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Acute Paronychia
Understanding acute paronychia, a sudden and painful infection of the skin fold around the fingernail, and why prompt treatment helps.
What is Acute Paronychia?
Acute paronychia is a sudden, painful bacterial infection of the skin fold around the fingernail, usually developing over a day or two. It often follows a minor injury such as a hangnail, nail-biting, an ingrown nail, or trauma to the nail fold from a manicure.
Acute Paronychia at a glance
What is it?
A sudden, painful bacterial infection of the skin fold around the fingernail
Common symptoms
Sudden redness, swelling, warmth and throbbing pain at the side or base of the nail
Who it affects
Anyone, more common after nail-biting, hangnails, ingrown nails or a manicure
Is it serious?
Usually resolves well with prompt treatment, but a pus collection needs draining
Treatment options
Warm soaks and antibiotics for very early cases, or drainage once pus has collected
First step
An assessment to determine whether pus has collected and drainage is needed
Symptoms and how Acute Paronychia presents
The main symptoms are sudden redness, swelling, warmth and throbbing pain at the side or base of the nail, developing over a day or two.
There is sometimes a visible collection of pus under the skin fold.
Causes and risk factors for Acute Paronychia
- A hangnail
- Nail-biting
- An ingrown nail
- Minor trauma to the nail fold, such as from a manicure
- A splinter or minor injury near the nail
How is Acute Paronychia diagnosed?
Acute paronychia is usually diagnosed on examination and the story of rapid onset, which distinguishes it from the more gradual, longer-standing pattern of chronic paronychia.
Treatment options for Acute Paronychia
Very early, mild cases without a collection of pus may settle with warm salt water soaks and oral antibiotics.
In some circumstances it may be necessary to see a hand surgeon about acute paronychia, but in most instances it can be self-managed (see the video below) or managed by your general practitioner or local urgent care clinic.
When to see a hand surgeon about Acute Paronychia
Sudden, worsening redness, swelling and pain around a fingernail, especially if you can see or feel a collection of pus, should prompt intervention. This could be with a hand surgeon, but if you watch the video below you may be able to self-manage the condition. If you are unable to self-manage the condition please see your general practitioner or an urgent care clinic for assistance.
Watch: How to drain Acute Paronychia
Frequently Asked Questions
What is acute paronychia?
A sudden, painful bacterial infection of the skin fold around the fingernail, developing over a day or two, often following a minor injury such as a hangnail, nail-biting, an ingrown nail, or trauma from a manicure.
What causes it?
A hangnail, nail-biting, an ingrown nail, minor trauma to the nail fold such as from a manicure, or a splinter or minor injury near the nail.
What can I do myself?
Very early, mild cases without a collection of pus may settle with warm salt water soaks. Watching the video guide on this page can help you self-manage the condition if appropriate.
What can a hand therapist do?
Acute paronychia is not typically managed by a hand therapist. Most cases are self-managed or treated by a GP or urgent care clinic.
What can a hand surgeon do?
In most instances acute paronychia can be self-managed or managed by your GP or a local urgent care clinic. In some circumstances it may be necessary to see a hand surgeon for surgery, if alternative options (GP or urgent care clinic) are unable to assist.
What can I expect from treatment?
Very early cases can settle with warm soaks. Once pus has collected, drainage relieves the pressure and pain quickly. Acute paronychia usually resolves well with prompt treatment.
What happens if it's left untreated?
Generally if a collection of pus at the nail fold is left untreated it will discharge at some point, but spreading infection with redness and pain can also occur.
Related conditions and treatments
Acute paronychia is different from chronic paronychia, a longer-standing, low-grade form of infection in the same area. A deeper infection of the fingertip itself is called a felon.