About Your Diagnosis

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 pus.

Living With Your Diagnosis
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 hand.

Treatment
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 drainage.

The DOs
• Use any pain medication only as prescribed.
• Elevate the finger above the heart to decrease pain and swelling.
• Soak the finger in Epsom salts or soapy water several times a day.
• Remove adherent dressings by soaking in warm water.
• Keep the bandage clean and dry. Change the bandage at least twice a day.
• Take prescribed antibiotics as directed for the stated length of time.
• Keep your follow-up appointment for recheck
The DON’Ts
• Don’t ignore or neglect a paronychia. Seek treatment early.
• Don’t try to drain a paronychia with pins or pocketknives at home.
• Don’t bite your nails.
• Don’t remove a wick unless instructed to do so by the doctor.
• Don’t allow the wound to become soiled until healed.

When to Call You Doctor
• If the pad of the finger becomes swollen or painful.
• 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 chills.
• If your pain persists beyond 24 hours after treatment.
• If you have a reaction to a prescribed medication.