Noah Sinclair
There are many reasons why your finger hurts under the nail. It could be due to a nail injury, infection, or irritation. For instance, you may have smashed your finger, causing a hematoma, which is when blood or fluid gathers under your nail. It could also be due to an ingrown nail, hangnail, fungal infection, or paronychia, which is swelling around your fingernail or toenail. In some cases, it could be a more serious issue, such as a subungal tumor. Depending on the cause, treatment can vary from home remedies to medical treatments, including antibiotics and, in rare cases, surgery.
| Characteristics | Values |
|---|---|
| Hangnails | Loose bits of skin that surround your fingernail |
| More common in cold weather when your skin becomes drier | |
| Can be painful and could lead to infection if pulled or ripped | |
| Can be treated at home by washing hands with soap and water, applying antibiotic cream, and covering with a bandage | |
| May require doctor's treatment if infection occurs | |
| Ingrown fingernails | Occur if you clip or bite your nail too close to the nail bed, injure it, or get a fungal infection |
| Can be treated by removing any hanging parts of the nail with clean tools, cleaning and soaking the nail in cool water | |
| Hematomas | Blood or other fluid gathers beneath your nail, producing pain |
| Can be caused by smashing your finger or dropping something heavy on it | |
| Can be treated at home by gently pressing on the nail to stop further bleeding | |
| May require medical attention if they worsen or become extremely painful | |
| Paronychia | Swelling, redness, and warmth around the fingernail or toenail |
| Can be caused by a cut near the nail (acute) or activities that cause cold and wet hands (chronic) | |
| Can be treated at home by soaking the affected area in warm water for 15-20 minutes, multiple times a day | |
| May require medical treatment with antibiotics or steroids if symptoms do not improve | |
| Subungal tumors | Nodules underneath the fingernail that can cause severe pain |
| Require diagnosis and treatment by a doctor |
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What You'll Learn
Hematoma (blood or fluid under the nail)
A hematoma under the nail, also known as a subungual hematoma, is usually caused by a direct blow or crush injury to the fingertip. This can happen, for example, if you get your finger caught in a door or drop something heavy on it. This type of injury can cause bleeding under the nail, which can be very painful due to the pressure applied to the nail bed. The affected nail will typically change colour and appear purple, brown, or black.
A small subungual hematoma may not require medical attention and can be treated at home by applying ice to reduce swelling and taking over-the-counter anti-inflammatory medications such as aspirin or ibuprofen. However, if the hematoma is extremely painful or worsens, it is important to seek medical attention. Your doctor may recommend draining the hematoma to relieve the pressure and pain, a procedure known as decompression or trephination. During this procedure, a small hole is made in the nail to allow the blood to drain out. In some cases, your doctor may need to numb the area before performing the procedure.
If there is a large area of bleeding under the nail, the nail bed may be injured, and the entire nail may need to be removed. The nail bed may also need to be repaired with stitches. In most cases, a new fingernail will regrow within 8 weeks, while a new toenail may take up to 6 months to fully regrow.
It is important to keep the affected area clean and dry after treatment to prevent infection. Follow-up care may include monitoring for signs of infection, such as warmth, redness, increasing swelling, or fever. If you experience any of these symptoms, be sure to consult your doctor.
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Hangnails (dry skin around the nail)
Hangnails are the loose bits of skin that surround your fingernail. They are common, especially in cold, dry weather when your skin becomes drier. Hangnails can be painful if pulled or ripped and can lead to infection. To treat a hangnail at home, follow these steps:
- Soak the affected finger in clean, warm water for 10 to 15 minutes.
- Massage vitamin E oil, petroleum jelly, or mineral oil very gently into the area.
- Gently clip the hangnail with sterile nail clippers, nail scissors, or cuticle cutters to prevent it from catching on anything and to reduce the risk of further infection.
- If you cut too deep and it bleeds, rinse with warm water and cover with an antibacterial or antibiotic ointment.
- Moisturize the affected area with hand cream to prevent the skin from drying out further and to prevent more hangnails from forming.
Hangnails that continue to ache or do not heal after several days may be infected and require medical attention. Your doctor may prescribe a topical or oral antibiotic to clear up the infection.
To prevent hangnails, keep your skin moisturized and make simple lifestyle changes:
- Moisturize your hands and cuticles daily.
- Avoid using harsh soaps and chemicals like acetone.
- Wear gloves when house cleaning, washing dishes, and gardening.
- Wear gloves when going outside in cold weather.
- Drink lots of water and eat a well-balanced diet.
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Fungal infections
Fingernail pain can be caused by fungal infections, such as paronychia, which is an infection around the nail. Paronychia can be caused by yeast-like organisms such as candida, which is a type of fungus that causes toenail fungal infections. Paronychia can also be caused by bacterial infections, which can occur simultaneously with fungal infections.
The symptoms of paronychia include 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. If the infection is fungal, it tends to occur more slowly, and the nail may look detached, abnormally shaped, or discoloured. Paronychia can be acute or chronic. Acute paronychia causes throbbing pain, redness, warmth, and swelling in the skin around a nail. In some cases, a small collection of pus forms under the skin next to the nail or underneath the nail itself. Chronic paronychia usually causes less dramatic symptoms than acute paronychia, and the area around the nail is tender, red, and mildly swollen, with the cuticle missing and the skin feeling moist.
To treat paronychia, you can soak the infected area in warm water for about 15-20 minutes, a few times a day. For acute paronychia, this treatment can be done two to four times a day. If your symptoms do not improve or pus develops, you should see a doctor. A doctor may treat acute paronychia with an oral or topical antibiotic and may drain the pus if necessary. Chronic paronychia is usually treated with a topical corticosteroid ointment or cream, sometimes with a topical antifungal agent. It is important to keep the skin clean and dry and to wear gloves when exposed to potential irritants.
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Ingrown nails
There are several home treatments for ingrown nails. Soaking the nail in warm, soapy water for 20 minutes twice a day can help to soften the nail and make it easier to treat. Placing a small wad of cotton under the edge of the nail will help to lift it off the skin, allowing the nail to grow outwardly. Topical antibiotics can be applied to prevent infection, and a protective bandage should be placed over the nail to keep the area clean.
If home treatments do not help, a doctor may recommend non-invasive medical procedures. They may place a piece of tape around the bottom of the finger to pull the skin away from the nail, or they may insert a small wedge of medicated cotton between the nail and the inflamed skin. In some cases, a small string of dental floss may be placed to separate the nail from the nail bed. If the ingrown nail has developed into an abscess, a doctor may need to drain the pus. Surgery is rarely required for ingrown fingernails, but it is more common for ingrown toenails.
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Paronychia (swelling around the nail)
Paronychia is a skin infection around the nails, causing inflammation of the skin around a finger or toenail. It can be acute (lasting less than 6 weeks) or chronic (persisting longer than 6 weeks). Paronychia is usually caused by a bacterial infection, but viral pathogens may also be implicated. It can also be caused by fungi, as moisture allows certain germs, such as candida (a type of fungus) and bacteria to grow.
Acute paronychia develops rapidly, usually over a few hours, and affects a single nail fold. Symptoms include pain, throbbing pain, redness, warmth, swelling, and tenderness in the skin around the nail. In some cases, a small collection of pus forms under the skin next to the nail, or underneath the nail itself. The nail plate may thicken and distort, with transverse ridges. Acute paronychia can be treated at home by soaking the infected nail in warm water 3 to 4 times a day for at least 15 minutes. This can help reduce pain and swelling and it should heal within a few days. If symptoms do not improve with this treatment, or if pus develops, you should see a doctor.
Chronic paronychia is a gradual process and usually affects several nails on the same hand. It is mainly caused by hand dermatitis, constantly cold and wet hands, or an allergic reaction. It is more common in people with diabetes and can cause distorted, ridged, yellow, green, or black nail plates. Treatment for chronic paronychia includes topical corticosteroid ointment or cream, with or without a topical antifungal agent. It is important to keep the skin clean and dry and to protect the nails from harsh chemicals.
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Frequently asked questions
There are several possible causes of pain under your fingernail, including:
- A hangnail, which is common in cold weather when your skin is drier.
- A nail injury, such as smashing your finger or dropping something heavy on it, causing a hematoma.
- An ingrown nail, which can occur if you clip or bite your nail too close to the bed, or if you injure it.
- A fungal infection, which can cause changes to your nail and may result in pain.
- Paronychia, a swelling around your fingernail or toenail that can be caused by fungi, bacteria, or dermatitis.
Treatment for pain under the fingernail depends on the underlying cause. In general, you can try soaking the affected nail in warm water for at least 15-20 minutes, multiple times a day. You can also apply a topical antibiotic ointment or cream and cover the area with a bandage. Keep the affected area clean and dry.
If the pain is severe, persists for more than a week, or is accompanied by other symptoms such as redness, swelling, or discoloration, you should seek medical advice.
You should see a doctor if:
- The pain is severe, worsening, or not responding to home treatments.
- There is a large bruise or hematoma under the nail, as the doctor may need to drain it to relieve pressure and pain.
- You have a torn or cracked nail that is exposing the nail bed.
- You have signs of infection, such as redness, swelling, or pus.
- You have injured the nail bed or suspect a broken bone in your finger.
