Painful, red and swollen nail fold (paronychia)

Paronychia is inflammation of the nail fold (the skin and soft tissue that frames and supports the nail).

It's most commonly caused by infection, injury or irritation, and is about three times more common in women than in men. Sometimes, it's associated with an underlying skin condition, such as eczema or psoriasis , or another medical condition, such as diabetes or HIV .

Paronychia can develop over a few hours (acute paronychia). If it lasts for more than six weeks, it's known as chronicparonychia.

Acute paronychia

Acute infective paronychia usually starts after a minor injury to the nail fold, such as from nail biting, picking or manicures. The affected area is red, warm, tender and swollen. After a while, pus canform around the nail and may lift the nail.

Acute paronychia is often the result of a staphylococcus infection, but it can sometimes be caused by the virus responsible for cold sores (herpes simplex virus) . In this case it's known as herpetic whitlow.

Treatment for acute paronychia includes antibiotic creams or tablets . If there's a large amount of pus, surgically draining it can help. With treatment, an infected nail fold can clear up in a few days. If it isn't treated or doesn't respond to treatment, the problem can become long-term (chronic).

Chronic paronychia

Chronic paronychia often affects people who have their hands in water for long periods, or come into contact with chemicals, such as cleaners, bartenders, canteen staff or fishmongers.

It may start in one nail fold but can affect several fingers. The affected nail folds are swollen and may be red and sore from time to time, often after exposure to water. The nail plate gradually becomes thickened and ridged as it grows, and may become yellow or green and brittle.

See your GP if the condition is severe. They may prescribe antibiotic creams or tablets. In some cases,they may refer youto adermatologist (skin specialist).

It can take months for chronic paronychia to clear, and up to a year after thatfor your nails to return to normal. Keeping your hands dry and warm, frequently using emollient hand cream and not biting or picking your nails can help.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 21 Dec 2018