Paronychia - Western SummaryWestern Medicine Summary

Western Medicine

Western Summary

Paronychia is a common condition where the skin around the nail becomes inflamed and painful. In some cases, the inflammation can be the result of an infection. 

Symptoms

Paronychia refers to inflammation of the skin next to a nail. This often appears as an area of pink or red skin, with or without edema or swelling present. Pain is a frequent symptom occurring with paronychia. 

 

Causes

Paronychia is often divided into acute and chronic forms. The acute form can be due to bacterial infection or recent injury. The chronic form is more likely to be due to candida or other fungal/yeast infection. Environmental factors such as frequent hand washing or exposure to a moist environment might contribute to the development of the condition. Some medications that are taken for other medical conditions may lead to the development of paronychia. Some example medications include methotrexate, isotretinoin, and some medications used to treat HIV. 

Treatments

Warm soaks (with or without vinegar) or warm compresses may help alleviate this condition without any other treatment.[1] 

  • Antibiotics: If a bacterial infection is present, treatment with antibiotics might be necessary in addition to drainage of any collections of pus. 
  • Antifungals: Yeast or fungal infections can be treated with antifungals systemically, topically or both. 
  • Anti-inflammatory agents: Topical corticosteroids are helpful to decrease inflammation and swelling if there is no infection present or if the infection is adequately treated. Since corticosteroids, an antiinflammatory medication, work in some cases of paronychia, there is a theory that the chronic forms of this condition really represents a type of ongoing skin inflammation without the presence of an infection.

​1.    Rockwell PG. Acute and chronic paronychia. Am Fam Physician.2001;63(6):1113-1116; PMID: 11277548.

2.    Tosti A, Piraccini BM, Ghetti E, et al. Topical steroids versus systemic antifungals in the treatment of chronic paronychia: an open, randomized double-blind and double dummy study. J Am Acad Dermatol.2002;47(1):73-76; PMID: 12077585.