Isla Bennett
Swollen nails can be a symptom of paronychia, a bacterial or fungal nail infection, or an ingrown toenail. In the case of paronychia, the infected area can become red, swollen, and painful, with a pus-filled blister forming around the nail bed. Ingrown toenails, on the other hand, occur when the corner of the toenail grows into the surrounding skin, causing redness and swelling. While most cases of paronychia can be treated at home, ingrown toenails may require medical attention and, in some cases, partial or complete nail removal. In both instances, proper treatment is key to promoting nail health and regrowth, which typically occurs very slowly over a few months.
| Characteristics | Values |
|---|---|
| Acute Paronychia Healing Time | 5-10 days |
| Chronic Paronychia Healing Time | Several weeks |
| Ingrown Toenail Healing Time | A few months |
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What You'll Learn
Acute paronychia
Paronychia is an infection of the skin that surrounds a toenail or fingernail. It usually results from bacteria entering the skin through cuts in the cuticle and the nail fold (the skin around the nail). However, it can also be caused by fungi, viruses, or yeast.
There are two types of paronychia: acute and chronic. Acute paronychia symptoms appear over a few hours or days, with the infection only affecting the nail fold and not extending deeper into the finger or toe. The symptoms of acute paronychia include throbbing pain, redness, warmth, and swelling in the skin around the nail. In some cases, a small collection of pus forms under the skin next to the nail or underneath it. Acute paronychia is usually caused by bacterial infections, but it can also be caused by viruses or yeast. With proper treatment, acute paronychia usually heals within 5 to 10 days, and rarely recurs in healthy individuals.
Chronic paronychia, on the other hand, develops more slowly and usually lasts six weeks or longer. It may start in one nail fold but often spreads to several other fingers or toes. The affected skin may be red and tender, and sometimes pus can be expressed from under the cuticle. The nail plate thickens and is distorted, often with transverse ridges. The cause of chronic paronychia is not fully understood, but it is believed to be due to dermatitis of the nail fold, with several different microorganisms cultured, particularly Candida albicans and Gram-negative bacilli.
To treat paronychia, it is important to maintain good nail hygiene. This includes avoiding biting or chewing on nails and cuticles, trimming nails carefully without cutting them too short, and maintaining clean and dry hands and nails. In the case of acute paronychia, soaking the affected finger or toe in warm water can help. Antibiotics are often used to treat paronychia, and in some cases, pus may need to be drained by a healthcare provider.
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Chronic paronychia
Paronychia is an infection of the skin around a fingernail or toenail. The infected area can become swollen, red, and painful, and a pus-filled blister (abscess) may form. Paronychia usually clears up with treatment, but sometimes the infection comes back or symptoms last for weeks (chronic paronychia).
To treat paronychia, healthcare providers use antibiotics to kill the infection. Providers may also drain pus (thick, infectious fluid that builds up around a wound). They may also culture the fluid to see what specific bacteria might be causing the infection.
To prevent paronychia, it is important to avoid injuring the nails and the skin around them. Nails grow very slowly, so any damage to them can last a long time and increase the risk of paronychia. It is also important to maintain good hygiene by washing your hands and keeping your nails clean. Use gentle soaps that are not irritating to your skin.
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Ingrown toenail treatment
Ingrown toenails are a common condition that occurs when the corner of the toenail grows into the skin. This usually happens when toenails are cut with a taper around the corners. Ingrown toenails are typically not serious and can be treated at home.
Home Treatment
Ingrown toenail home treatment includes several simple steps:
- Soak your foot in warm water mixed with Epsom salt or soapy, sudsy water twice daily. Keep your foot dry the rest of the time.
- Gently lift the edge of your nail and place a small piece of cotton or dental floss between the nail and your skin. Change the cotton or floss daily to help the nail grow above the skin.
- Apply petroleum jelly to the tender area and bandage the toe.
- Wear comfortable shoes or sandals until your toe feels better.
- Take a non-prescription pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin IB) to help ease the toe pain.
Medical Treatment
If home remedies do not help, your healthcare provider may recommend:
- Lifting the nail: For a slightly ingrown nail, your healthcare provider may carefully lift the ingrowing nail edge and place cotton, dental floss or a splint under it. This separates the nail from the overlying skin and helps the nail grow above the skin edge, usually in 2 to 12 weeks.
- Taping the nail: Another approach, which minimises the need for daily replacement, uses cotton coated with a solution that fixes it in place and makes it waterproof (collodion).
Surgery
In some cases, surgery may be required to remove the ingrown toenail. After the procedure, you can take a pain reliever as needed and apply a wet compress for a few minutes a day until the swelling goes down. Rest and elevate the toe for 12 to 24 hours. It may take two to four months for your toenail to grow back.
Prevention
To prevent ingrown toenails, practice good foot care and avoid cutting your toenails with a taper around the corners.
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Nail regrowth after partial/complete nail avulsion
Swollen nails can be a symptom of paronychia, a bacterial or fungal nail infection. The treatment of swollen nails depends on the cause and severity of the infection. In some cases, antibiotics or antifungal medications may be prescribed. If the infection is severe or does not respond to initial treatment, a doctor may recommend draining an abscess or removing part or all of the nail.
Nail avulsion is a type of surgery performed to treat nail conditions that cannot be resolved by routine care, such as deformed, curved, or ingrown nails. During the procedure, either a partial or complete nail avulsion may be performed, depending on the severity of the condition. After the appropriate part of the nail is removed, a chemical is applied to the nail bed to prevent the nail from growing back.
The healing process after nail avulsion typically takes four to six weeks if part of the nail is removed and 10 to 12 weeks if the whole nail is removed. During the healing process, it is normal for the wound to weep a light yellow discharge and for the area to be inflamed or blistered. After three to 14 days, there is usually an increase in discharge, which then gradually reduces as a scab forms. Eventually, the scab will come away, leaving toughened skin over the nail bed.
To promote healing after nail avulsion, it is recommended to keep the area clean and dry, and to follow instructions from your healthcare provider regarding redressing the wound. You may also be advised to rest with your foot elevated and to take painkillers as needed. It is important to avoid getting the area wet until the first redressing to prevent infection and ensure proper healing.
In most cases, nail avulsion is a safe and effective procedure. However, as with any surgery, there are potential risks and complications. These may include prolonged numbness in the toe due to local anaesthesia, temporary damage to the new nail edge, and irritation. Additionally, the chemicals used during the procedure may pose a risk to pregnant individuals or those who are breastfeeding. It is important to discuss any concerns or risks with your healthcare provider before undergoing the procedure.
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Preventing nail infections
Nail infections, or paronychia, are usually caused by bacteria that enter broken skin near the cuticle and nail fold (the skin around the nail). In some cases, a nail fungus (usually candida) may occur along with the bacterial infection. To prevent nail infections:
- Keep your nails short. This helps prevent fungi and other germs from getting under your nails.
- Sanitize your nail clippers before use. Wash them with soap and water, then wipe them with rubbing alcohol.
- If you go to a salon for nail care, ask how often they disinfect nail clippers, emery boards, and other equipment. They should sanitize these after every client.
- Never share nail clippers, shoes, skates, towels, and other personal items. You can easily pick up a fungal infection by sharing personal items.
- Wear flip-flops or shower sandals when walking in warm, moist areas like gyms, locker rooms, spas, public showers, and pools.
- If you've just finished treating a nail fungus, throw away old shoes, boots, and skates, or disinfect them with an ultraviolet (UV) shoe sanitizer or ozone cabinet. Fungi can live in footwear and give you another infection.
- Put on a clean pair of socks every day and whenever your socks get sweaty. This helps prevent fungi from growing. Wearing moisture-wicking socks can also reduce the need to change your socks.
- Keep your feet dry and prevent overheating. Fungi thrive in moist places like damp shoes. Give shoes 24 hours to dry out before wearing them again, and sprinkle antifungal powder in your shoes.
- Avoid injuring your nails and the skin around them. Nails grow very slowly, so any damage can last a long time and increase the risk of paronychia.
- Avoid biting or chewing your nails or hangnails. Don't pick at your cuticles.
- Be careful not to cut your nails too short. When trimming cuticles, avoid cutting too close to the nail fold.
- Maintain good hygiene by washing your hands and keeping your nails clean. Use gentle soaps that are not irritating to your skin.
- Use lotion on your nail fold and cuticles if your skin is dry. Excessive dryness can cause the skin to crack.
- Wear waterproof gloves if you work with chemicals or if your hands will be wet for a long period.
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Frequently asked questions
It can take a few months for a toenail to regrow after a partial or complete nail avulsion.
Swollen nails can be caused by an ingrown toenail or paronychia (a nail infection).
Paronychia is an infection of the skin around a fingernail or toenail. It can be caused by bacteria or fungi and is characterised by pain, swelling, and redness around the nail.
Acute paronychia usually heals within 5 to 10 days with proper treatment, such as soaking the affected area in warm water or taking oral antibiotics. Chronic paronychia may take several weeks to heal and is often treated with topical corticosteroid ointments or creams.
To prevent ingrown toenails, trim your nails straight across and avoid cutting them too short. To lower the risk of paronychia, avoid biting or picking at your nails and cuticles, and maintain good hand and nail hygiene.
