Treatment for paronychia of the toenailsHave you noticed swelling and redness around your toenail(s) or that of a loved one? If so, it could be paronychia (pronounced Pair O Nickia). This common nail condition can affect both the fingernails and the toenails. Today we’re only going to discuss paronychia of the toenails.

Causes of Paronychia of the Toenails

When bacteria (most commonly staph) or fungus (candida or other fungus) gains entrance to the area around the cuticle and nails through a break in the skin, infection can develop.

  • Very commonly found along with an ingrown toenail.
  • Trauma to the nailbed (dropping heavy objects on the toes, wearing shoes that are too short, running).
  • Poor toenail practices (cutting the nails incorrectly or going to a nail salon frequently that may also have poor hygiene.)
  • Toenail fungus—fungal nails can also affect the skin around the nails.
  • Patients with diabetes—are more likely to develop paronychia caused by fungus. Paronychia can lead to foot ulcers, so taking care of this condition quickly if you have diabetes is very important.

Symptoms of Paronychia of the Toenails

  • Pain, swelling, and tender to touch
  • Redness
  • Pus and blisters
  • Fever and red streaks from the site can develop if it spreads to other parts of the body

Types of Paronychia of the Toenails

Acute paronychia—develops quickly with milder symptoms. Once treated the condition can go away in less than 6 weeks.

Chronic paronychia—develops more slowly and is often caused by fungus. It lasts for 6 weeks or longer.

Treatment of Paronychia of the Toenails

Your podiatrist should be able to diagnose this condition by visual inspection. Laboratory tests will confirm whether it’s caused by a bacteria or fungus so that proper treatment can begin.

  • If it’s bacterial then your doctor will prescribe antibiotics.
  • A fungal infection can be treated with Lamisil.
  • Soaking the nail in warm water with Epsom salt 2-to 3 times a day can help reduce swelling and pain (you can also try this on your own for several days to see if it goes away without additional treatment.)
  • Draining any blisters of pus.
  • Getting ingrown toenail treatment if needed.
  • Receiving treatment for toenail fungus if needed

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Preventing Paronychia of the Toenails

  • Cut your toenails straight across about once a month, don’t cut them too short, and avoid sharp nail implements.
  • Keep your feet moisturized if they are dry (dryness can allow cracks to develop in the skin)
  • Avoid going barefoot in locker rooms and at pools to avoid contact with fungus and bacteria.
  • Wear socks that wick away moisture—fungus loves to grow in warm, dark, and damp environments.
  • Be sure your shoes fit properly. Shoes that are too short, too narrow at the toe box, or too long (causing your feet to slide forward) can also lead to damaged toenails, toenail fungus, and paronychia. Athletes such as soccer players and rock climbers need to beware of wearing tight athletic shoes.
  • Get an ingrown toenail treated quickly.
  • Bring your own tools to a nail salon.
  • Don’t allow the salon tech technician to trim your cuticles. Your cuticles help prevent infections from entering your nail area.
Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
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