Characteristics and Treatments of Paronychia

Paronychia is a pathology of infectious origin, either bacterial or fungal, that affects the nails of the fingers and toes. It mainly manifests in the form of redness and swelling.
Characteristics and Treatments of Paronychia
Samuel Antonio Sánchez Amador

Written and verified by the biologist Samuel Antonio Sánchez Amador.

Last update: 27 May, 2022

Paronychia is an infection of the skin that can manifest around the fingernails and toenails. According to medical organizations, this pathology affects the cuticle and sides of the nail. A reddened, pus-filled blister, that’s tender to the touch indicates infection.

Like any infection of a bacterial or fungal nature, there’s an associated (albeit rather low) risk of it spreading to other tissues. Therefore, it’s essential to detect the disease promptly and to remedy it effectively. Stick around and learn more about paronychia along with its symptoms and treatments.

Description of paronychia

As we said above, this pathology responds to an infectious process around the nail. Studies indicate that the main symptom is inflammation of the nail plate (a tissue located on the distal end of the back of the fingers). In addition to that, there’s the destruction of the cuticle (the hard part of the nail), sometimes accompanied by suppuration.

This infectious disease can be classified in different ways, depending on medical criteria. We’ll describe it below.

Causal agents

The pathogen that causes this infection will determine the permanence and severity of it. Official sources, such as the US National Library of Medicine, report there are two types of paronychia according to the agent:

  • Acute. This one is of bacterial origin, due to streptococci, staphylococci, and pseudomonas. It appears suddenly, doesn’t last long, and is usually located on a single finger.
  • Chronic. This one is due to a type of fungi of the genus Candida. It could afflict more than one finger, takes longer to heal and there might be relapses.
An infected nail.
The inflammation around the nails can be of bacterial or fungal origin. Also, there are different levels of severity.


The previous classification is useful from an epidemiological point of view. This is because it allows you to know what to expect from the disease according to the causing pathogen. Still, from a surgical prism, it’s necessary to distinguish paronychia based on the severity of its symptoms. Sources cited above have created this classification:

  • First-degree. When the bacteria haven’t yet penetrated deeply but there’s a localized blister with pus.
  • Second-degree. When there’s an abscess (accumulation of pus) in the nail bed, due to deep bacterial penetration.
  • Third-degree. When the abscess extends to the subcutaneous adipose tissue.
  • Fourth and fifth-degree. When the infection is way deeper and reaches the bone or manifests as necrosis (tissue death).

As you can see, this infection becomes more serious as the bacteria delves deeper into the affected tissue. It’s for this reason that it’s essential to detect it quickly to avoid the rare, but possible, complications.

You might want to know the Causes of Swollen Hands and Remedies

Symptoms and causes

The symptoms of paronychia depend on the microorganism that causes it and the level of severity of the infection. Official portals have collected some of the most obvious clinical signs. Among them:

  • Pain, swelling, and redness at the base of one or more nails
  • The appearance of pus-filled blisters located in the area of ​​infection
  • Changes in the color of the nail or its separation from the fingertip
  • In the case of dissemination of the bacterial infection to the rest of the body, the patient may experience fever, chills, malaise, and muscle pain among other symptoms

Causes of paronychia

The causes of this infection are linked to the ease of entry of pathogens, beyond the external dermal barriers. Ongoing mechanical damage, such as nail-biting, finger sucking, or atypical growths with lesions, can predispose a person to the onset of this condition.

Similarly, according to scientific studies, exposure to continuous humidity promotes the appearance of fungal infections. Therefore, people with professions related to water handling (washing dishes or cleaning, for example) are more susceptible to chronic Candida paronychia.

Diabetes could be another risk factor. At least according to clinical investigations in which researchers observed that up to 30% of patients with fungal nail infections were diabetic.

Treatments for paronychia

This type of infection usually heals on its own; that is, it resolves itself after a few days. Professionals recommend soaking the affected nail in warm water several times a day to reduce discomfort.

You must consult a doctor in the event of the infections spreading or if there are abscesses. They may prescribe antifungals or antibiotics depending on the causative agent. In addition, they may recommend localized surgery if the abscess is really bad.

A person massaging their feet.
Toenails are also susceptible to paronychia, sometimes caused by tight shoes.

Learn about some Home Remedies for Onychomycosis (Hands and Feet)

Things to keep in mind

As you can see, this disease is of an infectious nature and mainly afflicts the skin around the nails. A special type of treatment isn’t always necessary, but it may require medical intervention if produced by bacteria such as Candida.

Finally, it’s essential not to bite your nails in order to prevent these types of pathologies. Thus, clip them regularly and consult a dermatologist or a podiatrist in the event of abnormal growth. Keep in mind that skin is your first defense barrier. This is why it’s essential to take care of it and not subject it to unnecessary stress.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Langer, M. F., Lötters, E., Wieskötter, B., & Surke, C. Infecciones del surco ungueal de los dedos. Tratamiento de la paroniquia.
  • Paroniquia, Recogido a 22 de agosto en
  • Paroniquia, Hospital San Diego. Recogido a 22 de agosto en
  • Alvarado, A., Hernández-Álvarez, G., Fernández, R., & Arenas, R. (2014). Onicomicosis por Candida en las uñas de las manos. Dermatología Revista mexicana58(4), 323-330.
  • Abad-González, J., Bonifaz, A., & Ponce, R. M. (2007). Onicomicosis because of Candida associated to diabetes mellitus. Dermatología Revista Mexicana51(4), 135-141.
  • Riquelme, Pablo Ruiz, and Esteban Urrutia Hoppe. “Manejo de la osteomielitis de la mano: revisión a propósito de un caso clÃnico.” ARS MEDICA Revista de Ciencias Médicas 44.2 (2019): 17-22.
  • Goettmann-Bonvallot, S., et al. “Patología ungueal.” EMC-Dermatología 51.4 (2017): 1-27.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.