Isla Bennett
Fingernail pain is a common issue with a variety of causes, from injuries to infections. Fingernails are made of laminated layers of a protein called keratin, and while the part that shows is composed of dead cells, the nail bed underneath is filled with sensitive nerve endings and blood vessels. This means that any injury or infection affecting the nail bed is likely to cause pain.
| Characteristics | Values |
|---|---|
| Cause of pain | Trauma, irritation, or infection |
| Types of infection | Bacterial, fungal |
| Symptoms | Throbbing pain, swelling, redness, soreness, bleeding, tenderness, mild redness, minimal swelling |
| Treatment | Soaking the infected area in warm water, antibiotics, antifungal medication, acetaminophen, icing, removing the damaged nail plate, repairing the nail bed, draining pus |
| Prevention | Avoid biting nails, avoid picking at the skin around nails, wear waterproof gloves if working with chemicals or if your hands will be wet for a long period |
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Paronychia (nail infection)
Paronychia is an inflammation of the fingers or toes in one or more of the three nail folds. It is caused by bacteria entering broken skin near the cuticle and nail fold, resulting in an infection. The cuticle is the skin at the base of the nail, and the nail fold is where the skin and nail meet. Paronychia can also be caused by trauma to the nail bed or cuticle area, such as accidents, nail biting, or frequent manicures or pedicures.
The symptoms of paronychia include pain, swelling, and tenderness around the nail. The skin may be red and warm to the touch, and there may be a build-up of pus under the skin. These symptoms usually develop over several hours or days but can sometimes take longer. If left untreated, the nail can become deformed, discoloured, and brittle, and the infection can spread deeper into the finger or toe.
The treatment for paronychia involves addressing the infection and draining any pus. Warm water soaks are often recommended, and topical or oral antibiotics may be prescribed to kill the bacteria. In some cases, surgical intervention may be necessary to drain an abscess.
There are two types of paronychia: acute and chronic. Acute paronychia is caused by bacterial infections and usually affects only one digit at a time. It can be treated with warm soaks and topical antibiotics. Chronic paronychia, on the other hand, is caused by irritants and can last for six weeks or longer. It typically involves multiple digits and may require frequent follow-up monitoring to prevent superinfections or deep-seated infections.
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Trauma to the nail
Nail injuries can also lead to more serious issues such as bone fractures or tissue tears, so it is important to seek medical attention if there is significant pain or bleeding under the nail. In some cases, a physician may need to create a small hole in the nail to drain blood and relieve pressure and pain. If the bone is broken or the bruise is very large, the nail may need to be removed and the nail bed repaired. Antibiotics may be prescribed to prevent infection.
Nail trauma can also lead to secondary infections, such as bacterial, viral, or fungal infections. Bacterial infections are often caused by staphylococcal and streptococcal species, while viral infections can include human papillomavirus, which causes warts. Fungal infections, typically caused by Candida, can lead to swelling of the proximal and lateral nail folds and mild nail dystrophy. These infections can be difficult to eradicate and may require timely surgical drainage to prevent permanent nail loss.
Additionally, repeated trauma to the nails, such as from nail-biting or cuticle-biting habits, can lead to nail deformities and disorders such as onychophagia and retronychia. Nail-biting can also lead to acute paronychia, a type of bacterial infection that causes swelling and irritation under the nail. These habits can cause horizontal ridges and raised areas on the nails, as well as permanent nail shortening due to keratinization of the distal nail bed.
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Gel manicures
While gel manicures can be beautiful and long-lasting, they can be tough on nails. The process of removing gel polish can be rough on nails and requires extra care to prevent nail damage. Gel manicures can cause nail brittleness, peeling, and cracking, and repeated use can increase the risk of skin cancer and premature skin aging on the hands.
To keep your nails healthy before, during, and after gel manicures, dermatologists recommend the following tips: Be proactive with your manicurist. Ask if their tools are sterilized and ensure they are cleaning and disinfecting tools after every client. Never let your manicurist push or cut your cuticle as this could lead to inflammation and infection. Try to space out gel manicures to give your nails a rest and always have them removed at a salon to avoid damage.
Additionally, consider wearing sunscreen with an SPF of 30 or higher on your hands before getting a gel manicure to prevent skin cancer and premature skin aging caused by ultraviolet radiation used to seal the polish. Avoid picking or peeling gel nail polish, as this can damage your nails. Instead, make an appointment with your manicurist to have the polish removed properly.
To care for your nails in between gel manicures, try not to wear any nail polish for one to two weeks or longer to allow your nails time to repair. Rehydrate your nails by applying a moisturizing product, such as petroleum jelly, to your nails and cuticles several times a day to minimize brittleness and help prevent chipping.
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Hangnail
If your hangnail does not improve within one to two weeks, or shows signs of infection, such as blisters and pus, you should contact your doctor. Symptoms of an infected hangnail may include pain, redness, swelling, throbbing, and tenderness.
To prevent hangnails, you can try to keep your skin well-moisturised, particularly in dry and cold weather, and avoid biting or picking at your nails and the surrounding skin.
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Psoriasis
Fingernail pain is a common issue that can be caused by various factors, one of which is psoriasis.
Nail Psoriasis
Nail psoriasis is a form of psoriasis that affects the nails on both your fingers and toes. It causes discoloration, pitting, and changes in the texture of your nails. In addition, it can lead to nail separation from the nail bed, resulting in discomfort and pain.
Symptoms of Nail Psoriasis
Nail psoriasis can manifest in several ways. Common symptoms include nail crumbling, roughness, and the presence of blood under the nail. Additionally, it can cause your nails to become dry, thick, and raised, resulting in sensations of pain and discomfort.
Treatment of Nail Psoriasis
The treatment of nail psoriasis focuses on managing the condition to prevent it from worsening. Early intervention is crucial to reduce the impact of nail psoriasis and psoriatic arthritis on your daily life. In severe cases, systemic treatments may be necessary, such as tablet-based or injected medications, to improve psoriasis on the nails and skin simultaneously.
Diagnosis of Nail Psoriasis
Healthcare providers utilize the Nail Psoriasis Severity Index (NAPSI) to assess the severity of nail psoriasis. This tool divides the nail into four equal sections, or quadrants, and assigns a score based on the presence of any nail psoriasis symptoms within each quadrant.
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Frequently asked questions
There are several reasons why your fingernail might ache. It could be due to an injury, such as a bruise under the nail, or a more serious nail bed injury. It could also be due to a hangnail, which is a small, ripped piece of skin near the cuticle, or an ingrown nail. In some cases, it may be caused by a fungal or bacterial infection, which can lead to nail pain and tenderness.
For minor nail bed injuries, the nail should heal on its own. However, if there is severe damage, such as cracking of the nail bed, it may need to be surgically treated by a doctor. If the pain is caused by a hangnail, it's important to leave it alone and allow it to grow out. Maintaining good nail hygiene is crucial in such cases.
A nail infection, or paronychia, can cause pain, swelling, redness, and discoloration of the finger, especially around the cuticle. It may also lead to thickening of the nail and pus drainage. In most cases, it is caused by bacteria or fungi. Treatment options include oral or topical antibiotics, antifungal medications, and, in some cases, surgery to remove part of the nail.
