Toenail excision for Paronychia and ingrown toenail

Paronychia typically develops as a result of trauma, irritation, or infection. It can happen to fingernails or toenails. Nail inflammation tends to develop when bacteria enter the cuticle and nail fold, causing infection.

Who gets paronychia?

Acute paronychia typically follows a break in the skin, especially if the vulnerable site is between a proximal nail fold or cuticle and the nail plate. These points can lead to the development of paronychia:

  • If the nail is bitten, or the nail-fold is habitually picked
  • Following manicuring
  • Ingrown toenails (onychocryptosis)
  • In infants that suck their thumbs
  • On the application of artificial fingernails

Treatment for paronychia

Acute paronychia
  • Soak infected fingers in warm water 3-4 times daily.
  • Topical antiseptic may be prescribed for a minor infection.
  • Oral antibiotics may be necessary for severe bacterial infection. Usually, tetracycline is prescribed.
  • Consider early treatment in case of severe infection.
  • A surgical incision may be required for abscess.
  • In rare cases, the nail must be removed to allow pus to drain.
Chronic paronychia
  • Keep the hands dry and warm.
  • Avoid wet work, or use waterproof gloves.
  • Keep fingernails clean.
  • Wash regularly after dirty work with soap and water and dry carefully.
  • Apply emollients frequently.
Other points to take care of:
  • Patients with diabetes with toenail paronychia infections must be tested for signs of cellulitis.
  • Surgical excision of the nail bed may be necessary.
  • Eponychial marsupialization involves surgical removal of a narrow strip of skin next to the nail to reduce the risk of infection.
  • Acute paronychia usually clears up within days or weeks; it rarely recurs in healthy individuals. However, chronic paronychia may persist for months or longer and can reoccur in people with an open wound on their fingers. Surgery is helpful for recurrent attacks of paronychia and ingrown toenail.