Dear Doctors: Right after I got a manicure, the skin around two of my fingernails got red and really swollen. My roommate says it can happen when the manicurist cuts your cuticles. Is that true?
Dear Reader: Fingernails play a crucial role in protecting and stabilizing the tips of the fingers, making the state of our nails an important part of general health.
You have described the symptoms of paronychia, an inflammation and infection in the skin surrounding a fingernail or a toenail. It can occur when a pathogen, typically bacteria, finds a way past the barriers that protect the tissues around and beneath the nail.
One of these barriers is the cuticle — the band of tissue that arcs across the top of the nail. It shields the nail root, where nail growth begins. The folds of skin along the sides of the nail also offer protection. With the cuticle, they shield the complex and delicate tissues involved in nail growth.
The most common cause of paronychia is a staph infection caused by the bacterium Staphylococcus aureus. Strep bacteria and fungi can cause nail infections as well.
The infection can occur when the protective barriers around your fingernails or toenails are breached due to an injury, an ingrown toenail, from biting your nails or cuticles, from prolonged contact with water or other liquids, from contact with a corrosive substance — and, yes, from an injury that occurs in the course of having your nails cut or filed and the cuticles trimmed or pushed back during a manicure.
This type of infection usually is pretty straightforward. Diagnosis is made by a visual exam, and treatment depends on the severity. Mild cases can be treated at home. This includes soaking the area several times a day in clean, warm water to help ease pain and swelling. Dry it thoroughly, and use a topical antibiotic.
You will want to see your health care provider if an abscess has formed, which might need to be lanced and draind.
As with any infection, the infected area must be kept clean and dry. When an infection fails to clear up, oral antibiotics might be prescribed. If so, take the entire course of antibiotics even if the infection appears to be better.
To avoid paronychia, don’t bite or chew your nails or cuticles. Avoid cutting your cuticles and nails too short. Wear waterproof gloves when working with water. Using hand lotion and rubbing it into your cuticles will help keep them soft and hydrated, which will keep them from cracking.
Dr. Eve Glazier and Dr. Elizabeth Ko are UCLA Health internists.
