#28 Nail Series: Part 2: Paronychia | Dr. Shabari Arumugam

 What is Paronychia ?

What are the symptoms of chronic Paronychia?

What are the self care measures?

Welcome to the Part II of Nail series : Paronychia

Paronychia is a common infection of the skin around the finger or toenails (the nail folds). There are two types - ‘acute paronychia’ develops quickly and lasts for a short period of time; and ‘chronic paronychia’ develops slowly, lasting for several weeks and often comes back. Chronic paronychia is not caught from someone else.

Acute Paronychiais often caused by the Staphylococcus aureus bacteria, although any number of germs such as candida (yeast) or the cold sore virus (herpes simplex) can be involved. Acute Paronychia usually starts after a minor injury to the nail fold, such as from nail biting, picking or manicures. The affected area is red, warm, tender and swollen. After a while pus may be seen, which can form around the nail and may lift the nail.

Chronic paronychia is caused by a mixture of yeasts (candida, herpes simplex and bacteria Staphylococcus aureus). It is most common in people who often have their hands in water, detergents or chemicals, have poor circulation (cold hands and feet) or diabetes.

Women get chronic paronychia more often than men.

Is chronic paronychia hereditary?

No.

What are the symptoms of chronic paronychia?

• the skin may be red and shiny around the nail
• tenderness of the skin around the nail
• swelling at the base or sides of one or more nails
• pus-filled blisters, white, yellow or even greenish
• changes in nail shape, colour, or texture (ridges). This can be apparent for many months after the paronychia has cleared as the nail slowly grows out
• detachment of the nail

Can chronic paronychia be cured?

Yes - but remember that just as it starts slowly, it also clears slowly.

How can chronic paronychia be treated?

• Usually an antibacterial and/or antifungal cream or lotion improves the condition within a few weeks. In addition, a steroid cream may be prescribed to speed up improvement.
• If creams or lotions are not successful antibiotic or antifungal tablets by mouth may be needed.
• Surgery is not usually needed, but sometimes a doctor may make a small cut and drain the area to help clear the condition if medication treatment fails.
• Avoid frequent hand-wetting, manicures and irritating substances.   
• Underlying conditions such as diabetes and poor circulation must also be treated to help improve paronychia.

Self care (What can I do?)

• You should keep your hands as warm and dry as possible; you will not get better until you do this. 
• Wear gloves for any tasks using water, irritants and chemicals, including shampooing and washing up.
• Avoid biting your nails, manicuring your nail folds, and pushing back the cuticles.
• Do not use nail varnish until the condition has been treated.
• Occasionally a change of occupation may be worth thinking about. 
• Do not apply false nails until the condition is resolved.

If you have further queries, please leave it in the comments.

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