Paronychia (Nail Fold Infection)


Nail fold infection or paronychia is an infection of the folds of tissue surrounding the nail of a finger or, less commonly a toe.

Types of nail fold infection

  • Acute paronychia: Symptoms of acute paronychia appear over hours or a few days. The infection is only in the nail fold and doesn’t extend deeper inside the finger or toe. Symptoms go away with treatment and last less than six weeks.
  • Chronic paronychia: Symptoms develop more slowly than acute paronychia, and they usually last six weeks or longer. Several fingers or toes can be infected at once.

Signs and symptoms of nail fold infection

  • Pain, swelling and tenderness around the nail.
  • Skin that is red and warm to the touch.
  • Pus that builds up under the skin. A white to yellow, pus-filled abscess may form. If an abscess forms, it may require antibiotics and/or drainage.

Risk factors of nail fold infection

  • Accidental trauma
  • Artificial nails
  • Manicures
  • Occupational trauma (e.g., bartenders, housekeepers, dishwashers, laundry workers)
  • Onychocryptosis (i.e., ingrown nails)
  • Onychophagia (nail biting)

The treatment of acute paronychia includes: 

  • Local skin-care measures
  • Topical or oral antibiotics
  • Surgical modalities, depending upon the severity of inflammation and presence or absence of abscess or associated ingrown nail.

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