What is the treatment for paronychia?

Question

Hello doctor,

I am concerned about having paronychia on my toe, and the nail is black or near dark green for four months. I have tried three different types of oral antibiotics, various antifungal and antibiotic creams. Even though it is not painful anymore, the nail is still discolored. The skin is reddish and swollen at the bottom of the nail. Kindly suggest treatment.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

It seems that you are suffering from paronychia with ingrown nails. Paronychia is a soft tissue infection around a fingernail that begins as cellulitis but that may progress to a definite abscess (accumulation of pus). It is of two types.

Acute Paronychia - Painful and purulent condition which occurs most frequently and is caused by staphylococci (if the duration is for four months).
Chronic Paronychia - Usually caused by a fungal infection (if the duration is more than six months).

I suggest you follow the below-mentioned instructions.

Gram staining and culture can be done to rule out the bacterial cause.
Potassium hydroxide (KOH) 5 % smears can be done to rule out any 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 an acute episode, I advise you to take the following medication.
1. Take tablet Augmentin 625 mg twice daily (if not sensitive to penicillin group).
2. Topical Fusidic acid cream (Butyl hydroxyanisole) can be applied twice daily for five days.
3. Clotrimazole cream twice daily for five days
Do not cut the toenail from the side. It can be cut from the front. If cut from the side, nails grow by pinching the skin and cause recurrent problems.

Kindly consult a specialist, talk to them, and take medications with their consent.

I hope this information will help you.

Thank you.