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Paronychia: The toenail troublemaker

Paronychia is an infection of the skin around the toenails. It usually affects the skin at the base (cuticle) or up the sides of the nail.

There are two different types of paronychia: acute and chronic.

Paronychia: The Toenail Troublemaker

Paronychia: The Toenail Troublemaker

Chronic paronychia, meanwhile, usually develops slowly, causing gradual swelling, tenderness and redness of the skin around the nails. It usually is caused by a fungal infection and can often affect more than one of your extremities. If left untreated, chronic paronychia may eventually cause the cuticle to break down or separate the nail from the skin entirely.

Paronychia is more common in adult women and in people who have diabetes. People who have weak immune systems are also at higher risk of getting this condition.

Paronychia is most often caused by common skin bacteria entering the skin around the nail that has been damaged by trauma, such as:

If you have paronychia, you usually can make the diagnosis yourself as the throbbing pain, swelling and redness in an area of damaged skin around a nail is typically very hard to ignore. If you are diabetic, however, this problem can creep up on your, making routine trips to the podiatrist even more important.

A doctor can diagnose paronychia with a simple physical exam. In some cases, a fluid sample may be sent to a laboratory to identify the bacteria or fungus that is causing the infection.

The type of treatment depends on the type of paronychia. If diagnosed early, acute paronychia without obvious abscess can be treated nonsurgically. If soft tissue swelling is present without fluctuance, the infection may resolve with warm soaks 3-4 times daily.

For chronic paronychia, your doctor will most likely treat the infection with antifungal medication that is applied to the skin, such as clotrimazole (Lotrimin, Mycelex) or ketoconazole (Nizoral).

With proper treatment, an acute paronychia usually heals within 5 to 10 days. A chronic paronychia, however, may require several weeks of antifungal medication. Even after proper medical therapy, a paronychia may return.

If you have diabetes, there’s a risk that paronychia could spread to deeper tissues and bones, or into the bloodstream and other parts of the body. In extreme cases of deep infection, paronychia can result in the loss of fingers, toes or limbs.

You should call your doctor if the redness extends beyond the skin around your nail or if an abscess is forming.

Follow Delray Beach Podiatry on Twitter @Delray_Podiatry

The content on this website is for informational purposes only. Do not rely or act upon information from without seeking professional medical advice. If you live in South Florida and would like a consultation with Dr. Ian Goldbaum, a podiatric physician and surgeon with over 30 years of experience, please see our contact information below:


16244 S. Military Trail #290, Delray Beach, FL 33484



8198 Jog Road #100, Boynton Beach, FL 33437



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