Paronychia is an infection of the skin just next to a nail (the nail fold). The infected nail fold looks swollen, inflamed and may be tender. There may also be a small collection of pus in the swelling. The nail itself may become infected or damaged if a nail-fold infection is left untreated.

What causes nail-fold infections?

Bacteria tend to cause acute (sudden-onset) nail-fold infections which are painful. Candida, which is a yeast (a type of fungus), is another common cause.

Why do nail-fold infections develop?

Many nail-fold infections occur for no apparent reason. However, the following can increase the risk of bacteria and other germs getting into the nail-fold skin and causing infection:

Water. You are more likely to develop a nail-fold infection if your hands are in water for long periods, particularly with detergents.

Injury. For example, nail biting, poor manicure, damaged or diseased nails or nail folds, etc.

Covering. For example, if you use gloves for long periods, or use artificial nails, it can cause a moist, airless condition around your fingernails.

What is the treatment for nail-fold infections?

Bacterial infections

If your infection is caused by a bacterium then an antibiotic for seven days may be prescribed. Sometimes pus from a bacterial infection has to be drained by a very small cut if it collects next to the nail. It may also help to soak the affected finger in warm salted water four times a day. Painkillers, such as paracetamol or ibuprofen, often work well to ease any pain.

Candidal and fungal infections

These are usually treated with an antifungal cream. Treatment is usually needed for 3-6 months before the infection goes completely and a new healthy nail fold has formed. Sometimes, a course of antifungal tablets or antifungal nail paint is needed for 6-12 months to clear the infection, particularly if the infection spreads to your nail in addition to your nail fold.

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