Paronychia: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Paronychia?
A primary care doctor can often diagnose and treat paronychia, a skin infection around the nail. A dermatologist, a doctor who treats skin and nail problems, may help with severe or long-lasting cases. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is paronychia?
Paronychia is a skin infection that occurs around the nails. It is a common condition. It can affect the hands or, less often, the feet. It can be acute or chronic. Doctors call it chronic when it lasts longer than six weeks.
Symptoms
The main symptom is a painful, red, swollen area around the nail.
- The redness is often at the cuticle or at the site of a hangnail or other injury.
- There may be pus-filled blisters, especially with a bacterial infection.
- The nail may look detached, oddly shaped, or a different color.
Bacteria cause the problem to come on suddenly. A fungus tends to cause it to appear more slowly. If the infection spreads to the rest of the body, symptoms may include fever, chills, and red streaks along the skin.
Causes and who gets it
Paronychia comes from injury to the area, such as biting off or picking a hangnail, or trimming or pushing back the cuticle. Bacteria, Candida (a type of yeast), or other fungi can cause the infection. A bacterial and fungal infection can occur at the same time. Fungal paronychia may occur in people who have a fungal nail infection, have diabetes, or expose their hands to water a lot. Children who suck their fingers or bite their nails are prone to it. Jobs such as baker, bartender, and dishwasher seem to raise the risk of long-lasting paronychia.
How doctors diagnose it
Your provider can usually diagnose paronychia by simply looking at the sore skin. Pus or fluid may be drained and sent to a lab to find out what kind of bacteria or fungus is causing the infection. A chronic case that does not improve with treatment should be checked for unusual causes, such as cancer.
Treatment
Soaking your nail in warm water 2 or 3 times a day helps reduce swelling and pain. Your provider may prescribe antibiotics that you swallow. In severe cases, your provider may cut and drain the sore with a sharp instrument, and part of the nail may need to be removed. If you have chronic paronychia, your provider may prescribe antifungal medicine, sometimes with a steroid cream. For chronic paronychia, treatment mainly means avoiding things that irritate the nail area, such as long contact with water, manicures, nail injury, and finger sucking. Paronychia often responds well to treatment, but fungal infections may last for several months.
When to see a doctor
Contact your provider if symptoms continue despite treatment, or if symptoms get worse or new symptoms appear. Get medical care right away if you have a fever, chills, or red streaks along the skin. These signs can mean the infection has spread to the rest of the body. Complications are rare, but they may include an abscess, which is a pocket of pus, or a spread of infection to tendons, bones, or the bloodstream.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can examine the nail, start treatment, and arrange follow-up visits. They can also refer you to a dermatologist when needed.
Common questions
Does warm water soaking help paronychia?
Yes, soaking your nail in warm water 2 or 3 times a day helps reduce swelling and pain.
How long does paronychia last?
It depends on the cause. Paronychia often responds well to treatment, but fungal infections may last for several months.
Is paronychia serious?
It can lead to problems, but complications are rare. They include an abscess, lasting changes in the shape of the nail, and spread of infection to tendons, bones, or the bloodstream.
How can I prevent paronychia?
You can prevent paronychia by caring for your nails and the skin around them. Do not bite or pick your nails, and wear rubber or plastic gloves, ideally with cotton liners, around detergents and chemicals. Do not trim your cuticles or use cuticle removers, and bring your own tools to nail salons.
Can paronychia affect toenails?
Yes, it can affect the feet, but it is less common there than on the hands.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
