paronychia, a bacterial or fungal skin infection, develops around the nail, causing pain, swelling, and tenderness. It usually results from bacteria entering broken skin near the cuticle and nail fold. The treatment for paronychia depends on the severity and type of infection. Acute paronychia, a sudden and painful infection, typically heals within 5-10 days with proper treatment. However, chronic paronychia, a less obvious and longer-lasting infection, may require several weeks of antifungal medication. Fungal nail infections, characterized by thick, discolored, and brittle nails, can also take a long time to treat, sometimes requiring up to 6 months of medication.
| Characteristics | Values |
|---|---|
| Healing time for acute paronychia | 5-10 days |
| Healing time for chronic paronychia | Several weeks |
| Healing time for fungal nail infections | A few months |
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What You'll Learn
Acute paronychia symptoms
Acute paronychia is a bacterial or fungal skin infection that develops around the nail. It is caused by polymicrobial infections after the protective nail barrier has been breached. This can occur due to biting or chewing nails, but it is more common in work conditions that require hands to be frequently wet or exposed to chemicals.
The treatment for acute paronychia depends on the extent of the infection. If diagnosed early, it can be treated non-surgically with warm soaks in water, Burow solution, or 1% acetic acid. Topical antibiotics should be used if simple soaks do not relieve the inflammation. Oral antibiotics are usually unnecessary unless the patient is immunocompromised or a severe infection is present.
If an abscess has formed, it must be drained. This can be done by gently elevating the eponychial fold from the nail using a small blunt instrument, such as a metal probe or elevator. This technique does not require an incision, and no tissue excision is typically needed. The wound is then irrigated with an isotonic sodium chloride solution, and gauze packing is inserted to keep the cavity open for drainage.
In summary, acute paronychia is a bacterial or fungal nail infection with symptoms that develop quickly and can be effectively treated with a combination of warm soaks and topical antibiotics. Abscesses, if present, require drainage, which can be achieved through simple instrumentation without the need for tissue excision or incision.
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Chronic paronychia symptoms
Chronic paronychia is a nail infection that develops slowly over time. It is characterised by symptoms lasting at least six weeks and is caused by irritant contact dermatitis rather than an infection. It is often associated with distorted, ridged nail plates.
Common irritants include acids, alkalis, or other chemicals used by housekeepers, bartenders, dishwashers, laundry workers, and florists. People with constantly cold and wet hands, such as swimmers, are also susceptible to chronic paronychia.
The symptoms of chronic paronychia include redness, tenderness, and swelling of the nail folds. It may start in one nail fold, particularly the proximal nail fold, but often spreads to several other fingers or toes. The cuticle may be totally absent, and Beau lines (deep side-to-side grooves in the nail) may be present.
In some cases, chronic paronychia may be caused by a chronic fungal infection. Candida albicans and Gram-negative bacilli, pseudomonas, are commonly cultured in cases of chronic paronychia.
The main complication of chronic paronychia is nail dystrophy, where the nail plates become distorted, ridged, and discoloured (yellow, green, or black) and brittle.
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Treatment for fungal infections
A fungal nail infection causes the nail to become discoloured, thickened, distorted, and easy to break. It is unlikely to get better without treatment. However, treating a fungal nail infection can take a long time, and treatments may cause side effects.
If you suspect that you have a fungal nail infection, you should speak to a pharmacist or a doctor. A pharmacist may suggest an antifungal nail medicine that you brush onto the nail. You will need to use this regularly for a few months before you start to see an improvement. You should keep using the treatment until advised to stop by a healthcare professional. Stopping treatment early could cause the infection to return.
If treatments from a pharmacy do not work, your doctor may prescribe antifungal tablets. Before starting treatment, your doctor will take a sample of your nail to test what kind of infection you have. They may also need to do a blood test before and during your treatment to check that your liver is working properly. You may need to take antifungal tablets for up to 6 months. Antifungal tablets are not suitable for people with certain conditions, including liver or kidney disease, and they may be unsuitable for people who are pregnant or breastfeeding.
In some cases, badly infected nails need to be removed. This is a small procedure performed while the area is numbed under local anaesthetic. The nail can grow back. If the infection fails to clear, a doctor can treat the nail so that it cannot grow back.
There are many treatment options for fungal nail infections, but none are ideal. Medicine applied to the nails has a low cure rate, and antifungal pills can cause side effects. Nail removal requires wound care. Researchers are working on new and better ways to treat nail fungus. One treatment showing promise is the use of lasers and light treatments to clear nail fungus. While this treatment is promising, more research is needed to know whether it is safe and effective for most people. Researchers are also looking at other potential treatments, including patches, nail lacquers, and gels.
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Treatment for bacterial infections
Paronychia is a bacterial or fungal skin infection that develops around the nail. It usually affects the skin at the base (cuticle) or up the sides of the nail. The infection can occur when bacteria enter broken skin near the cuticle, often through small cuts caused by nail biting or picking at the cuticles. It can also be caused by exposure to irritants such as detergents and other chemicals, or by frequent exposure to water.
Most nail infections can be treated with antibiotics, which may be prescribed by a doctor. Topical anti-bacterial ointments may also be recommended. In some cases, an abscess may need to be drained by a doctor, and in rare cases, part of the nail may need to be removed.
For mild cases of paronychia, home treatment may be sufficient. Soaking the infected area in warm water for about 15 minutes a few times a day can help reduce pain and swelling and promote healing. Topical steroids may also be used in conjunction with warm soaks. In addition, maintaining good hand hygiene and keeping nails trimmed and smooth can help prevent paronychia.
Chronic paronychia, which lasts longer than six weeks, may be more challenging to treat. It often involves stopping the source of irritation, controlling inflammation, and restoring the natural protective barrier. Topical anti-inflammatory agents, steroids, or calcineurin inhibitors may be used. In severe cases, more aggressive treatments may be required, and surgical intervention may be necessary for recurrent or severe infections.
It is important to consult a medical professional for guidance if you suspect you have paronychia, as they can provide appropriate treatment and prevent worsening infections.
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Preventing nail infections
Nail infections, or paronychia, are usually caused by bacteria entering broken skin near the cuticle and nail fold (the skin around the nail). Fungi can also cause nail infections, which can spread from other people. Here are some ways to prevent nail infections:
Keep your nails short and clean
Trimming your nails helps prevent fungi and other germs from getting under your nails. Cut your toenails straight across and keep them shorter than the end of your toes. Sanitize your nail clippers by washing them with soap and water, then wiping them with rubbing alcohol.
Practice good hygiene
Keep your hands and feet clean and dry. Fungi thrive in moist places, so it's important to keep your nails and the skin around them dry. If your job requires your hands to be wet, you may need to take time off to prevent nail infections. Change your socks daily and whenever they get sweaty. Wear moisture-wicking socks to reduce the need to change your socks as often.
Protect your feet in public places
Fungal nail infections can spread in places like communal showers, gyms, and pools. When walking in these areas, wear flip-flops or shower sandals to prevent nail fungus and athlete's foot. Keep a pair of flip-flops near the pool so you can easily slip them on.
Disinfect footwear and equipment
Fungi can live in footwear, so it's important to disinfect your shoes, especially if you've had a nail infection in the past. You can buy an ultraviolet (UV) shoe sanitizer or ozone cabinet online. If you go to a salon for nail care, ask how often they disinfect their equipment. Equipment that isn't properly sanitized can spread fungal infections between clients. Never share personal items like nail clippers, shoes, towels, and skates, as you can easily pick up a fungal infection from others.
Treat underlying skin conditions
People with underlying skin conditions may be more prone to developing nail infections. It's important to manage these conditions effectively and consult a dermatologist for specialized advice.
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Frequently asked questions
Acute paronychia usually heals within 5 to 10 days with proper treatment.
Chronic paronychia may take several weeks to heal. Treatment for chronic paronychia can also take a long time, and symptoms may last for weeks.
Fungal nail infections can take a long time to treat. Antifungal nail medicines need to be used for 6 to 12 months, and it may take several months before improvements are visible.
Bacterial nail infections are usually treated with antibiotics. Acute bacterial paronychia can be treated rapidly with antibiotics, reducing symptoms quickly.
