Have you noticed swelling, redness, or pain around your toenail? You might wonder if you’ve developed an ingrown toenail—but another common culprit is a condition called paronychia.
What Is a Paronychia?
Paronychia (pronounced pair-uh-NIK-ee-uh) is an infection or inflammation that develops around the toenail. It usually happens when bacteria (like staph) or fungus (such as candida) enter the skin near your nail through a small break or cut.
Common Causes of Paronychia
Here are the most frequent reasons I see paronychia develop in my Seattle clinic:
- Ingrown toenails – While an ingrown toenail isn’t paronychia, it is the top cause of this condition. When the nail grows into the skin, it allows bacteria or fungus to enter.
- Trauma to the nail – Dropping something on your toe, wearing shoes that are too tight or too long, or repetitive impact from running can all lead to infection.
- Improper nail care – Cutting your nails too short or visiting salons with poor hygiene can set you up for an infection.
- Toenail fungus – Fungal nails can extend infection to the skin around the nail.
- Diabetes – Diabetic patients are at higher risk for fungal paronychia, which can lead to serious complications if not treated quickly.
Symptoms of Paronychia
Early recognition is key. Look out for:
- Redness, pain, swelling, or tenderness around the nail
- Pus or blisters
- Fever or red streaks moving up the foot (a sign the infection is spreading—seek care immediately)
Acute vs. Chronic Paronychia
- Acute paronychia: Develops quickly, often from bacteria. With proper treatment, it usually heals within a few weeks.
- Chronic paronychia: Develops slowly and lasts six weeks or longer, often caused by fungus. This type requires longer treatment and more follow-up care.
Diagnoses and Treatment of Paronychia in North Seattle
Diagnosis starts with a careful visual exam and sometimes a lab test to confirm whether it's bacteria or fungus. Treatment depends on the cause:
- Bacterial infections: Oral antibiotics and topical medication.
- Fungal infections: A topical antifungal medication such as Lamisil (terbinafine).
- Home care: Soak your toe in warm water with Epsom salts 2–3 times a day to relieve pain and swelling.
- In-office care: We may need to drain any pus, treat an ingrown toenail, or address fungal toenails as part of a full recovery plan.
If symptoms don’t improve within a few days, don’t wait—professional treatment prevents serious complications.
How to Prevent Paronychia
Most cases are preventable using the following recommendations:
- Cut nails properly – Trim straight across and avoid cutting too short.
- Moisturize your feet – Prevent cracks that allow bacteria in.
- Avoid going barefoot – Especially in locker rooms, public showers, or around pools.
- Wear well-fitting shoes – Choose shoes with a roomy toe box and moisture-wicking socks.
- Treat ingrown toenails early – Don’t allow them to become infected.
- Be cautious at nail salons – Bring your own tools and never let anyone cut your cuticles.
Conclusion
If you’re dealing with pain, swelling, or redness around your toenail, don’t ignore it. With prompt diagnosis and treatment, paronychia is very manageable—and you’ll be back to comfortable, active living in no time.
