Symptoms and Signs of Paronychia (Nail Bed Infection)

Medical Author:
Medically Reviewed on 11/4/2021

Doctor's Notes on Paronychia (Nail Bed Infection)

Paronychia is an inflammation of the folds of tissue surrounding the nail most commonly due to infection. The infection is usually bacterial (most commonly, staph or strep) but may be due to fungi. The infection may be acute (coming on suddenly) or may build up over time (chronic). A skin injury, including sucking or biting the fingers, is a common way for an infection of the fingernail area to begin.

Redness, pain or tenderness, and swelling around the base of the nail are the most common symptoms of paronychia. The redness and swelling may spread to involve the surrounding area of soft tissue. Chronic paronychia may be associated with other symptoms including:

  • breakdown of the cuticle,
  • separation of the nail from the underlying skin, and
  • thickening, deformation, or hardening of the nail.

What Is the Treatment for Paronychia?

Acute paronychia may sometimes go away after soaking the affected nail in warm water 3-4 times a day. More serious infections may require antibiotics or antifungal medications prescribed by a doctor. If an abscess is present, it may need to be drained before antibiotics are given. Sometimes a cream to keep the skin dry is recommended for people with chronic paronychia.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.