Paronychia - inflammation around the nail

How does paronychia manifest?

The process itself takes place on the palms, but due to the thickness of the skin, the liquid penetrates through the lymphatic openings to the areas surrounding the nail plate. Often paronychia provokes the occurrence of periungual panacirium - acute purulent inflammation of the tissues of the finger.

The nature of the course of this disease can be:

Acute , in which it lasts less than one and a half months. The disease is bacterial in nature and is accompanied by severe pain and suppuration, mainly on the back of the fingers. Tissues located closer to the palm may also be affected - in this case, the inflammation spreads deeply, involving the hand.
Chronic , with a duration of more than one and a half months. As a rule, this type of paronychia is caused by chemicals, dermatitis, psoriasis, eczema, and onychomycosis. In the chronic course of the disease (without the development of an abscess), the nail plate is affected: it becomes deformed, splits, becomes dull and yellow, crumbles, thickens (with fungal infection).

What really hurts?

Pain is our body’s call for help, a signal that something is wrong. Special nerve endings, nociceptors, which permeate living organs and tissues, are responsible for reproducing the signal. Under the influence of thermal, chemical, mechanical stimuli, the intensity of which exceeds the excitability threshold, in a fraction of a second the receptors transmit a signal to the brain. A person feels pain of a different nature and intensity depending on the severity of the damage. The reason may lie not only in the reaction of nerve endings to the stimulus, but also in malfunctions of the nervous system itself.

We know that the nail plate consists of keratinized or otherwise dead cells. Protects the terminal phalanges of the fingers from external irritants. There are no nerve endings or blood vessels in it. Otherwise, when trying to cut our nails, we would experience severe pain. In fact, pain is caused not by the nails, but by the soft tissues of the bed and ridges in contact with them with many nerve endings and blood vessels.

Causes of the disease

Hands and nails are an area of increased risk of injury. The skin surrounding the nail plate is quite thin, so it is easy to damage. The inflammatory process that develops in tissues is the result of injury. Women suffer from paronychia much more often than men, and the main reason for this is manicure done with instruments that have not been sterilized. Infectious agents such as staphylococci, streptococci, and fungi penetrate into soft tissues.

Factors that can lead to inflammation:

constant mechanical impact on the hands or feet, work at elevated temperatures;
frequent contact with aggressive chemicals or cold water;
hangnails (in children, the habit of biting their nails and the skin around them);
injury during manicure or pedicure;
nail extensions;
poor hand skin care, which results in cracks;
weak immunity;
insufficient hygiene;
inappropriate or low-quality shoes, as well as using someone else’s shoes;
thrombosis, thrombophlebitis and other diseases in which blood circulation in the feet is disrupted;
lack of vitamins, unhealthy diet;
stress;
diseases of the endocrine system, especially diabetes.

Possible complications

With timely treatment of paronychia, fingers or toes are quickly cured. If you delay it and wait for everything to go away on its own, then the infection will even reach the muscles, tendons, bones of the finger, and enter the systemic bloodstream. Accumulations of pus can undermine the nail and lead to its detachment from the nail bed. In advanced stages, partial or complete removal of the nail plate with long-term rehabilitation is often required.

The main complication of chronic paronychia is nail dystrophy, caused by inflammation in the nail matrix. It manifests itself in the form of fragility, delamination of the nail plate, distortion of the shape, and the formation of grooves and grooves. The color of the nail plate may change.

Classification of paronychia and main symptoms

Characteristic forms

Simple types of paronychia manifest themselves as an independent form of the disease, which is not a consequence of complications of other diseases. The skin around the nail turns red, swells, and minor pain appears. As a rule, with good immunity, the body copes with a simple form of paronychia in a few days; a visit to a doctor is not required.
The purulent (pyococcal) form develops when microorganisms (staphylococci, streptococci) enter the tissues. The disease begins with the appearance of swelling and throbbing pain. After a couple of days, suppuration of the soft tissue occurs. Recovery begins after opening the abscess. Sometimes an abscess can spread to the hand; extremely rarely, it can spread throughout the body, affecting internal organs.
Candidiasis is a form caused by fungi of the genus Candida. The nail fold loses the inner layer that protects the nail from damage. This form is chronic and is accompanied by minor inflammation. The purulent process is usually absent or not very pronounced. When fungi affect not only the skin, but also the nail plate, it begins to peel, crumble, thicken, and change shade. Most often, workers in the confectionery industry suffer from inflammation in the chronic stage.
Ulcerative form - usually caused by pathogenic microorganisms or household chemicals, temperature exposure, injury, eczema or psoriasis. Ulcerative paronychia sometimes manifests itself as a complication of a simple form. Sores form on the skin around the nail, which can cause secondary infection.
Horny form - occurs infrequently, mainly in patients with syphilis, characterized by the appearance of hyperkeratotic papules.
The dry form is characterized by mild inflammation and the absence of suppuration. At the same time, the nail fold noticeably becomes coarser and flakes off.
Tourniol is a form in which beta-hemolytic streptococci, staphylococci, and fungal microflora enter the tissue through wounds and burrs. Loose bubbles appear on the skin, the contents of which begin to fester. After opening the blisters, horseshoe-shaped wounds remain around the nail. Symptoms such as weakness and increased body temperature may appear. Tourniol is dangerous due to complete detachment of the nail and the development of lymphadenitis.
Eczematous and psoriatic forms - the nail fold swells, becomes slightly inflamed, blisters appear, peeling, and the skin becomes thick. When the vesicles break open, crusts form. The nails acquire a lattice surface, longitudinal grooves, turn yellow, crumble and peel.

With the development of a purulent process, only the smallest ulcers open on their own. Therefore, to avoid an abscess, it is necessary to seek medical help as soon as possible.

Why do my toenails hurt?

The toes near the toenail may hurt at rest, when supporting the leg, walking or intense physical activity. Sometimes tingling, burning, and numbness are felt along with the pain. The main reasons that cause such sensations include injuries, ingrown nails, pathologies of the joints of the toes (gout, arthritis, arthrosis), fungal infection.

Onychomycosis

Fungal infections on the feet are much more common than on the hands. After all, the warm, moist environment in shoes creates favorable conditions for the propagation of the pathogen.

With onychomycosis, a change in color and structure of the plate is observed, yellow or white spots appear, itching, and an unpleasant odor. The nail becomes cloudy, crumbles easily, and flakes. Soft tissues may also become inflamed and the skin may peel off. Typically, a fungal infection affects several nails at the same time.

If you suspect onychomycosis, go to the doctor and get tested. Once the diagnosis is confirmed, the podologist will clean the affected areas and prescribe medications that destroy the infectious agent.

Ingrown nail

Ingrown toenail or onychocryptosis is a common cause of pain under the nail on the big toe. The disorder is caused by improper cutting, when the plate is cut with rounded edges, orthopedic problems, and genetic predisposition. Onychocryptosis is very painful and sometimes interferes with full support of the leg and walking. If you have an ingrown toenail, you need to go to the doctor as soon as possible, since if not treated in a timely manner, this leads to severe purulent inflammation, swelling, and bursting, throbbing pain.

Symptoms

Typically, the signs of paronychia are quite pronounced, which allows you to make a diagnosis quickly and accurately. They are expressed as follows:

the patient complains of pain in the area of the nail plate; the nature of the pain can be different: throbbing, constant, pulling;
swelling of the nail fold occurs and can spread to the entire upper part of the finger;
due to swelling and pain, it is difficult to bend your fingers and work with your hands; if parochinia has developed on the foot, it hurts to put on shoes;
damaged skin becomes red, burgundy, dark purple, and if there is suppuration, then yellow-green;
if the process affects several fingers, body temperature often rises and pain appears.

The doctor determines the presence of the disease and determines the cause of the pathology: it may be associated with professional activity or with exposure to pathogenic microorganisms. In the second case, a microbiological test is prescribed to determine which pathogen caused the disease.

To confirm the inflammation process, the patient undergoes a general blood and urine test.

Based on the type of pathogen, paronychia is divided into:

bacterial: in acute cases the culprit is Staphylococcus aureus, and in chronic cases – streptococci and pseudomonads;
viral, the causative agent of which is the herpes simplex virus;
fungal, in which infection occurs with fungi of the genus Candida;
non-infectious, developing from exposure to adverse and irritating environmental factors, as well as as a side effect from taking certain medications; may be associated with skin diseases.

The “leaders” are bacterial and fungal forms of paronychia.

Diagnostics

When you press

If pain occurs only when pressing on the nail, then you should pay attention to its integrity and color: yellow, white coating, thickening of the nail tissue, unpleasant odor - signs of fungal infection.
It will be possible to get rid of these defects, as well as pain, only with competent treatment prescribed by a dermatologist. The absence of modifications in the nail plate while pain persists is a reason to change shoes.

Constant unpleasant feeling

Pain under the nail plate is the first sign of the development of onychocryptosis. The first step is to confirm or exclude this diagnosis and begin treatment in a timely manner. Advanced onychocryptosis requires surgical intervention, so it is better to prevent the ingrowth of the plate until its lateral surface has completely grown into the tissue.

Reference. An immediate visit to the doctor will be required if blood or purulent discharge begins to ooze from under the nail, the body temperature has increased, and pulsation, sharp pain and burning are felt at the site of the ingrowth.

After removing gel polish

Regular application of gel polish thins the nail plate and destroys its structure. In the future, infection with a fungus is quite possible. The situation can be corrected. First, you need to temporarily give up pedicures using chemicals, and also undergo a course of restorative procedures using moisturizing oils and vitamin complexes.

Treatment options

The initial stage of the disease can be treated conservatively. If slight redness and mild swelling occur, you can use home methods. If a purulent process is noticeable, emergency assistance from a specialist - a podologist, surgeon, or dermatologist - will be required. For any inflammation accompanied by the accumulation of pus, surgical intervention is necessary.

During the treatment process, you need to remember the following rules:

When doing housework and any other work, hands must remain dry, all actions are carried out wearing protective gloves;
if the cause of the disease is chemicals, you need to temporarily stop or at least limit contact with them;
if parochinia is localized on the feet, you should wear only comfortable, spacious shoes of good quality.

Treatment of purulent form

If an abscess is present, the abscess is opened surgically. If this is not done, the patient's condition will inevitably worsen. This operation is performed with or without local anesthesia. In the first case, small incisions are made on the skin, in the second, punctures are made with a needle. Immediately after opening the abscess, a bandage with ointment is applied, the pain stops, and the patient feels relief. Ointments must be effective against Staphylococcus aureus. Drainage is almost always installed to speed up the separation of pus. In more serious cases, where the abscess has spread to the nail bed or there is an ingrown nail, partial removal of the nail may be necessary. Oral antibiotics are also prescribed, especially if the immune system is weak.

If the cause of parochinia is a fungus, antifungal drugs are used, for example, clotrimazole. Sometimes the doctor prescribes antifungal medications for internal use, such as fluconazole.

Parochinia, which has developed against the background of eczema, psoriasis or syphilis, requires specific treatment methods. Conventional therapeutic measures are supplemented by physiotherapeutic procedures (corticosteroids, ultraviolet irradiation).

After the operation and installation of drainage, the patient should come back for a follow-up appointment some time later to assess the condition. Usually, with adequate care and compliance with all medical recommendations, paronychia is completely cured and has no relapses. The patient is recommended to take multivitamin complexes to strengthen the body's protective reserves.

Treatment of paronychia with home methods

You can engage in independent treatment only if there is no purulent inflammation. Under no circumstances should children be treated at home!

If there is definitely no abscess, then baths with antiseptics (chlorhexidine, povidone-iodine), which are done several times a day for 15 minutes, will help.

Herbs such as calendula and chamomile also have antiseptic properties. Decoctions of them can also be used in the form of baths.

A good effect is obtained by using a solution of sea salt, as well as soda and potassium permanganate for baths.

The listed solutions can also be used for compresses.

Prevention of paronychia

Prevention:

keep your hands and feet clean and dry at all times;
get rid of the bad habit of biting your nails and surrounding skin;
After washing your hands, apply cream to the skin;
When contacting aggressive chemicals, be sure to use gloves;
do not cut the cuticle, especially on the toes;
do not bite off hangnails;
disinfect manicure and pedicure tools;
trim toenails correctly to prevent ingrown nails;
fight sweaty feet;
monitor blood glucose levels;
wear comfortable, high-quality and dry shoes.

If infection does occur, paronychia begins to develop, without wasting time, seek medical help. This will allow you to cure the disease painlessly, in a short time and without the risk of complications.

Kombucha for onychocryptosis

Don't know what to do when your toenails hurt? Kombucha, previously steeped to the point where vinegar is formed, will help cope with pain. Treatment is carried out with one piece of medicine. We cut it off and place it on the affected area of the nail, then cover it with polyethylene and fix it with a plaster or fabric bandage.

This method is best done at night. By morning it will be easier for you to get rid of an ingrown toenail, since the tissues will noticeably soften and the pain symptom will completely disappear. After this, all that remains is to carefully pry the nail as deep as possible with manicure scissors and pull out the cut part using tweezers.