Acute Paronychia

Acute paronychia is a sudden and painful inflammation that appears around the nail, typically due to bacteria entering through small skin injuries. It's one of the most common hand infections and is especially frequent in individuals who bite their nails, cut their cuticles, or work in environments that keep their hands moist for extended periods.

What Causes Acute Paronychia?

The infection usually begins when the skin barrier around the nail is broken — due to nail-biting, manicuring, or pulling a hangnail — and bacteria such as Staphylococcus aureus or Streptococcus pyogenes enter the area. In some cases, particularly in moist environments, Pseudomonas aeruginosa may also be involved, often giving the nail bed a greenish tint.

Symptoms to Watch For:

• Redness and swelling near one side of the nail

• Pain and tenderness in the affected area

• Throbbing pain in the finger

• Sometimes pus (an abscess) forms beneath the skin

• Difficulty using the affected finger due to discomfort

Treatment Options

Home Care (for mild, early cases):

• Soak the finger in warm (not hot) water mixed with antiseptic solution such as Savuion – 2 to 3 times a day, for 10–15 minutes

• Keep the area dry between soaks

• Avoid pressure or manipulation of the affected area

If symptoms persist beyond 48 hours or pus is visible, medical intervention is advised.

Medical Treatment:

If an abscess has formed, a doctor may need to drain the pus. This is done with a sterile needle or small incision at the base of the nail fold. In most cases, no anesthesia is needed, but if required, local numbing techniques can be used.

Drainage provides rapid relief. Afterward, the area is usually left open to heal and is monitored for a few days.

Topical treatments may include:

• Mupirocin ointment, applied 2–3 times daily.

Oral antibiotics are usually not necessary unless:

• The infection is spreading

• The patient is immunocompromised

• There’s extensive cellulitis

In such cases, antibiotics may include:

• Cephalexin for general coverage

• Clindamycin, Trimethoprim-sulfamethoxazole, or Doxycycline for suspected MRSA

• Ciprofloxacin if Pseudomonas is suspected

Paronychia before drainage

Paronychia after drainage

Preventing Future Infections

To reduce the chance of recurrence:

• Avoid biting your nails or pulling hangnails

• Do not cut or push back the cuticle

• Use moisturizing creams after handwashing

• Wear gloves with cotton liners when handling water or cleaning agents

• Keep nails short and clean

• Diabetics should maintain good glucose control

• Educate children and adults alike to avoid finger-sucking

When to See a Doctor in Tel Aviv

If you notice worsening pain, pus, or spreading redness, don’t delay. Our clinic in Tel Aviv provides fast and effective treatment — ideal for residents, expats, and travelers who need reliable care in English. Whether it’s a simple drainage or antibiotic prescription, our experienced team is here to help.