On six-year boy appeared cuticles. On the little finger on his right hand, next to the nail appeared swelling that is reddish and painful when touch.
It is an infection of the skin around the nail, which is called paronychia. Inflammation is the first on the skin surface, and quickly transmitted to the soft tissue under the skin and forms a painful, red swelling. The swelling is usually preceded by itching or burning sensation, but there are children in whom the infection happens literally “overnight”.
What Is It?
A paronychia is an infection of the skin that surrounds a toenail or fingernail. There are two different types of paronychia, acute and chronic:
- Acute paronychia — This usually appears as a sudden, very painful area of swelling, warmth and redness around a fingernail or toenail, usually after an injury to the area. An acute paronychia typically is caused by an infection with bacteria that invade the skin where it was injured. The injury can be caused by overaggressive manicuring (especially cutting or tearing the cuticle, which is the rim of paper-thin skin that outlines the outer margins of your nail). It can also result from biting the edges of the nails or the skin around the nails, picking at the skin near the nails or sucking on the fingers.
- Chronic paronychia — This is an infection that usually develops slowly, causing gradual swelling, tenderness and redness of the skin around the nails. It usually is caused by Candida or other species of yeast (fungus). It often affects several fingers on the same hand. People who are more likely to get this infection include those with diabetes or workers whose jobs constantly expose their hands to water or chemical solvents. Such jobs include bartending, house cleaning, janitorial work, dentistry, nursing, food service, dishwashing and hairdressing.
An acute paronychia causes throbbing pain, redness, warmth and swelling in the skin around a nail. In some cases, a small collection of pus forms under the skin next to the nail, or underneath the nail itself. Often, only one nail is affected.
A chronic paronychia usually causes less dramatic symptoms than an acute paronychia. Typically, the area around the nail is tender, red and mildly swollen; the cuticle is missing; and the skin around the nail feels moist or “boggy.” Several nails on the same hand may be affected at the same time.
If you have a mild acute paronychia, you usually can make the diagnosis yourself. Look for throbbing pain, swelling and redness in an area of damaged skin around a nail.
If you are diabetic, have several affected fingers or toes, or have severe symptoms (pus, fever, severe pain), you must be evaluated by a doctor. In most cases, your doctor can make the diagnosis by examining the affected area. However, if there is an accumulation of pus, the doctor may take a sample of the pus to be tested in the laboratory for bacteria or fungi.
To prevent paronychia, try the following:
- Keep your hands and feet dry and clean.
- Wear rubber gloves with an absorbent cotton lining if your hands are exposed routinely to water or harsh chemicals.
- Be gentle when you manicure your nails. Avoid cutting your cuticles or pushing them back.
- Avoid biting your nails and picking at the skin around your nails.
- If you have diabetes, keep your blood sugar levels within a normal range by following your diet and taking your medications.
At home, you can treat bacterial paronychia by soaking your hands or feet in hot water for about 15 minutes. Do this three to four times a day. It will help provide relief from the pain and the swelling. You can also add an antibacterial soap to the mix. Ideally, this should be done when the first signs of redness or swelling appear.