Springdale Mason Pediatrics

Fingernail Infection - Bacterial

Definition

  • Mild bacterial infection of the skin fold next to the fingernail

Call or Return If

  • Pus pocket appears
  • Spreading redness occurs
  • Fever occurs
  • Not gone by day 4
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Redness and swelling of the skin next to the fingernail
  • Usually involves just one small part of the skin fold
  • The red area is painful and tender
  • The redness comes out over a few days
  • A pus pocket (large pimple) may occur
  • The medical name is acute paronychia

Causes

  • Normally the nail plate (fingernail) and the skin fold forms a tight seal. The cuticle is a strip of dead skin cells. It seals the nail groove (the space between the skin and nail plate). It acts to fill this gap.
  • If this seal is broken, it provides an entry for germs. Staph is the most common germ to infect the area.
  • A hangnail is a loose piece of cuticle. Picking at, pulling or chewing a hangnail often starts the problem.
  • Nail biting is another trigger.
  • For teenagers, frequent manicures or using sculptured nails can cause this.

After Care Advice

Overview:
  • This is a mild infection of the cuticle (skinfold around the fingernail).
  • It is usually caused by bacteria.
  • Pulling at hangnails or other injury to the cuticle often starts the process.
  • Usually, it can be treated at home.
  • Here is some care advice that should help.
Warm Soaks:
  • Soak the infected finger in warm water and an antibacterial soap.
  • Soak for 10 minutes.
  • Repeat 3 times per day until infection is gone.
Antibiotic Ointment:
  • Use an antibiotic ointment (OTC) to the area 3 times per day.
  • Cover it with a Bandaid.
  • Keep doing this until the redness and pain are gone.
Antibiotic by Mouth:
  • If the infection is spreading, your doctor may prescribe an antibiotic.
  • The drug will kill the germs that are causing the infection.
  • Give the drug as ordered.
  • Try not to forget any of the doses.
Pain:
  • To help with the pain, give acetaminophen (such as Tylenol) OR ibuprofen. Use as needed.
Pus Pocket Drainage:
  • Pus pockets need to be opened and drained.
  • Drainage is safer if done by a doctor.
  • If the pus pocket is small and your doctor wants you to open it, here's how:
  • Use a needle. First, clean it with rubbing alcohol.
  • Make a large hole through the center of the pimple.
  • Help the pus come out with gentle pressure.
  • Throw away the needle and all the pus.
  • Keep using an antibiotic ointment 3 times per day.
Prevention of Recurrent Fingernail Infections:
  • Do not pick at or chew loose pieces of cuticle (hangnails). Instead, cut them off with nail clippers.
  • If your child is a nail biter, help him give up this bad habit.
  • For teens, avoid frequent manicures.
What to Expect:
  • With proper treatment, this mild infection should clear up in 3 days.
  • Sometimes, the redness will turn into a large pimple or pus pocket.
  • If this occurs, contact your child's doctor to drain the pus.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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