What is a Paronychia and What Should You Do About It?

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I recently had a very serious nail infection and I am hoping that my experience will help other people. What started as a fun weekend at a local water park ended in two surgeries and a hospital stay. Nail infections, known as Paronychias, are actually very common and anyone can get them in their toe nails and/or finger nails. Paronychias are usually caused by common bacteria entering the body around nail beds after they have been injured.

Upon leaving the water park, I noticed the skin just below my fingernail (towards the top knuckle) was red and sore. I figured I had just bumped it on something and didn't think much about it. By the next morning I could tell it was infected. I really thought it was no big deal; the area inflamed was still rather small. I decided to treat it with Neosporin at home and told myself that if it wasn't better by Friday I would call the doctor. Friday came and it wasn't any better, but I didn't have time to call the doctor. By Monday it was getting much worse, so I finally made an appointment - nine days after the infection started. It turns out with Paronychias you really need to get to the doctor within a couple of days of the infection setting in.

At the appointment the doctor really didn't know what was wrong with it and seemed rather annoyed at my being there. Begrudgingly he prescribed some antibiotics and sent me on my way. By Friday of that week I knew my finger was no better. The next Monday I went back to the doctor. He was very surprised to see me. He still didn't know what was going on, but recommended I see a hand surgeon. That sounded like a bit much to me, so I asked if we could try another round of antibiotics. He readily agreed. As it turns out this was a big mistake.

By the end of the third week of dealing with this persistent finger infection my finger was no better and actually getting worse each day. On the next Tuesday I finally made it to the hand surgeon who instantly diagnosed it as a Paronychia and said I needed surgery as soon as possible. It was a few days before I could line it up and finally after one month I had surgery.

The surgery on Friday involved making an incision along the base of the nail all the way across my finger, which was supposed to allow the infection to drain. They also removed my finger nail. I was heavily sedated for the surgery, but woke up just 30 minutes later with a bandaged finger. After a couple of hours in recovery I was sent on my way with instructions to soak my finger several times a day and take antibiotics for a week.

Three days later, on Monday, my finger was worse than ever, and the infection was spreading from the tip of my finger down to my middle knuckle. It turns out Paronychias are a lot harder to get rid of than I thought. The surgeon was surprised to see me in his office on Monday. After a whirlpool treatment and new antibiotics I was told to come back on Thursday prepared for another surgery. It seemed the surgeon didn't even have that much hope that the new treatment plan would work.

Sure enough, the infection didn't get any better and on Thursday I went back in. This time the Infectious Disease doctor was called in. He took one look and informed me I would need a second much more extensive surgery and need to stay in the hospital a few days for IV antibiotics. All of this for one little finger infection seemed unreal, but just a few hours later I was waking up from a surgery that took twice as long and was much more painful. The next few days are a blur of pain and treatment, but finally I was released to continue my recovery from home.

I would like to say that it has been smooth sailing since that time, but honestly over a month after my last surgery, I still can't use my finger. The entire tip is numb and the incision site still hurts. There was a chunk cut out to allow the infection to drain better and it is not done healing and won't be for another month. I do not want anyone else to make the mistakes I made. If you have redness, swelling or tender places around your nails suddenly, you are likely dealing with a Paronychia. As small an area that these infections start in, they are very serious and need prompt attention by a doctor. If treated promptly these types of infections can be taken care of completely without all the problems I had.

Comments 50 comments

Jmell 7 years ago

I can relate to your agony of the fingernail virus! I had a similar experience but was diagnosed differently and minus the surgery. My case was cured by shots and prescription fungus creams. It started out very much like yours, but was rapidly growing down the side of my finger, more like a flesh eating bacteria. Scared me.

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Hawkesdream 7 years ago from Cornwall

Thanks for sharing this, like you I would probably leave it and hope that it got better all by itself.

Mighty Mom profile image

Mighty Mom 7 years ago from Where Left is Right, CA

I'd never heard of this condition before reading your hub. Your intriguing title drew me in and from there I just kept reading and reading. I'm glad to see that (fingers x'd-- at least the ones you can still use!!) you are on the mend. I imagine it could have had even worse consequences. Here's to continued recovery. MM

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thelesleyshow 7 years ago from US

Oh that's terrible. What a horrible condition. I hope you continue to have success. Thumbs up!

E.Lapier 7 years ago

I have been to 2 different dr's now and they both told me my finger wasn't infected but it's swollen, red, purple and oozing out reddish, yellowish fluid and seems to be getting worse not better and I'm going camping this weekend, so I may try and see another Dr. I just don't understand how this is normal??

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Shubhadevi 7 years ago

Sorry for you. It is great you have shared your experience, which helps others to be alert about the infection.

Adirondacky 7 years ago

Thanks for letting me know I wasn't over-reacting about my finger infection. Within 2 hours, it went from red and swollen to hot and pussy with fingertip numbness. And this was after soaking it in hot salt water for 2 hours! Luckily, I work with nurses and one told me to go to the doctor right away. I was able to get in quickly, and he diagnosed me with this condition. He prescribed me anitbotics and told me to soak in warm epsom salts 2x day. Doing much better! I thought I was jumping the gun a bit, but you have eased my mind!

Cheeky Girl profile image

Cheeky Girl 7 years ago from UK and Nerujenia

This is a good hub. I have learned something new here. Thanks for this. Here's a curious tip. A friend of mine works in a printing firm, and always uses a silicon based cream while being around both printing inks and paper and dryer powder to dry print work. He recommends the cream as its easier to clean hands after and also helps prevent inks and chemicals being absorbed by the skin. It seems our skin has "memory". Which is great. I can hardly remember what I had for breakfast this morning, but my skin has memory!

Just thought I'd share that with you! Seriously, good Hub!

thaninja profile image

thaninja 7 years ago from America

Damn - I always chew my nails..I will have to be more careful!

ciidoctor profile image

ciidoctor 6 years ago

very useful info

Julie 6 years ago

Got paronychia. Went from slight soreness to horrible pain in 6 hours. Had slight tear under nail from cracked cuticle. Had tetanus shot and went to my MD who does natural medicine. Have used colloidal silver and goldenseal and oregon grape seed extract and have had success so far. Be careful -- these things set up VERY fast and are so painful. If your hands get dry and crack in winter, start using moisturizer with gloves at night to prevent cracking and you'll save yourself agony, time, money and fingers.

Leora Rosen 6 years ago

Been enjoying all your hubs! I had a paronychia, too--it was lanced by my primary doc, then swelled right back up and needed antibiotics, which resolved it. The next time I started to get one, I called my naturopath, who was able to give me cheap recommendations that completely resolved it. I had to soak my finger twice a day in warm water with Epsom Salts, then wrap in guaze with St. John's Wort Tincture, as well as taking a homeopathic once a day. The homeopathic that worked for me was Hepar Sulph. The next time I got one, I repeated her advice, but after a few days of no improvement, the naturopath recommended a "stronger" homeopathic: Belladonna. The paronychia resolved itself internally (didn't get popped) both times without my ever visiting the real doc. I think the homeopathic recommendations are different in every case, but I just thought my experience might help someone. No recurrence so far--those three incidents were all in the space of a couple months.

Barb 6 years ago

Yes I also had this, thank God it was not to bad and I work at a clinic so I saw a doctor very quickly. I truly think I came in contact with this at a nail salon where I had fake nails done.

Michael 6 years ago

healing from Paronychia right now. I managed to get onto it within three days, and the doctor prescribed antibiotics that are so far, working. I've leaked no pus though, and I'm worried it's burrowed within, but appparently it's all good.

No more nailbiting, this infection is damn hard to treat. Btw, my infection was treated with Cephalexin.

I'd encourage googling of the infection, as I knew exactly what I had before I went to the doctor (and luckily my GP was able to identify it within a second of looking at it, bl with your GP)

kelly 6 years ago

I was diagnosed today with pariychia as well.I actually looked it up on the internet and kind of diagnosed myself as the DR agreed.It is very painful.It started almost 2 mnths ago and i know it is going to take a looong time to go back to normal. i have it on 4 of my fingers. The Dr put me on antibiotics every 6 hours for 2 weeks. I am glad you finally got it over with, as my journey for recovery has just begon.

brianna 6 years ago

im suffering from a severe case of paronychia my finger on my left hand is swollen hot and red just underneath my finger near the top of my hand hurts to. i went to the hospital a few days ago and i got antibiotics they do not appear tobe working a whole lot. no pus or blood has come out maybe only a drop of each

JOsh 5 years ago

I'm in the same boat as Brianna - this is reaaly terrible. began 5 days ago and on cephaplex. it's got to be at least 100 deg hot. ring finger... swollen bigger then thumb ;(

Poka 5 years ago

I had a hang nail on my thumb and I chewed it off (bad move). The skin around the nail and in the thumb became swollen and painful. I waited a few days, hoping it would go down. The few days turned into two weeks to no avail. Finally I went into the ambulatory dept at the hospital. They diagnosed it with paronychia and tried to lance it. That didn't turn out well for a few reasons: the needle used to inject lidocaine to numb my thumb hit a nerve and instead the anesthesia went straight to my head making me woozy. My thumb was numb but not in the area where the paronychia was present. The doctors began to incise and I felt everything! I screamed from the pain and began to panic. When he squeezed my thumb, no pus was presented, making me and the doctors believe that it was an infection in the meat of my thumb. I was prescribed Augmentin and sent home. It's been a week of this antibiotic and no improvement. My thumb is bigger than ever. Hurts like hell too. So now I'm entering week 4 and I am worrying big time. I am diabetic. I don't want to lose my thumb! I work in IT and I need my hands for work. I am returning to the hospital and this time I will demand that surgery is performed and hopefully I will get a doctor that will put me to sleep to fix this. I's worth a shot though. I will keep you updated.

Thanks for sharing!

Jennifer profile image

Jennifer 5 years ago Author

Poka, you definitely need to see a ortopaedic surgeon. they will know exactly how to handle this and get you in for surgery quickly. I would not go through the ER or urgent care, you need to see a specialist. Good luck, I really feel for you as I know exactly what you are going through.

Angela 5 years ago

I had a paronychia and went to Urgent care, as I lost my job and have no insurance. 1st visit, dug out black part,prescribed antibiotics (the big "K") and told if not better in a few days, come back. I was not even told to soak the area. I went back and now my finger is black, has pus, and is purple. Changed the bandage, changed the antibiotic, still no soaking instructions and told come back if not better.Well this game continued for 4-6 weeks. My finger was black and a fungus, like the ones you see on bread, was on the sight. Now it is black to my mid-knuckle. Now I have had three different courses of antibiotic and I am in so much pain, at times it trumps giving birth. I decided to go the emergency room and the doctor stated it needed surgical incision, which he did, and took off the nail. He packed it, prescribed another antibiotic and said go back to Urgent care and have the packing removed. I did and the doctor there removed it and did not place another. Of course the wound began to scab over. Oh, I forgot, the first three times I went the scab crusted over where it could not heal. Many more nuances to the story and to date finger has gotten better but I still have pain and cannot feel anything from tip to almost the knuckle. I had three different doctors at urgent care. The one who saw me the most, could not get me out of threre fast enough. Where he was trying to be cute and jokey, he told me that within 24 hours, I needed to see a Hand Specialist in another town or a referral to see the specialist where he is located, whichever came first. It has now been over two months, and I still have not seen the specialist. You are going to love this, the appointment set for me is on DECEMBER 23, 2010, at which time I will be at the 4-5 months with this mess. I have complained, did not do any good and I sit here wondering what is going on. This is the same county urget care that saw kidney stones in one kidney, cancelled 2-3 follow up appointments (three months apart) and I could not come to one because I was ill. Over three months ago, after cat-scan, xrays, ultrasound, bloodwork, and fecal tests, the Urologist's prognosis is, your in deep trouble!!! He stated I needed a lithrotypsis and now I have them in both kidneys. I have one at 6 measure six mm and 5mm. He saw me six weeks later and told me the same as the previous visit. He did no referral at the previous visit and he is doing it after six weeks have passed. This has been going on for almost a year and I have blood in my urine and feces. How long should this be allowed to go untreated. I was told if the pain becomes horrendous, jut go to the ER!! If I did not know better,I would swear they are trying to kill me. I have also lost weight unexplained and called to speak with this doctor and was told that he did not take calls at his private practice and I would have to wait until the next appointment!!!! I am absolutely horrified and at the end of my rope. Sorry for being long winded and there are still many more travesties to list. Thanks for listening and does any one have some suggestions for me?

Yasitha 5 years ago

where do they inject lidocaine?

please reply soon

Mairahh 5 years ago

I am having it now. The doc gave me really strong antibiotics and a cream. I hope it will work. He told me to go in again if it doesn't get better in these 2 days for an incision.

Anthea 5 years ago

Thanks for posting. I too have had an incident and now mine is slowly healing. I was put onto different antibiotics as the swab test came back with two bacterias and the antibiotics was only killing one of them. I too didn't think much of the pain as I thought I'd just pushed down the cutical abit hard, then that night was in agony. It's aweful you had to go through all that. Glad it's all over now! (I hope!).

Dr.G.Prabhakara Gupta. 5 years ago

Hello. In my practice I used to see cases like Paronynychia(acute or chronic)cases especially in middle and aged in patients too,some cases in childrens too.My steps of management are 1)Medical management,2)surgecal procedure,3)Postoperative care, 4)rehabilitation and 5)Prevention councilling.

Barbara 5 years ago

My Dr. lanced my infected fingernail and gave me one round of antibiotics. Well, I had to come back because it was no better so he put me on another round of a different antibiotic. This whole time I have had a GREEN THUMB - no pun intended. Well, it's green in the right hand corner of the thumb and will not go away! I can't believe my Dr. never did even suggest soaking my fingernail. It stills looks different from my nail on the left hand as the skin seems to be separated from the nail. I'm really getting worried now as I'm moving to another area of the state soon and this doesn't seem to be getting that much better.

Evie 5 years ago

I have a hard time finding someone who specializes in treating this! What kind of specialist would be able to perform such a procedure?

Ajm 4 years ago

I'm bit my fingernail and it's been sore within a day the pain is awful can't sleep it's tender around the nail and has a tiny green bit on side of the skin. Everyone's cases sound terrible I'm scared now. Is there not a cream to buy over counter? X

Jennifer profile image

Jennifer 4 years ago Author

Ajm - typically an over the counter ointment (like neosporin) is not going to be strong enough. I would start soaking it right away and head to the doctor tomorrow.

Amy 4 years ago

I cannot imagine the amount of pain you were in! I am currently suffering from paronychia for the past 4 days, and it is the WORST! I went to the doctor and she tried making an opening to allow the pus to be released but it was a fail. Im on antibiotics and soak my finger in warm water and put antibiotic cream afterwards. So far, it looks worse :( Advice to anyone who reads this: DO NOT CUT/BIT HANGNAILS OR CUTICLES OR ANYTHING AROUND NAIL. something so small can literally turn big.

Collin c. 4 years ago

I knew exactly how you feel. I had This disease 2 years ago and it lasted about 3 weeks and it only got worse til I couldn't take it anymore. I had to elevate my hand up so that I wouldn't feel a pulse in my finger cuz it scared me. I just ended up poppin it and it felt so much better after

Margie 4 years ago

Thanks for letting people know what happened with your finger infection! My finger tip started swelling, turned red, and became hot & painful last week. I called the Dr. on Wed., they said they would work me in next week. By Sunday the pain became absolutely unbearable. I went to Urgent Care. Luckily I had a Dr. that knew what to do. He numbed it, then lanced it, and told my to start soaking it right away. Its much better now, but still mildly painful. Seems hard to believe something so small could cause so much pain. It really is important to see a Dr.asap if this happens to you!

plain-pretty Minzie 4 years ago

Wow I don,t even know where to start from,mines was in jan 2012,,it was the most painful time in my life ,it started from the cuticle after a day or so it started to swell it was my index finger at the right,wow I thought I was gonna loose my finger it swells with puss and was very large very hott as well,u could boil an egg on it,,i did,nt went to the doctor,cause I was saying it's just a finger,I sterile and popped it myself,,it was like a flesh eating bacteria,,right now the side of my nail eat out the nail takes it,s time growing bk,,hope when it all heals it don,t look retard,,just saying ,I had beautiful fingers,and this thing spoil it,,,paronynychia,,if this evr comes bk ,,know what to do,

rosa 4 years ago

I'm suffering from it now...infection started to spread up my hand..scary...antibotics are working thank god...I soak my hand 5 times a day in sterile water n peroxide50/50...I have a chunk missing which I pray grows back...hate this..annoying but scary infection. It's still hurts a little n red n pus...

saul 4 years ago

Yeah that last comment was my girls. (Rosa).... Love u baby :) but yeah her finger was very infected n to see her that way.... Every day 5 times a day gotta soak it...n see her freak outbout it almost every time... Hope she gets better...

Anele 4 years ago

I can relate to these stories esp. plain-pretty Minzie. I just got this Paronychia and my GP is telling that I have to do HIV test coz it's rare that antibiotics don't work. Anyways i'm reading your story but what I don't get is how was the problem solved?

Jennifer profile image

Jennifer 4 years ago Author

My paronychia was finally solved with surgery and IV antibiotics. I seem to be antibiotic resistant though and most people aren't.

kathryn 4 years ago

hi im suffering from this right now and im kind of scared. i play volleyball and i dont want this to be an ongoing problem for me. i regularly bite my finger nails and the skin around them and i guess i bit the cuticles on the thumb and index finger of my left hand too much because i noticed early last week that it was slightly swollen and red around the cuticle. i didn't think much of it and just threw a band-aid over the fingers and figured it would go away in a day or two. boy was i wrong. the areas continued to get red and more swollen and i could see that there was white pus developing underneath the skin as well as some kind of red/purple coloration. in addition my thumb would ooze some kind of orange substance. it started to get really bad yesterday and hurt a lot so i decided it was time to call the doctor, especially after i googled "cuticle infection" and discovered paronychia. this morning i woke up before my doctors appointment and it was even worse. on my thumb the swelling had moved down my finger a bit and several tiny, pus-filled bumps developed down my thumb around the knuckle as well. swelling also increased on index finger. went to the doctor, he saw me for literally less than 5 minutes, prescribed me some antibiotics and said to soak in water and epsom salts. the fact that he didn't seem worried reassured me but as the day went on and i waited for my prescription to be ready, the condition has worsened. both my thumb and index finger feel completely stiff and very numb and i can barely move them. they are throbbing with pain. along the index finger and thumb bone that goes into the hand, its also sore as well as my arm. every few minutes i experience a random pang of excruciating pain in my hand and/or arm. i finally picked up my antibiotics about an hour ago and took my first one and im hoping it will help. but im very scared that if i wait too long to ask someone about why my arm and hand are sore as well, the infection might be spreading or something. MY QUESTION: should i be concerned about the pain in my hand and arm? is it possible for paronychia to spread through the fingers to the hand and even up the arm???? i keep thinking of the final scene in requiem for a dream!!! aaahhhh!!!

Priss 4 years ago

From day 1 you should have soaked your finger in Apple Cider Vinegar (ACV). Continue to soak it daily in ACV. ACV will cure fungus of the nails, foot odor, chapped skin, etc.

I've used it for years. After paying a lot of money to a Medical Doctor to cure a nail fungus and none of the different antibiotics worked, I began dipping my finger in pure ACV. The fungus healed shortly. Also use on you feet to kill the odor. ACV is a natural healer for many ailments that the medical folks will not tell you about.

Jennifer profile image

Jennifer 4 years ago Author

Thanks Priss, what a great idea. I have been reading lately of the benefits of ACV and trying to cook with it more and I bet if I had done this it would have really helped.

Jean 4 years ago

Thanks Cause my brother caught an infection with his finger nail a bit black and red sores. Right now he's in the hospital and i want to know how long it will probaly take for him to recover

Jane 4 years ago

I currently have this and I actually feel it is more painful then when I broke my arm! I have such a pain in my hand and arm and was worried it was spreading. The doctor did say this was normal and you might also get swelling under your armpit. I'm now on a week of antibiotics 4 times a day. My actual finger is so swollen I can't bend it or straighten it, and the rest of my hand is the same just from being a bit swollen I think. Makes driving interesting. My advice would be get it sorted ASAP I left mine for four days as thought it would go away bu itself.

sophh 4 years ago

I had the exact same, but wasn't as bad as that, i was crapping my pants hhaha!

cassandra 4 years ago

I have all the symtoms of the nail infection it is 3 times of the size of normal fingers and pain is really bad its red and pad of the finger is huge im thinking i need to get it lanced at the doctors but really scared what should i do

Zoe 4 years ago

Helpful post! I've had it on my 3 middle toes (both feet) for like 2 weeks, I've had this before but I didn't know what it was then, and when I kept my feet dry it just went away by itself. But this time (I have no idea where I could've gotten it from) it was a bit more serious so I went to see the doctor after about 3-4 days, I knew it was Paronychia after some Google research already though... I was prescribed Cephalexin and some antifungal powder spray, I THINK it's healing - there's no pain, I can bend my toes freely (still a bit tight) but my toes look still a bit swollen and hard and red... and the colour's getting darker, I'm freaking out!! I've had no pus or blood and I can't see them around my toenails... Does anyone know if I'm healing properly? Should I go see a doctor again? I hate this thing so much!!!!!!!

mike 3 years ago

Ive been dealing with this pretty much all year, off and on and ive been trying many different things, Apple cider vinegar will be the next thing i try. for anyone who has had it and its gone away for good, please let us know.

Evan 3 years ago

Listen to this man. I'm currently in a hospital bed right now with IV antibiotics in my arm and a bandaged finger that looks like a shark bit it. Early detection is apparently crucial.

Lena 2 years ago

Thanks for your transparency. I'm recovering now from this. How long before your the numbness went away?

harish 2 years ago

Add Your

I think I got paronychia

chris 19 months ago

It is very hard to get antibiotics to the end of our fingers and toes,even with an IV. Most of times Dr's have to cut open and clean it out.

NJmike 8 weeks ago

Soaked it in apple cider vinegar half hour in the morning and half hour at night. 2 days in a row. Started showing signs of die-off. It's been a week since and it's about 50% healed already. Another week, I should be back to normal. No doctor involvement. No surgery. No antibiotics.

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