This image displays redness and swelling around the cuticle of the nail typical of early paronychia.
This image displays redness and swelling around the cuticle of the nail typical of early paronychia.
This image displays a collection of pus from an infection (paronychia) in the bottom part of the nail fold.
This image displays a collection of pus from an infection (paronychia) in the bottom part of the nail fold.

Images of Nail Infection, Bacterial (Paronychia) (2)

This image displays redness and swelling around the cuticle of the nail typical of early paronychia.
This image displays a collection of pus from an infection (paronychia) in the bottom part of the nail fold.

Nail Infection, Bacterial (Paronychia)

Paronychia, commonly known as bacterial nail infection, is inflammation of the region of the finger or toe from which the nail plate originates, which is called the proximal nail fold (PNF). This inflammation may occur in the short term (acute) or may be a long-term problem or one that keeps coming back (chronic).

  • Acute paronychia develops along a break in the skin and is usually seen at the side of the nail. This type of nail infection is often caused by a bacterial infection but may also be caused by herpes, a type of viral infection.
  • Chronic paronychia occurs most often in people whose hands are constantly or often exposed to moisture. This disorder often results from contact dermatitis, a type of skin inflammation caused by exposure to chemicals that are irritating to the skin. People with chronic paronychia may have periodic painful flare-ups. This type of nail infection may be complicated by the addition of a fungal infection, commonly due to a type of yeast called Candida or bacterial infection, and this may lead to abnormal nail growth.

Who's At Risk?

Acute paronychia may occur at any age but is particularly common in children. Viral paronychia occurs more often in adults and may be seen with genital herpes infection or in people who work in health care.

Chronic paronychia is most common in adult women and those who work in places where their hands are kept moist, such as food handlers.

Signs & Symptoms

Bacterial nail infection most often affects the proximal nail fold of the fingers and less commonly affects the toes.

  • Acute: The proximal nail fold is red, swollen, painful, and may contain pus. Usually one nail is affected.
  • Chronic: The proximal nail fold is swollen, red, and has no cuticle (the strip of hardened skin at the base and sides of a fingernail or toenail). One or more nails may be affected.

Take a picture of your skin condition with Aysa

Symptom checkers like Aysa can help narrow down possible skin conditions by analyzing a skin photo.

Self-Care Guidelines

  • Try soaking the nails in warm water for acute paronychia.
  • Avoid water and chemical exposure to prevent symptoms of chronic paronychia.
Advertisement

Treatments

For acute paronychia, the doctor may:

  • Puncture and drain the affected area and test for bacteria or viral infection.
  • Prescribe antibiotics for a bacterial infection or an antiviral medication for a herpes infection.

For chronic paronychia, the doctor may:

  • Prescribe a topical steroid.
  • Prescribe a topical antifungal medication.
  • Prescribe topical or oral antibiotics.

Visit Urgency

See your child’s doctor for evaluation if you notice signs of bacterial nail infection.

Advertisement

References

Bolognia, Jean L., ed. Dermatology, pp.263-264, 1072. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.660, 2590. New York: McGraw-Hill, 2003.