Fingernail Infection (Paronychia)

What is a fingernail infection?

A fingernail infection is an infection at the base of the fingernail caused by bacteria or yeast.

Your child will probably have:

• A large pimple at the junction of the cuticle and the fingernail
• Redness and tenderness of this area
• Occasionally, pus draining from this area

What is the cause?

If the cuticle has a large pimple or is draining pus, it is usually infected with the Staphylococcus bacteria. The bacteria usually enter the skin through a break in the skin caused by pulling on or chewing on the cuticle. If the cuticle area is only red and swollen without pus, it is usually due to Candida (yeast). Yeast infections usually occur in children that suck their thumb or finger, bite their nails, swim a lot, or have waterlogged cuticles from other activities.

How long will it last?

With proper treatment, this infection should clear up in 7 days. If not, your doctor will probably prescribe an oral antibiotic.

How can I take care of my child?

• Antiseptic soaks

  If the cause is bacteria, soak the infected finger 3 times a day for 15 minutes in warm water and liquid antibacterial soap. Do this for 4 days, or longer if the wound has not healed.

• Antibiotic ointments (for bacterial infection)

  Buy an over-the-counter antibiotic ointment. Apply the ointment 4 times a day. Cover it with an adhesive bandage. Continue to apply the antibiotic ointment until no signs of infection remain. Sometimes your healthcare provider may prescribe an antibiotic pill.

• Open any small pimple

  Any visible pus pocket needs to be opened and drained. If it’s a small pimple, you can do it using a needle sterilized with rubbing alcohol or a flame. Make an opening where the pus pocket joins with the nail. If the pus doesn't run out, gently squeeze the pus pocket. If the pus pocket is large or spreading, have your healthcare provider drain it.

• Yeast (Candida) infections

  For yeast infections apply Lotrimin cream or ointment (no prescription needed) 3 times daily. Also, keep the area dry. Do not cover it with a bandage.

• Prevention

  Discourage any picking or chewing of hangnails (loose pieces of cuticle). Instead, cut these off with nail clippers.

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

• Your child gets a fever.
• A red streak spreads beyond the cuticle.

Call during office hours if:

• The infection has not improved after 48 hours on home treatment.
• The infection is not totally cleared up by 7 days.
• You have other concerns or questions.