Overview

Fingernail infection, medically known as paronychia, is a common condition where the skin around the fingernails becomes infected. This infection can be acute (sudden onset) or chronic (persistent or recurring), affecting one or multiple fingers. Fingernail infections are often caused by bacteria, fungi, or yeast, leading to redness, swelling, and pain around the nail. While most cases are mild and treatable at home, severe infections can cause abscesses and may require medical intervention. Early treatment prevents complications and promotes faster healing.

Causes

Several factors can cause fingernail infections, depending on the type of pathogen involved:

• Bacterial infections: Usually caused by Staphylococcus aureus or Streptococcus species, especially after nail biting, picking, or minor trauma.
• Fungal infections: Yeast such as Candida species can cause chronic paronychia, particularly in people whose hands are frequently wet.
• Trauma: Cuts, hangnails, or injury to the nail area can allow microorganisms to enter and cause infection.
• Manicures: Improper nail salon hygiene or aggressive manicuring can lead to infection.
• Water exposure: Constant exposure to water weakens the skin barrier, increasing the risk of fungal paronychia.
• Underlying skin conditions: Eczema or psoriasis can increase susceptibility to nail infections.

Symptoms

The symptoms of fingernail infection can vary based on the cause and severity:

• Redness: Skin around the nail becomes red and inflamed.
• Swelling: Noticeable puffiness and tenderness near the nail bed.
• Pain: Throbbing or aching pain, especially when pressure is applied to the nail.
• Pus formation: In bacterial infections, yellow or white pus may be visible under the skin or nail.
• Warmth: The infected area may feel warm to the touch.
• Nail changes: Thickening, discoloration, or separation of the nail from the nail bed in chronic or fungal infections.
• Recurrent infections: Chronic paronychia can cause repeated flare-ups, especially with continued exposure to moisture.

Diagnosis

Diagnosis of fingernail infection is usually straightforward and involves:

• Clinical examination: A healthcare provider visually inspects the nail and surrounding skin for signs of infection.
• Patient history: Questions about recent trauma, nail care habits, and occupational risks help identify contributing factors.
• Pus culture: In cases of pus, a sample may be taken to determine if bacteria or fungi are present and guide treatment.
• Fungal tests: A nail clipping or skin scraping may be examined under a microscope or cultured for fungal organisms in chronic cases.

Treatment

Treatment depends on the type and severity of the infection:

• Home care: Mild cases may resolve with warm water soaks (15-20 minutes, 3-4 times a day) to reduce pain and swelling.
• Topical antibiotics: Mupirocin or fusidic acid creams may be used for bacterial infections.
• Oral antibiotics: Severe bacterial infections with pus formation may require oral antibiotics like dicloxacillin or cephalexin.
• Drainage: If an abscess forms, a doctor may perform a minor surgical procedure to drain the pus and relieve pressure.
• Antifungal treatments: Chronic or fungal paronychia is treated with antifungal creams or oral medications like fluconazole or itraconazole.
• Avoiding irritants: Protective gloves and avoiding frequent wetting of hands help prevent worsening in chronic cases.

Prognosis

The prognosis for fingernail infections is generally excellent with appropriate treatment:

• Rapid recovery: Most acute bacterial infections resolve within 5-10 days with proper care.
• Fungal infections: May take several weeks to months to clear completely but respond well to treatment.
• Prevention of recurrence: Good nail hygiene, minimizing trauma, and protecting hands from excessive moisture can prevent recurrences.
• Complications are rare: Untreated or severe infections can lead to abscesses or permanent nail changes, but these are uncommon with timely treatment.

Early treatment and preventive care usually result in complete healing, allowing individuals to resume normal activities without long-term effects.