Paronychia

TreatmentTreatments are different for acute and chronic paronychia.Acute ParonychiaA mild case of acute paronychia (minor swelling or redness near the nail) may be treated by soaking the affected nail in warm water. This treatment can be repeated 2-4 times daily, for about 15 minutes each.In most cases, this type of paronychia heals within 5-10 days. If your condition does not improve, your doctor may prescribe oral antibiotic medication. In cases where an accumulation of pus (abscess) is suspected, your doctor may also cut the area with a scalpel to drain it.Chronic ParonychiaSince some chronic cases might be caused by fungi, your doctor may give you an antifungal medicationperhaps in a liquid formulation called ciclopirox, which is applied directly to the infected area. Studies have shown that oral treatment for fungi does not produce better results than simply applying cortisone cream (see below).Chronic paronychia may also be caused by a mixed bacterial infection which can be treated with antibiotics. You may need to take the medication for several weeks. Some dermatologists believe that chronic paronychia is often caused by inflammation rather than by either bacterial or fungal infections. For such non-infectious paronychia the use of cortisone creams can be helpful.

Whatever treatment is prescribed, it is important to keep the skin clean and dry. It is also important to avoid getting irritating substances, such as strong cleaners or certain foods, on the area. Surgery may be recommended in some cases of chronic paronychia that do not respond to other treatments.Symptoms may subside with treatment. However, permanent damage to the nail or surrounding tissue sometimes result. Prevention To help prevent paronychia: Keep your hands and feet clean and dryWear rubber gloves if your hands are routinely exposed to water or chemicalsAvoid biting your nailsAvoid cutting, pulling, or tearing your cuticlesAvoid artificial nails, vigorous manicures, or treatments that remove the cuticles If you have diabetes , maintain your blood sugar levels as close to normal as possible Practice proper hygeine. Do not share bathroom supplies (towels). RESOURCES: American Academy of Dermatologyhttp://www.aad.org National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse, National Institutes of Healthhttp://www.nih.gov/niams CANADIAN RESOURCES: Canadian Dermatology Associationhttp://www.dermatology.ca/ References: Daniel CR III, Daniel MP, Daniel J, Sullivan S, Bell FE. Managing simple chronic paronychia and onycholysis with ciclopirox 0.77% and an irritant-avoidance regimen. Cutis . 2004 Jan;73(1):81-5.

Dwayne C. Common acute hand infections. Am Fam Physician . 2003;68:2167-76. Last reviewed November 2007 by Ross Zeltser, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.