Paronychia

What is paronychia?

Paronychia is an infection of the skin around your finger or toenails, which is caused by either a bacteria or a fungus. It can vary in severity, but it’s often swollen and painful. There are two types of paronychia:

• Acute paronychia – this happens suddenly and doesn’t usually last very long. It’s more common around your fingernails than your toenails.
• Chronic paronychia – this usually lasts longer than acute paronychia and either doesn’t get better or keeps coming back after you think it’s gone. This is more likely to happen to your toenails than acute paronychia is.

The infection usually affects the skin at the bottom (cuticle) and side of your nail. It can happen to anyone at any age, and it isn’t usually serious but often needs treatment to clear up the infection. As with other types of infection, it can worsen or spread.

Paronychia is similar to another condition called herpetic whitlow (or whitlow finger), and as a result these conditions can sometimes be misdiagnosed or mistaken for one another.^[1]

Who gets paronychia?

Anyone of any age can get paronychia, but it’s more likely if your fingers or toes are exposed to irritation and bacteria.

There are some factors that can make a paronychia infection more likely to happen around your fingers or toes:

• Nail biting;
• Over manicuring;
• Poor hygiene at a nail salon;
• Artificial nails;
• Exposure to certain chemicals (such as detergents);
• Constant exposure to water for your hands or feet;
• Not wearing protective gloves when you should (though constantly wearing gloves can also increase the risk of getting paronychia as it provides the perfect environment for germs to thrive);
• Certain skin conditions;
• Not changing your socks regularly;
• Ill-fitting shoes;
• Sporting activity;
• Injury around the nails;
• Pulling hangnails;
• Sucking fingers;
• Ingrown toenails;
• Weakened immune system;
• Health conditions like diabetes, hyperhidrosis, pemphigus vulgaris and obesity;
• certain medications.

Paronychia is more common in adult women and people who have diabetes. People with a weakened immune system, such as people taking medicine after a transplant, or people with HIV, are more at risk of getting paronychia.

How common is paronychia?

It’s not known exactly how common paronychia is, but it’s a relatively common skin and nail condition that’s easy to treat, and it’s believed to be around three times more common in women than in men.^[2]

What causes paronychia?

Paronychia is usually caused by a bacterial infection, but it can also be caused by yeast, fungal infections, and irritants. Some viruses can also cause warts around your nails, irritating your skin. If your skin is already sore or irritated, the risk of you developing paronychia becomes more likely.

Paronychia caused by bacteria can get worse quickly, whereas paronychia caused by a fungal infection usually gets worse over time.

What are the symptoms of paronychia?

The symptoms of paronychia are pretty typical of an infection and can appear on your nail fold and underneath your cuticles (the area of skin next to and underneath your nails).

These symptoms include:

• Redness of the skin around your nail;
• Pain and tenderness, particularly if pressure is applied;
• Swelling around your nail;
• Pus that may look yellow;
• Possible abscess or blisters around your nail.

The symptoms are usually on one nail, but if it’s caused by underlying health issues, or lifestyle or occupational factors like constant exposure to water or chemicals, then you might see symptoms on more than one finger or toe.

Can paronychia lead to other problems?

If paronychia is left untreated, or there’s a prolonged infection or severe infection, then the nail itself can become infected and painful. Not treating paronychia also comes with a slight risk of the infection spreading to other areas and even the loss of your nail.

Some types of paronychia can keep coming back without treatment, so the painful symptoms associated with the infection can be a regular occurrence. In extremely severe cases of infection, there can be permanent damage to tendons in the hand or foot. But this is quite rare.