Welcome to our comprehensive guide on paronychia, a common nail infection that can cause discomfort and irritation.

In this article, we will explore the meaning of paronychia, its causes, symptoms, and available treatment options. Whether you’re experiencing this condition yourself or seeking information for someone else, we aim to provide valuable insights to help you understand paronychia better and navigate the path to recovery.

What is Paronychia?

Paronychia — Meaning

Paronychia is a localized infection that targets the skin surrounding the nails. It commonly affects both fingernails and toenails, causing discomfort and irritation in the affected area. The infection typically begins in the nail fold, which is the fold of skin that lies beside the nail plate.

Paronychia can occur as a result of various factors that compromise the integrity of the nail fold. This includes activities or habits that cause trauma to the skin around the nails, such as biting or picking at the nails, exposing the area to excessive moisture, or prolonged exposure to irritants. These factors create an environment conducive to the growth of microorganisms, leading to infection.

The condition can vary in severity, ranging from mild cases characterized by redness and swelling, to more severe cases where the infection progresses and leads to the formation of pus. In some instances, the infection can spread to the nail plate itself, potentially causing nail deformities or changes in its appearance.

Prompt identification and appropriate management of paronychia are important to prevent the infection from worsening or spreading. Proper hygiene, such as keeping the nails clean and dry, can help reduce the risk of developing paronychia. If an infection occurs, seeking medical attention is advisable to determine the appropriate treatment approach and prevent potential complications. If an infection occurs, seeking medical attention is advisable to determine the appropriate treatment

Types of Paronychia

Paronychia are of two major types:

Acute Paronychia:

Acute paronychia is typically caused by a bacterial skin infection. It often develops due to factors such as nail biting, picking, or an ingrown toenail. The affected area becomes red, swollen, and tender. In some cases, pus-filled blisters or abscesses may develop. Prompt treatment is important to prevent the infection from spreading.

Chronic Paronychia:

Chronic paronychia, on the other hand, is characterized by persistent symptoms that develop gradually and persist over a longer period. It is commonly associated with repeated exposure to irritants or fungal infections. In some cases, chronic paronychia can be linked to conditions like nail psoriasis or toenail fungal infections. Symptoms of chronic paronychia include ongoing redness and swelling around the nail, and the nails may become thickened or develop ridges.

Who gets Paronychia?

Paronychia can affect individuals of all ages and genders. Here are the factors that can influence the likelihood of developing paronychia:

Acute Paronychia:

• Nail-biting or habitual picking of the nails
• Breaks in the skin due to manicuring
• Infants who suck their fingers or thumbs
• Ingrown toenails (onychocryptosis)
• Application of sculptured or artificial fingernails
• Treatment with medications like oral retinoids (acitretin, isotretinoin)
• Other drugs such as epidermal growth factor receptor and BRAF inhibitors (vemurafenib, dabrafenib)

Chronic Paronychia

• People with hand dermatitis
• Individuals with constantly cold and wet hands, including dairy farmers, fishermen, bartenders, cleaners, housewives, and those with poor circulation

Additionally, acute and chronic skin infections, including paronychia, can be more frequent and severe in individuals with diabetes, chronic debility, or compromised immune systems due to medications or underlying diseases.

Paronychia — Causes

Here are a few of the causes of Paronychia:

• Bacterial and fungal infections: Acute paronychia is commonly caused by bacteria such as Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas, or fungal pathogens like Candida albicans.
• Skin irritation and injury: Paronychia can result from skin irritation or injury, such as nail biting, picking, chewing, pulling hangnails, or an ingrown toenail.
• Moisture and wet environments: Prolonged exposure to moisture, often due to occupational factors like dishwashing or frequent hand immersion, creates a favorable environment for bacteria and fungi to grow and contribute to paronychia.
• Irritant dermatitis: Chronic paronychia can be caused by irritant dermatitis, a condition characterized by itchy and red skin, which weakens the skin barrier and allows germs to enter.
• Underlying health conditions: Certain factors such as having diabetes, or having a weakened immune system due to organ transplants or HIV infection, can increase the susceptibility to paronychia.

Paronychia — Symptoms

Acute Paronychia:

• Redness, swelling, and tenderness around the nail.
• Pain or throbbing sensation.
• Warmth and localized heat in the affected area.
• Pus-filled blisters or abscesses may develop.
• Nail may appear discolored or detached if the infection spreads.

Chronic Paronychia:

• Gradual onset of symptoms.
• Persistent redness and swelling around the nail.
• Thickened, pitted, or ridged nails.
• Nail may become distorted or separate from the nail bed.
• Chronic discomfort or pain.

Diagnosis for Paronychia

Diagnosis for paronychia typically involves a physical examination and a review of the patient’s medical history.

During the examination, the following diagnostic steps may be taken:

• Clinical Examination: A thorough visual examination of the affected nail and surrounding skin is conducted by a healthcare professional. They look for characteristic signs such as redness, swelling, tenderness, and the presence of pus-filled blisters.
• Gram Stain Microscopy: Microscopic examination of a sample, such as fluid or pus from the affected area, is performed using Gram stain. This staining technique helps identify bacteria present in the sample, aiding in determining the bacterial cause of paronychia.
• Potassium Hydroxide (KOH) Microscopy: KOH microscopy involves treating a sample with a potassium hydroxide solution to dissolve skin cells. The remaining material is then examined under a microscope to detect fungal elements, assisting in the diagnosis of fungal paronychia.
• Bacterial Culture: When a bacterial infection is suspected, a sample is collected and sent for bacterial culture. This involves placing the sample on a culture medium that promotes bacterial growth. The resulting colonies are identified, enabling the determination of the specific bacteria causing the infection.
• Viral Swabs and Tzanck Smears: In cases where a viral infection such as herpetic whitlow is suspected, viral swabs may be taken from the affected area to detect the presence of viral pathogens. Tzanck smears, which involve microscopic examination of a sample, can also help identify specific viral changes in cells.
• Nail Clippings for Culture (Mycology): When a fungal infection is suspected, nail clippings may be obtained for culture. The clippings are cultured in a laboratory to promote fungal growth, facilitating the identification of the specific fungal species responsible for the infection.

Paronychia — Treatment

The treatment of paronychia depends on the severity and type of infection, as well as the underlying cause. Here are some commonly used treatments for paronychia:

• Self-care and prevention measures.
• Warm water soaks.
• Oral antibiotics for bacterial paronychia.
• Incision and drainage for abscesses.
• Topical antifungal medications for fungal paronychia.

NOTE: It is important to consult with a healthcare professional for proper diagnosis and guidance on the most suitable treatment approach for individual cases.

Conclusion

To sum up, Paronychia is a common condition that affects the skin around the nails, characterized by redness, swelling, and potential infection. It can be caused by various factors and may require proper diagnosis and treatment for effective management. If you suspect you have Paronychia or are experiencing any related symptoms, it is advisable to seek medical attention from a qualified dermatologist.

To find a local dermatologist who can provide expert guidance and personalized treatment for Paronychia or other skin concerns, Skin and Hair Academy offers a convenient and reliable resource. By visiting our Find Local Dermatologist portal, you can access a comprehensive database of dermatologists in your area. Skin and Hair Academy is committed to connecting individuals with the best dermatological care, ensuring optimal skin health and well-being.

FAQs

1) Is paronychia a fungal infection?

Paronychia can be caused by both fungal and bacterial infections. There are two types of paronychia: acute paronychia, which is usually caused by bacteria, and chronic paronychia, which can be caused by a combination of bacteria and fungi. However, fungal infections are more commonly associated with chronic paronychia

2) What does paronychia look like?

Paronychia typically appears as redness, swelling, and tenderness around the nail. In acute paronychia, there may be a pus-filled blister or abscess. In chronic paronychia, the area around the nail may be swollen, tender, and have a thickened, discolored nail plate.

3) Will paronychia go away by itself?

In some cases, paronychia may resolve on its own, especially if it is mild and caught early. However, it is generally recommended to seek treatment, especially for severe or chronic cases, to prevent complications and promote faster healing.

4) What is the fastest way to get rid of paronychia?

The treatment for paronychia depends on the severity and type of infection. The following measures can help alleviate symptoms and speed up the healing process:

• Soak the affected finger or toe in warm water several times a day for about 15 minutes.
• Gently push back the cuticle using a blunt instrument after soaking, if it is not too painful.
• Keep the affected area clean and dry.
• Apply over-the-counter antibiotic ointment or cream.
• If necessary, a doctor may drain any pus-filled abscess and prescribe oral antibiotics or antifungal medication.

5) How long does paronychia last?

The duration of paronychia varies depending on the type, severity, and treatment received. Acute paronychia can typically resolve within a few days to a week with proper treatment. Chronic paronychia may take longer to heal, ranging from a few weeks to several months. It’s important to follow the recommended treatment plan and consult a healthcare professional if the infection persists or worsens.