Definition of Paronychia

Paronychia is inflammation and infection of the skin that surrounds the nails. It commonly occurs in people who bite their fingernails or the skin around them or who have frequent cuts around their fingernails.

Paronychia is common in children who suck their thumbs or fingers

Paronychia of a toenail may accompany an ingrown toenail. Splinters, insect bites and stings, and other injuries around the tips of the fingers or toes can fester, allowing infection to creep under the nail.

Chronic and Acute Paronychia

Paronychia can be acute (come on suddenly) or chronic (persist or recur over a period of time). Acute paronychia is generally painful and pustular (produces pus). Staphylococcus aureus, a strain of bacteria that normally lives on the skin, is the usual cause of the infection.

Less commonly, a strain of Streptococcus or Pseudomonas (bacteria), or the fungus (yeast) Candida albicans, may be the culprit.


Symptoms of paronychia include redness, swelling, pain, and occasionally bleeding or pus discharge. The doctor can diagnosis paronychia based on the symptoms and the history of their development and occurrence. Treatment may include

  • Warm soaks three to four times a day, keeping the affected finger or toe dry at all other times
  • Topical antibiotic or antifungal medication
  • Oral antibiotic or antifungal medication


Occasionally the doctor may need to lance (make a sterile incision) the infected area to release the pus collected within. The paronychia generally heals within 7 to 10 days, though may recur if related to behaviors or exposures that continue.

Untreated paronychia becomes very painful and may cause infection to spread into deeper tissues, with the potential for permanent damage to the nail as well as to tendons, ligaments, muscle, and bone.

Characteristics of Paronychia
symptomspain, redness, and swelling
skin around the nail appears tight and bright red
may have pus
precipitating trauma (sliver, pulled hangnail, biting the nail or skin)
sudden onset
tenderness and swelling of the skin around the nail
redness and increased discomfort with prolonged exposure to water (such as washing dishes)
ongoing for longer than four to six weeks
repeated exposure to water, chemicals, other irritants
discolored or thick nail on the affected finger or toe
separation of the cuticle from the nail bed
infective agentStaphylococcus aureus
Candida albicans
medicationoral antibiotic medications such as clindamycin, cephalexin, or amoxicillin and clavulanic acidtopical antifungal medication such as miconazole
oral antifungal medication such as ketoconazole or fluconazole


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