What to do if the nail bed is inflamed?

Table of Contents

How can you treat nail bed inflammation?

What can you do about the pain?

Can you prevent inflammation?

Here you can find out everything about this topic!

What is nail bed inflammation?

Inflammation of the nail bed (med .: paronychia) is a nail bed infection, often caused by bacteria such as staphylococci. It is most uncomfortable and painful. The nail bed is the skin or tissue around and under the nail.

Paronychia can affect both fingers and toes. Often not only the nail bed is involved, but also the nail fold and cuticle.

Inflammation of the nail bed is a nuisance because the pain increases sharply when the affected area is touched. Inflammation of the nail bed on the toe is excruciating if shoes that are too tight are worn. But this disease is also very unpleasant on the fingernails.

How is nail bed inflammation treated?

It is possible to treat the nail bed inflammation on the finger or toe yourself in the initial stage. For example, warm baths can help.

To do this, the affected nail is bathed in lukewarm water three times a day for about 15 minutes. 

For example, chamomile or curd soap can be added to the water, which is anti-inflammatory. After bathing, the nail and the surrounding skin should be carefully dried.

In the case of inflammation of the nail bed, ointment compresses with a pull ointment (e.g., Globe Ichthammol Ointment) are a treatment option. The active ingredient ammonium bituminosulfonate in this ointment has a weak antibacterial and anti-inflammatory effect.

Depending on the extent of the inflammation of the nail bed, the doctor can also opt for internal drug treatment.

Here, for example, the antibiotics clindamycin, cefuroxime, or cefazolin are prescribed.

If there is a fungal infection in addition to the inflammation, the doctor relies on antimycotics (fungicides), for example, in the form of nail polish.

Some of these drugs require a prescription, and they are also available in the form of ointments or tablets for oral use (fluconazole or itraconazole).

Surgical intervention in severe cases

If the pus is more significant on the nail bed, it may be necessary for the doctor to cut open the infected area so that the pus can drain away. In some cases, the nail needs to be removed.

After the treatment, the inflamed area is bandaged with a disinfecting ointment bandage. The follow-up treatment retakes place in the practice.

If an ingrown nail causes the nail bed inflammation, the doctor may surgically remove the nail.

Further surgical measures may be necessary, especially if the paronychia has attacked the bone. 

Causes of nail bed inflammation

The most common pathogens causing paronychia on the toe or fingers are the bacterial species staphylococci or streptococci. Herpes viruses or yeasts can also cause the infection of the nails.

Like the common disease of nail fungus, the pathogens cannot penetrate as long as the skin and the surrounding tissue are healthy.

If a fungal nail disease is already advanced, the nail bed is susceptible to inflammation, which is why early treatment of the fungal infection makes sense.

An infection is possible if there are minor wounds in the cuticle, the nail fold, or the nail wall. The bacteria can easily penetrate the affected tissue and establish themselves, causing inflammation.

Numerous risk factors can lead to minor injuries and irritation of the tissue.

End-stage onychomycosis on the big toe.
End-stage onychomycosis on the big toe.

Often inflammation of the nail bed is caused by an ingrown nail or by incorrect nail care.

Other risk factors for infection:

  • chewing fingernails
  • Fake Nails
  • Shoes that are too tight
  • Intense irritation of the skin (e.g., from cleaning agents)
  • diabetes
  • Eczema
  • Circulatory disorders
  • Weakened immune system
  • Exposure to these risk factors increases the chances of developing an infection of the nail bed.

Inflammation of the nail bed on the toe or fingers: symptoms

The symptoms of nail bed inflammation are varied. First, an external change in the area of ​​the nail can be seen.

The skin is red, and the infected area is swollen. Already at this early point in time, pain can be felt.

In this picture you can see the inflamed nail fold on the big toe.
In this picture, you can see the inflamed nail fold on the big toe.

The pain is often described as throbbing and stabbing. The infected area often feels hot. In the case of inflammation of the nail bed on the toe, wearing shoes can already lead to pain.

If the nail bed inflammation is present on the finger, special care is required in everyday life, as one often touches the affected area unintentionally and thus causes pain.

After a few days, pus can also form, which is then mainly responsible for tenderness. In addition, symptoms such as fever and malaise may occur.

Trying to squeeze out the pus yourself is not advisable as it can lead to further complications.

If the pus sits in deeper layers of the skin and you try to express it, it can be pushed even deeper into the tissue layers of the affected areas.

In the worst case, this can lead to blood poisoning (sepsis).

Depending on how far the inflammation spreads, the nail may even be lost (check out this article: Toenail loosens ). In the chronic course, the inflammation often occurs on several nails at the same time.

Classification of the paronychia

If it lasts six weeks or less, it is acute paronychia, which is usually the case.

Anything that lasts longer is known as chronic paronychia. Both types of nail bed inflammation are excruciating. 

In addition, nail bed inflammation can be classified according to the cause :

  • Infectious (by bacteria, fungi, herpes viruses)
  • Medicinal (e.g., chemotherapy)
  • Due to systemic disease (e.g., in patients with psoriasis)
  • Traumatic (e.g., ingrown nail)
  • Contact allergic
  • By tumor formation

Nail ulcer (parasitism)

Inflammation of the nail bed can spread to neighboring structures, leading to a pancratium (nail ulcer). 

Both fingers and toes can be affected.

Symptoms here are often stabbing, pulsating pain with a feeling of heat, and function or mobility are often restricted.

The inflammation leads to the formation of pus, and a pus bubble becomes visible. There may be fever and chills as the disease progresses, and the neighboring lymph nodes may swell; blood poisoning is also possible. 

Home remedies for nail bed inflammation

The list of home remedies for nail bed inflammation is long. But do they help? Many people use chamomile, arnica, salt, or even savoy cabbage. Quite a few home remedies have anti-inflammatory properties.

The remedies are usually put into water, and then a foot bath is taken. Alternatively, you can, of course, bathe your hands to treat the infection.

To accelerate wound healing, the affected area should be immobilized and, if possible, elevated. It would help if you also avoid risk factors.

When to see a doctor

Not everyone with paronychia needs to be treated immediately by a doctor. Often there is only a minor injury and inflammation that will heal on its own.

As a rule, a doctor should be consulted after three days if the infection has not improved. Even if the symptoms worsen quickly, a visit to the doctor is helpful to clarify whether it is an inflammation of the nail bed.

People with chronic diseases (diabetes mellitus, circulatory disorders, weakened immune system) should seek medical advice immediately.

Which doctor should you go to if you have an inflammation of the nail bed?

As with nail fungus, the family doctor or the dermatologist (dermatologist) can help with paronychia.

A simple visual diagnosis is made by the doctor taking a closer look at the nail and skin most of the time. The patient is asked about possible causes.

A smear may then be taken to find out whether the nail bed inflammation is a microbial pathogen. After a few days, the result will come with the exact cause of the inflammation.

In the case of a chronic course, the doctor can also arrange a blood and urine test and ask the patient about professional activities and lifestyle habits.

Prevention of inflammation of the nail bed

  • Use gloves to protect hands from chemicals or injuries (washing up, cleaning, gardening, etc.)
  • Carefully perform manicures/pedicures
  • Avoid cosmetic nail polish
  • Wear broad, comfortable shoes
  • Keep hands and feet dry and protect from the cold
  • Regular moisturizing of the skin on hands and feet with suitable care creams (preferably moisturizing)

If these tips are followed, the risk of nail bed inflammation can be reduced.

The proper nail care makes the difference!

The nail is often injured if the nail is not properly cared for.
The nail is often injured if the nail is not properly cared for.

Correct nail care can prevent infection and nail bed inflammation. Fingernails and toenails should be trimmed short regularly (but be careful with the nail wall and cuticle).

The fingernails can be filed round, whereas only the sharp edges of the toenails should be filed so that no injuries are caused to the nail bed. These could promote inflammation!

Proper cuticle care is essential. At most, this should be carefully pushed back with a blunt slide. It is vital that the skin is not too dry and tears as a result. To do this, you can treat them regularly with nourishing creams or oils.

People with diabetes have a decreased sensation in their feet and are unaware when they injure their nails and surrounding skin.

Therefore, particular caution is required here. In this case, medical foot care is recommended.

As long as the nail bed inflammation has not healed, the cuticle should not be pushed back, and cosmetic varnishes should not be used.

What to do if the nail bed is inflamed?
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