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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 enters 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 large pimple

    Open and drain any visible pus pocket using a needle sterilized with rubbing alcohol or a flame. Make a large opening where the pus pocket joins with the nail. If the pus doesn't run out, gently squeeze the pus pocket.

  • 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.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2009-06-19
Last reviewed: 2012-05-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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