Paronychia

Ever bitten your nails? Pulled at a hang nail? Went to get a manicure and had your cuticles pushed back? 

This might have caused an infection. When the nail beds are traumatized, they can let bacteria, already on our hands, enter. This infection can cause a warm and painful, possibly red and swollen, area to develop at the base of the nail bed. This infection often goes away with minimal or no treatment; sometimes however, it requires a doctor to use a needle to relieve the pressure and release pus that's built up.

How do you pronounce that?

Yes, first things first: pear-uh-nick-ee-ah.

What is it?

Paronychia is an infection or inflammation of the nail bed. The base of the nail may become red, swollen, warm, and painful. The swelling may increase as pus collects under the skin. This can occur when the cuticle or nail bed is damaged and bacteria enter, such as from picking at a hangnail or getting a manicure. The infection often goes away with minimal or no treatment. However, in some cases it can damage the nail bed, cause the nail to loosen, and lead to infections that spread.

What do you do?

If there's no pus or notable swelling (from an abscess/pus under the skin), treatment can be easy, warm soaks are often used. These soaks are often used 3-4 times a day, though it's not known how effective these are. If the infection persists or is more severe, an antibiotic may be given. This antibiotic would likely be a type of penicillin drug that treats staph infections - or might be clindamycin.

Augmentin is often used, but as MRSA has become more common, drugs that treat MRSA are often used.

If there's pus under the skin, it's important that this drains. This might happen spontaneously - or with help. If the infection persists, a doctor may need to use a needle or blade to drain the abscess or pus that's built up.

It's important to avoid trauma to the area infected. This means keeping fingers covered from kids who suck their fingers.

Chronic paronychia is treated differently, as it often isn't caused by bacterial infections. The first is often avoiding the trauma that causes it or water exposure that led to it. In some cases, a doctor may give medicine to reduce inflammation, treat an infection, or may recommend surgical treatment. These chronic infections may cause the cuticles/nail bed to separate from the base of the nail. This separation leaves an opening that can let bacteria enter, leading to a secondary problem as a new infection develops.

Who gets it?

A sudden case of paronychia is often due to a sudden trauma to the nail bed. This can be from a manicure or from biting nails or sucking on fingers. It can be from working with your hands or tools as well.

Chronic cases can be due to repeat injuries or water exposure, as well as different sorts of infections. Those who wash dishes or swim may be at particular risk.

Those who have immune system issues - like those on immunosuppressive drugs or who have HIV - may be more at risk. 

What sort of bugs causes it?

It's usually due to a bacteria - in particular Staph or Strep. It can also be due to Pseudomonas - or in chronic cases Candidal or Mycobacterial infections. In rare cases something more serious might be mistaken for paronychia - but this is very rare.

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