Paronychia is a very common infection afflicting women. It is a painful infection of the skin around the nails on the hands or feet. It may develop quite suddenly, even overnight. Once it appears, however, the condition is hard to ignore. The infection presents with swelling and redness and the loss of the cuticle surrounding the nail. Infections occur more frequently in the skin around the fingernails.
Types of Paronychia
Acute Paronychia is caused by trauma to the cuticle, which introduces opportunistic bacteria into the skin around the nail. Examples of trauma could be as simple as a hangnail, or by the patient biting her nails or sucking a finger. It may even result from a manicure.
Chronic Paronychia is usually caused by repeated exposure to water or perhaps an irritant. The infectious agent in chronic cases of paronychia is thought to be a yeast or other type of fungus. As a result the infection can be very difficult to cure. Chronic paronychia is usually not very painful. Pain may come and go and be linked to water exposure. The infection is considered chronic when it has been ongoing for six weeks, according to WebMD's Dermatology page.
Is It Paronychia or an Ingrown Toenail?
A patient may be confused by an infection in the toes. Ingrown toenail is a common condition in adults involving the big toe, but it may affect any toenail. According to eMedicine Health online, an ingrown toenail occurs when the nail of the toe, most commonly the big toe, cuts into the skin around it. The symptoms can be similar. Ingrown toenails present with redness, swelling, and pain, as do both types of paronychia. However, an important difference is that paronychia involves the loss of the cuticle and usually differs in location.
Paronychia may involve only the skin at the bottom of the nail, or it may encircle the whole nail while ingrown toenails usually only affect the corners at the top. This is an important distinction. Another interesting difference is that paronychia afflicts mostly women with a 3:1 ratio while ingrown toenails are more typically found in men.
Treating Paronychia
Treatment depends on the type of infection, whether it is chronic or acute, or the type of infectious agent found in culture.
Acute Paronychia is treated with oral antibiotics. Often these may be coupled with soaking the affected hand or foot. If the infection is severe enough that pus has developed, a doctor may need to drain it or instruct the patient on how to do it herself.
Chronic Paronychia is usually treated with antifungals, sometimes topically in creams and other times orally. Keeping the affected hands or feet dry and clean, also if the patient can identify the irritant that caused the infection she should avoid it as much as possible. It may take months for the patient to see the infection clear up.
Chronic paronychia is a difficult infection to clear. Patients may not find satisfaction in the treatments outlined here. The key to the infection is the re-growth of the protective cuticle around the nail. Antifungals may prove ineffective. Some studies have shown steroids to have a higher success rate and some physicians have found that yeasts and other funguses, while present in patient cultures, are not the true source of irritation. A further disturbing fact is that the diagnosis is often done without a culture. More research is needed.
