I keep on getting recurrent paronychia. How can I prevent these infections?

Paronychia usually starts because of trauma to the skin near the nail. So to prevent a paronychia:

- avoid traumatizing your finger nails

- avoid the habit of biting your nails

- wear rubber gloves if your hands are constantly in contact with water

- if you are a diabetic, ensure that your blood sugar levels are under control

- if you work in a dirty environment, wash hands frequently

- wear protective gloves if you frequently deal with harsh chemicals

 Paronychia is an easily treated infection and the outlook is excellent

Does the nail ever have to be removed when one has a paronychia?

In some severe cases of paronychia where the infection has involved the fingernail, one may require partial or complete removal of the nail. In the majority of cases, antibiotics are very rarely required once the pus is drained. It is not necessary to obtain cultures from the fluid that is drained. However, some physicians may obtain cultures if the infection is severe. After drainage, one should continue with warm soaks. Healing takes anywhere from 5-7 days and in a few weeks the finger and nail will appear normal.

How is paronychia usually treated?

The treatment of a paronychia requires drainage of pus. This can be easily done in the physician’s office and takes less than 15 minutes. The entire finger is numbed and an incision is made on the side of the nail where the infection is most obvious. This will immediately relieve pain, redness, and swelling.

To ensure that all the pus is drained, some physicians may insert a small piece of gauze or wick in the incision. The wick will keep the wound open and allow pus to drain. This packing is left for about 24-48 hours. The finger should be soaked in warm water the next day and the wick replaced.

What can I do at home to treat my paronychia?

When a paronychia first develops, one should start home remedies at once. Soak the finger in warm water 3-4 times a day for at least 15-30 minutes each session. Soaking will relieve pain, redness, and swelling. There is a lot of debate about adding antibiotics or anti septic to the warm water soaks. In most cases, there is no need to do add anything. A simple soap and warm water is more than adequate. Because the finger can be painful, wear a splint or dress it in a thick gauze

How does a doctor make a Diagnosis of paronychia?

The diagnosis of a nail bed infection does not require any type of radiological study. Any physician with reasonable skills should be able to make a diagnosis of paronychia by looking at the nail. It is very rare to obtain any blood work or x-rays when a paronychia is suspected- unless you have a good insurance plan.

Can one drain the paronychia pus at home?

The treatment of pus in a fingertip usually requires a small incision to allow the fluid to drain. Pus drainage is not something that should be attempted at home, unless you have both medical personnel and sterile equipment at home.

Does one need to see a doctor for paronychia (infection of the nail edge?

Paronychia does not always have to be treated by a physician. In many cases, home remedies may help decrease redness and pain. However, there are times when the redness and infection extend to the entire digit and can be associated with severe pain. Further, the infection can extend into the deeper spaces of the fingertips. In such scenarios, a visit to a doctor or the Emergency room would not be a bad idea.