No, you should not put nail polish over a suspected Pseudomonas nail infection. The common environmental bacterium Pseudomonas aeruginosa thrives in moist, warm conditions and is the usual cause of what is informally known as Green Nail Syndrome. The application of nail polish or artificial nails creates an occlusive seal that traps moisture and warmth against the nail bed, which is the exact environment this bacterium needs to multiply rapidly. Covering the nail will not hide the infection but will instead accelerate its growth, potentially making the condition much worse.
Understanding Pseudomonas Nail Infection
This condition, medically termed chloronychia, is characterized by a distinctive discoloration of the nail plate. The pigments pyocyanin and pyoverdin, produced by the Pseudomonas bacteria, are responsible for the color, which can range from bright green to blue-green, or sometimes brownish-black. The infection usually takes hold in the space between the natural nail plate and the nail bed, a separation known as onycholysis.
Pseudomonas aeruginosa is an opportunistic pathogen that colonizes the nail when its protective barrier is compromised. Risk factors involve prolonged exposure to water, which weakens the nail structure and allows bacteria to enter. Minor trauma, pre-existing nail disorders like onychomycosis, or artificial nails that lift slightly can create the moist, dark pocket necessary for the bacteria to flourish. This infection is purely bacterial, though it can sometimes occur alongside a fungal infection.
Why Covering the Nail Exacerbates the Problem
Applying nail polish, gel, or acrylic overlays acts like a miniature incubator for the bacteria. This occlusive layer seals off the nail surface and traps moisture, creating a warm, damp environment ideal for Pseudomonas growth. This bacterium is also a facultative anaerobe, meaning it can thrive in areas with very little oxygen, such as the sealed space under a nail enhancement.
Covering the infection prevents the air exposure necessary to inhibit bacterial growth. The lack of air and continuous moisture significantly accelerate bacterial proliferation, deepening the infection into the nail plate and nail bed. This can lead to severe onycholysis, where the nail separates further from the nail bed, or cause an infection that is harder to clear. All nail coverings must be removed immediately.
Proper Treatment and Management Steps
After removing all nail coverings, keeping the affected area dry is fundamental to inhibiting the growth of Pseudomonas bacteria, which cannot survive on dry surfaces. The detached portion of the nail should be trimmed back as much as possible to eliminate the area where the bacteria are colonized and to allow topical treatments to penetrate.
For at-home management of a mild infection, healthcare providers often recommend daily soaks to help eradicate the bacteria. A common regimen involves soaking the affected nail in a solution of one part white vinegar (acetic acid) to one part water for 10 to 15 minutes, twice daily. Alternatively, a very dilute bleach solution (one teaspoon of household bleach mixed into one gallon of water) may be used, but this requires caution due to the risk of irritation.
If the infection does not improve within a few weeks, or if discoloration spreads, or if there is increased pain or inflammation around the nail fold, medical attention is necessary. A healthcare provider may prescribe a topical antibiotic, such as ciprofloxacin drops, applied directly to the affected nail bed. In rare or severe cases, or for immunocompromised individuals, a short course of oral antibiotics may be required.
Strategies for Preventing Recurrence
Maintaining a consistently dry environment for your nails is the most effective strategy against recurrence. If daily activities involve prolonged water exposure, wear protective, non-porous gloves, ideally with a thin cotton liner underneath to absorb moisture. Thoroughly drying hands and feet after bathing or swimming helps prevent the moist conditions the bacteria favor.
Avoid prolonged use of artificial nails or nail polish, as these products can trap moisture and lead to recurrence. Ensure that all nail tools used for manicures or pedicures are properly sterilized before use. Regularly checking nails for signs of separation from the nail bed (onycholysis) allows for early intervention before a bacterial infection takes hold.