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What is it about ?
Nails protect nerve endings on the fingertips and toes. Nails grow about 2-3mm per month throughout life. From below, the nail is attached to the nail matrix (nail matrix). At the base, it is fixed under a skin rim: the cuticle. The edges are slightly folded down and are anchored in the cuticle.
Paronychia is an infection of the cuticle. This infection is usually caused by bacteria (Staphyloccoccus aureus), which infests the cuticle through a small sore or along the edge of an ingrown nail. The infection can be acute or chronic. The chronic form mainly affects people whose profession involves frequent contact with water, as well as children who suck their fingers.
In the case of an ingrown nail, the edge of the nail penetrates the flesh of the finger or toe.
How to recognize it?
In acute paronychia, the nail stops growing and may partially peel off. Often there is discoloration and the formation of fluid or pus under the nail plate (the visible surface of the nail), which can slightly elevate the nail. Pus can also form in the cuticle.
Initially, chronic paronychia is also accompanied by signs of infection. After a while, a granulation tissue forms (“fleshy bud”) on the edge of the nail and may even cover the edge of the nail. In the event that the toenail is affected, the toe is also sore, red and swollen, so that it is no longer possible to endure narrow shoes.
How is the diagnosis made?
Most of the time, the diagnosis is made on sight. In chronic cases, the doctor will ask you questions about your job. Sometimes he will take a little pus with a cotton swab and send it to the lab to identify the bacteria present.
What can you do ?
At the onset of an infection, you can disinfect your finger or toe daily with, for example, povidone iodine or chlorhexidine-based disinfectant if you are allergic to solutions containing iodine.
If the condition becomes chronic, temporary interruption of work is sometimes necessary to avoid prolonged exposure to water for a period of time.
Do not wear shoes that are too narrow. Sometimes a medical pedicure can provide some relief. The pedicure can slightly lift the edge of the nail so that it does not embody more.
What can your doctor do?
In case of acute paronychia, the doctor will cut the purulent cuticle and drain the pus. Then you will need to do a disinfectant bath twice a day and then apply an antibiotic ointment. Usually this treatment is sufficient. In severe, fast-growing infections, antibiotics in tablet form are also necessary. In this case, the choice is a drug that acts specifically on staphylococci.
In chronic paronychia with granulation tissue formation, a piece of about 5 mm from the edge of the nail will be cut under local anesthesia. The groove thus created in the nail will then be treated with phenol. This part of the nail will never grow back again. Your nail will be a little narrower, but it will no longer be able to embody.
Want to know more?
- Ingrown toenails and whitlow: painful! – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Ingrown toenail (image) – DermIS – Dermatology Information System
- Chlorhexidine – CBIP – Belgian Center for Pharmacotherapeutic Information
- Povidone iodine – CBIP – Belgian Center for Pharmacotherapeutic Information
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