How to treat the the dry and cracked skin around my nails?

Question

Hello doctor,

I have dry, cracked skin slightly underneath and around my thumbnail. The symptoms have been present for over a year and a half, and I have used every lotion, moisturizer, oil, and Neosporin to get this condition to heal.

Many pieces of advice are given from various sources, including my doctors, who could not heal or help my medical condition.

The symptoms include dry, cracked skin that worsens if I do not apply coconut oil with a latex glove to moisturize the area.

It is excruciating, so I tend to do it daily.

Also, I am a chef and do a lot of work with my hands. I use my thumb a lot for the things I do in the kitchen.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I have examined your picture (attachments removed to protect the patient's identity). It seems you are suffering from paronychia with maybe ingrown nails. Paronychia is a soft tissue infection around a fingernail that begins as cellulitis but may progress to a definite abscess. Acute paronychia is a painful and purulent condition, most frequently caused by Staphylococci. Fungal infection usually causes chronic paronychia (if the duration is more than six months).

Gram staining and culture can rule out the bacterial cause. Potassium hydroxide (KOH) 5 % smears rule out the fungal cause. If soft tissue swelling is present without fluctuance, the infection may resolve with warm soaks three to four times daily. If an abscess has developed, incision and drainage must be performed. For acute episodes, you can take oral antibiotics like Augmentin 625 mg TDS (if not sensitive to penicillin group) with topical Fusidic acid cream plus Clotrimazole cream twice daily for five days.

Do not cut the toenail from the side. You can cut the nails from the front and side. Once they grow, they pinch the skin and cause recurrent problems.

Review after five days.

I hope this helps.

Thank you and take care.