Dr. M.J. Bazos, MD.
A paronychia is an abscess, or collection of
pus, under the skin folds that surround the fingernails. It is a common
condition that occurs when germs penetrate the area and grow. Common causes are
nail biting, hangnail biting, thumb sucking, penetrating injury, and foreign
bodies such as splinters. It is completely curable by draining the
Living With Your
The signs of a paronychia are
redness and swelling of the skin adjacent to the fingernails. As the problem
progresses, fluid or pus may be seen under the nail. The area is usually very
tender and feels puffy or fluid filled. As the paronychia progresses, throbbing
pain often occurs. If treated, the pain resolves in a few hours, with the
redness and swelling fading over a few days. If left untreated, the infection
can spread to cause disabling or deforming injury to the
treatment is to provide a way for the pus to drain. This may involve a small
incision over the area or simply separating a small portion of the nail from the
skin fold. The discomfort can be lessened by “blocking” the local
nerves with an anesthetic. There is little risk from the procedure. A minute
scar may form but is clearly preferable to the effects of untreated infection.
In advanced cases, a small piece of the nail may be removed. The nail almost
always regrows with a natural appearance. After the pus is drained, the doctor
may leave a small “wick” in place for a few days for continued
• Use any pain medication
only as prescribed.
• Elevate the
finger above the heart to decrease pain and
• Soak the finger in Epsom
salts or soapy water several times a
• Remove adherent dressings by
soaking in warm water.
• Keep the
bandage clean and dry. Change the bandage at least twice a
• Take prescribed antibiotics as
directed for the stated length of
• Keep your follow-up
appointment for recheck
• Don’t ignore
or neglect a paronychia. Seek treatment
• Don’t try to drain a
paronychia with pins or pocketknives at
• Don’t bite your
• Don’t remove a wick
unless instructed to do so by the
• Don’t allow the wound
to become soiled until healed.
to Call You Doctor
• If the pad
of the finger becomes swollen or
• If the finger becomes
painful to bend or swollen.
• If a
knuckle becomes painful or swollen.
If you have red streaks from the area, fever, or
• If your pain persists
beyond 24 hours after treatment.
you have a reaction to a prescribed medication.