Sunday, May 07, 2017

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Paronychia is an increasingly common condition that I am seeing in my office. With the huge popularity of nail technology and pedicures, it seems inevitable that this type of condition would be on the rise.Paronychia is an infection of the skin surrounding the nail or nail fold. When infected, the nail fold appears swollen, inflamed, and it may be tender.

What causes paronychia?

The most common cause of this condition is a bacterial infection called staphylococcus aureus which normally lives harmlessly on the surface of our skin. When the skin is damaged or broken, this bacteria can cause infection.

Candida is a yeast infection that tends to cause the paronychia to develop more slowly. It does not cause pus unless it presents alongside a bacterial infection. Less common causes come from other more rare microbes or germs.

People who are vulnerable to this condition are:

1. People who work in water for long periods of time. Good examples are cleaners, bartenders, fishermen, beauticians, and dairy farmers.

2. Injury: When the skin is damaged, microbes can invade. Poorly executed manicures and pedicures are a common cause. Pushing the cuticles back with hard, unsterilised instruments can cause huge problems. Nail biting, ingrowing toenails and dermatological conditions like eczema and psoriasis can also cause paronychia.

3. Occlusion: Covering the nails for long periods of time by using artificial nails and gloves can lead to moisture collecting around the nail. This provides a thriving environment for infections to develop.


If the cause is bacterial, antibiotics may be prescribed — orally, topically, or both. If it is very painful, painkillers may also be prescribed.

If the condition is chronic and lasting for more than six weeks, there may be an underlying skin condition or fungal infection, and these should be treated appropriately. Patients should try to keep their hands dry and avoid any skin irritants like harsh soaps or detergents. Patients should also avoid thumbsucking, nail biting, manicures and pedicures. If the cause is found to be an inflammatory skin condition like eczema, steroid creams are advised. If the cause is fungal, antifungal medication and life- style changes will be advised. In the worst-case scenarios, the nail may have to be removed to promote healing.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.

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