Nail and Nail Bed Infection

What is Paronychia?

Paronychia (pear-ah-NIK-ee-ah) is the most common nail infection, and is usually caused by bacteria and develops along the edge of the fingernail or toenail. A chronic form of paronychia is often due to fungal infection.

If left untreated, it can progress to a more severe infection of the entire finger or toe. Paronychia is distinguished from other infections such as onychomycosis and herpetic whitlow by its location and appearance.

What Causes a Paronychia?

Paronychias are most often caused by common skin bacteria (most commonly staphylococci bacteria) entering the skin around the nail that has been damaged by trauma, such as nail biting, finger sucking, dishwashing, or chemical irritants. Fungal infection also can be a cause of chronic paronychia and is considered particularly in people with recurrent infection. Paronychia can be confused with herpetic whitlow, which can form tiny pustules on the finger and is caused by a virus, but is not typically located at the nail edge. Herpetic whitlow is not treated with an incision and drainage as can be a paronychia.

What are the Signs and Symptoms of Paronychia?

The most common symptoms and signs are the following:

  • Swelling around the fingernail or toenail
  • Redness
  • Pus collection
  • Pain and tenderness to touch

How Does Select Orthopedic Specialists Diagnose a Paronychia?

Our doctors will examine the finger and decide how severe the infection is and what treatment is needed from basic antibiotics to needing to surgery to prevent spread of the infection.

What Is the Medical Treatment for a Paronychia (Nail Infection)?

If an abscess (pus pocket) has formed, the recommended treatment is to drain the patient’s abscess by doing an incision and drainage procedure.

  • The doctor will most likely use a medication (such as lidocaine) to numb the entire finger first and then will open the abscess using a surgical knife (scalpel).
  • Sometimes packing called a wick is placed in the abscess to allow it to continue to drain when one goes home and to keep it from closing up and reforming the abscess. The packing is usually left in for 24-48 hours.
  • In extreme cases, the infection can move under the patient’s fingernail and may need partial or complete nail removal. Antibiotic treatments are usually not necessary unless there is extensive infection spreading onto the digit.
  • A doctor may or may not take a culture of the drainage to check for the type of bacteria involved in the infection.
  • After the doctor has drained the paronychia, warm soaks are still recommended. Usually, medications such as antibiotics are only prescribed if the infection involves more of the finger than around the nail bed. Sometimes a topic antibiotic, such as Bacitracin, is applied. It is important to follow up with the doctor in 24-48 hours after treatment to be sure that the infection is healing properly.

Select Orthopedic Los Angeles

5 stars - Verified Patients
Los Angeles:
3617 S Avalon Blvd #200
Los Angeles, CA 90011
Culver City:
4173 Inglewood Blvd. Suite 300
Culver City, CA 90066

Phone: 213-935-8566

Some Insurances We Accept

  • Aetna PPO
  • Anthem PPO
  • Cigna
  • Regal
  • Employee Health Systems

Call our office for more insurance information.

People Love Us On Yelp