Paronychia is a common infection affecting the skin around a fingernail or toenail. Untreated, it can cause discomfort and lead to significant issues. This article explains paronychia, when professional intervention is appropriate, and how to care for the affected area, focusing on safe drainage practices.
What is Paronychia and When Does it Need Draining?
Paronychia is an inflammation of the skin folds around the nail. It arises when the protective barrier between the nail and nail fold is disrupted, allowing microorganisms like bacteria or fungi to enter and cause infection. Common causes include trauma, such as nail biting, picking at hangnails, frequent water exposure, or aggressive manicures.
Symptoms often include pain, swelling, and redness around the affected nail. A pus-filled abscess may form, appearing as a white to yellow collection of fluid under the skin. Paronychia can be classified as acute or chronic. Acute paronychia develops quickly, usually lasting less than six weeks, and is frequently caused by bacterial infections like Staphylococcus aureus following minor trauma.
Chronic paronychia develops more slowly, lasting six weeks or longer, and is often caused by a combination of yeast (such as Candida albicans) and bacteria. This form is common in individuals with prolonged water exposure or certain medical conditions. Drainage is necessary for acute paronychia when a visible pus collection or abscess has formed. Indicators for professional medical attention and potential drainage include severe pain, spreading redness beyond the immediate nail area, or a clear visible accumulation of pus.
Professional Drainage Procedures
When an abscess forms due to paronychia, a healthcare professional performs drainage to relieve pressure and facilitate healing. The procedure begins with a local anesthetic to numb the affected digit and minimize discomfort, allowing for thorough manipulation of the finger.
After the area is numbed and cleaned with an antiseptic solution, the professional will carefully examine the eponychium, the protective layer over the nail, to identify the most swollen or engorged point. In many cases, drainage can be achieved by gently lifting the eponychial fold away from the nail plate using a small, blunt instrument or a scalpel. This technique aims to release the pus without requiring a direct incision into the skin.
If a simple lift is insufficient, a small incision may be made at the most prominent point of the abscess, directed away from the nail fold to prevent further injury. The incision allows the pus to drain. The wound is often left open for continued drainage and to prevent re-accumulation of fluid. Maintaining sterile technique with proper medical instruments is important to prevent new pathogens and ensure a clean environment for recovery.
Why Self-Draining is Risky
Attempting to drain paronychia at home carries significant risks. Without proper sterile instruments and technique, new bacteria can be introduced, exacerbating the existing infection. This can lead to a more severe and widespread infection requiring aggressive medical treatment.
Improper self-drainage can also cause deeper tissue damage, potentially affecting nerves. Such damage can result in prolonged pain, impaired function, or permanent numbness in the affected digit. Pushing the infection further into the finger or bloodstream is another serious risk, leading to more severe conditions.
These include cellulitis, a rapidly spreading bacterial skin infection, or osteomyelitis, an infection of the bone. In rare but severe cases, untreated or improperly managed infections can necessitate surgical removal of the finger or toe to prevent the infection from spreading throughout the body. Professional medical intervention is important for safe and effective treatment of paronychia requiring drainage.
Post-Drainage Care and Prevention
After professional drainage, diligent post-procedure care promotes healing and prevents recurrence. Keeping the drained area clean is a primary step, often involving regular soaking of the affected finger or toe in warm water for about 15 minutes, several times a day. This practice helps facilitate continued drainage and keeps the area clean.
A healthcare provider may also recommend applying an antibiotic ointment as prescribed. Monitor the wound for signs of complications, such as increased pain, spreading redness, warmth, or new pus drainage; these warrant immediate medical attention.
To prevent future occurrences of paronychia, adopting proper nail care practices is beneficial. This includes avoiding nail biting, refraining from cutting or aggressively pushing back cuticles, and keeping hands dry, especially after washing or prolonged water exposure. For individuals whose occupations involve frequent contact with water or chemicals, wearing protective gloves can help maintain the integrity of the skin barrier around the nails.