What is the effective treatment for paronychia?

Question

Hello doctor,

I think I have paronychia. I trimmed my nails recently, but I accidentally cut the skin around my nails. Now it appears that I have got an infection as the area is reddened, swollen and painful when touched. What do you think? Also, need advice on what to use or treat it with, like cream or oral medicine.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

From your descriptions and the attached images (attachments removed to protect the patient's identity), it seems you have paronychia.

Paronychia is a soft tissue infection around a fingernail that begins as cellulitis but may progress to a definite abscess. It may be of two types.

1. Acute paronychia - Painful and purulent condition, most frequently caused by Staphylococci.

2. Chronic paronychia - Usually caused by a fungal infection (if the duration is more than six months).

In your case, 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 an acute episode, you can take oral antibiotics like Augmentin 625 mg tablet thrice daily (if not sensitive to penicillin group) with topical Fusidic acid cream and Clotrimazole cream twice daily for five days. Consult a specialist doctor, talk with them, and take medications with their consent. Do not cut toenails from the side. Instead, you can cut from the front. In addition, once they grow, side nails pinch the skin and cause recurrent problems. You can also do gram staining and culture to rule out the bacterial cause. Potassium hydroxide (KOH) 5 % smears rule out the fungal cause.

Thank you.