Paronychia is an infection of the skin around the nail, typically affecting the area where the nail and skin meet at the cuticle or the nail fold. It can be acute (sudden onset) or chronic (long-lasting), and it may affect fingernails or toenails.
🧬 Types of Paronychia
🔹 1. Acute Paronychia
- Sudden onset of pain, redness, swelling, and pus
- Usually caused by bacteria (commonly Staphylococcus aureus)
- Often follows trauma: nail biting, hangnail, manicuring, or finger sucking
🔹 2. Chronic Paronychia
- Lasts more than 6 weeks
- Mild swelling, redness, tenderness of nail folds
- Usually caused by repeated irritation + fungal infection (Candida)
- Common in people with wet hands frequently (dishwashers, healthcare workers)
🔍 Signs and Symptoms
| Symptom | Acute | Chronic |
|---|---|---|
| Redness and swelling | Intense | Mild to moderate |
| Pain | Sharp and throbbing | Dull and persistent |
| Pus formation | Common | May or may not occur |
| Nail changes | Rare | Common (thick, discolored, ridged nails) |
| Duration | Days to a week | Weeks to months |
⚠️ Risk Factors
- Nail biting or thumb sucking
- Aggressive manicuring or artificial nails
- Poor nail hygiene
- Frequent exposure to water or chemicals
- Diabetes or immunosuppression
🧪 Diagnosis
- Clinical exam
- Pus culture (for severe or resistant cases)
- Fungal testing (for chronic paronychia)
💊 Treatment
🔹 Acute Paronychia
- Warm water soaks 3–4 times daily
- Topical antibiotics (e.g., mupirocin)
- Oral antibiotics (if infection spreads or pus forms)
- Incision and drainage if an abscess develops
🔹 Chronic Paronychia
- Avoid moisture and irritants
- Topical antifungals (e.g., clotrimazole, ketoconazole)
- Topical steroids (to reduce inflammation)
- Systemic antifungals in severe or resistant cases
- Proper nail care and dry hand hygiene
🛡️ Prevention
- Avoid biting nails or cutting cuticles
- Keep hands and nails clean and dry
- Wear gloves when doing wet or dirty work
- Moisturize cuticles to prevent cracking
- Treat fungal nail infections promptly