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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. Early infection and long-standing nail fold problems are treated by video; a collection of pus needs draining in person.
- What it is: inflammation, usually infection, of the skin fold around a fingernail or toenail; acute if under 6 weeks, chronic if longer.
- Common causes: nail biting, picking at the cuticle or hangnails, manicures, and hands that are often wet.
- Self-care: soak the finger or toe in warm water 2 or 3 times a day to ease swelling and pain.
- Emergency: call 112 for red streaks spreading up the hand, arm or leg with a fever, chills or feeling very unwell.
Red streaks spreading from the nail, with a fever, chills or feeling very unwell, need 112. A whole finger that is swollen and painful to move, or a tense swelling full of pus, needs in-person care promptly, as it may need draining.
Can an online doctor treat paronychia?
Partly. Paronychia shows well on camera, so a doctor by video can recognise it, check for pus and signs of spreading infection, and treat it with soaks and antibiotic cream or tablets. Long-standing paronychia, where the nail fold stays swollen for weeks, is also managed online with creams and protection from water. When pus has collected into an abscess, it needs draining by a doctor in person, and the online doctor tells you when that is the next step.
How an online consultation helps with paronychia
- Infection checked: Redness, swelling, pus and any spread up the finger or hand, checked on camera.
- The right treatment: Soaks, antibiotic cream or tablets, or antiviral treatment when a cold sore virus is the cause.
- A clear next step: When pus needs draining in person, and how urgently.
- Nail folds that last: A plan for chronic paronychia: protecting the hands from water, and creams that settle the fold.
What the doctor checks in an online consultation
The doctor asks about:
- The nail: which finger or toe, how long it has been sore, and whether it came on over hours or weeks.
- Pus and spread: a yellow or white collection of pus, the nail lifting, red streaks or swelling of the whole finger.
- How it started: nail biting, a hangnail, a manicure, artificial nails or an ingrown toenail.
- Your hands: wet work, cleaning, hairdressing or food preparation, and hand eczema.
- Your health: diabetes, poor circulation, a weakened immune system, and medicines such as retinoids.
- Blisters: small, painful blisters on the fingertip, which can mean a herpes infection.
Before the call, find good light, and have the nail ready to show close up on camera, next to the same nail on the other hand.
Paronychia symptoms
Paronychia comes in two forms, with different causes and treatment:
Swipe sideways to compare →
| What differs | Acute paronychia | Chronic paronychia |
|---|---|---|
| How it starts | Over hours | Gradually, over weeks |
| How long it lasts | Less than 6 weeks | More than 6 weeks |
| What you notice | A painful, red, swollen nail fold, usually one nail; pus may collect and the nail may lift | Swollen, red nail folds on one or several fingers, the cuticle lost, the nail thick or ridged |
| Usual cause | Bacteria, after a break in the skin | Irritation of the nail fold from water and detergents, sometimes with yeast |
On a toe, paronychia often comes with an ingrown toenail. A thick, crumbly, discoloured nail without a painful fold is more likely a fungal nail infection.
Left untreated, paronychia can change the nail: it can grow with ridges or waves, turn yellow or green, become dry and brittle, or lift off the nail bed. The doctor diagnoses it from how it looks and how it started; a sample or an X-ray is rarely needed.
Whitlow and herpetic whitlow
Paronychia is sometimes called a whitlow. Herpetic whitlow is different: a painful infection of a fingertip, often the thumb or index finger, caused by the herpes simplex virus that causes cold sores and genital herpes. It starts with itching, burning or an odd feeling, then clusters of small blisters, 1 to 3 mm across, appear on a red, swollen fingertip, sometimes with a fever. In adults it is most often linked to genital herpes, or to contact with saliva at work, for example in dental or health care.
Herpetic whitlow usually clears in 2 to 4 weeks. It must not be cut open, because that can spread the virus and let bacteria in; keep the finger covered, and avoid touching your eyes, mouth or genitals. It can come back when the virus reactivates, usually more mildly.
What causes paronychia?
Acute paronychia usually starts with a small break in the skin around the nail that lets bacteria in, most often Staphylococcus aureus, sometimes streptococci. Chronic paronychia is usually a dermatitis of the nail fold, kept going by water and irritants, often with yeasts and bacteria found in the nail fold. Chronic paronychia is about three times as common in women as in men, and it is not caught from other people. Things that make paronychia more likely:
- nail biting, picking or cutting the cuticles, and pulling hangnails
- manicures and artificial nails
- hands that are often wet or cold, such as in cleaning, catering, bar work, baking, farming, fishing or hairdressing
- hand eczema
- diabetes, poor circulation or a weakened immune system, which make infection more frequent and more severe
- some medicines, including retinoids, some cancer treatments, some HIV medicines and some antibiotics
Painful blisters on the fingertip can be a herpes infection called herpetic whitlow, which is treated with antiviral medicine.
How to treat paronychia at home
Early, mild paronychia without pus can settle with care at home:
- Soak the finger or toe in warm water for about a quarter of an hour, 2 or 3 times a day, to ease swelling and pain and help pus drain, then dry it well.
- Take paracetamol or ibuprofen for the pain, following the leaflet.
- Do not squeeze it or try to cut it open.
- Keep the hands dry between soaks, and wear gloves for washing up and cleaning.
See a doctor if it is not improving after a day or two of soaks, if pus is collecting, if the redness is spreading, or if you have diabetes or a weakened immune system.
Which paronychia treatment might the doctor recommend?
Treatment depends on whether it is acute or chronic, and whether pus has collected. This is the framework the doctors use, in line with dermatology guidance.
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Red, sore nail fold, no pus | Warm soaks, sometimes an antibiotic cream | Yes | Not usually needed |
| More inflamed or spreading redness | Antibiotic tablets with soaks | Yes | If it does not improve |
| A collection of pus | Draining the pus | Yes, to assess | For the drainage |
| Painful blisters on the fingertip | Antiviral treatment for herpes | Yes | Not usually needed |
| Swollen nail folds for over 6 weeks | Gloves, a steroid cream, and an antifungal or antiseptic | Yes | If it does not respond |
Sore, swollen skin around a nail? A doctor can check it on camera and treat infection in one consultation.
See available times →Treatment options for paronychia
What you can do yourself
- Soak the affected finger or toe in warm water 2 or 3 times a day.
- Keep your hands dry and warm, and wear gloves for wet work.
- Leave cuticles alone and stop biting or picking the nails.
Prescription treatment
A prescription is never issued without a consultation. For acute paronychia, the doctor may prescribe an antibiotic cream, or antibiotic tablets for a more serious infection; finish the course so it does not come back. When herpes is the cause, antiviral medicine works best started early, within 2 days of the first symptoms. Chronic paronychia is treated as a dermatitis: a steroid ointment for a few weeks to settle the nail fold, repeated for flare-ups, often with an antiseptic or antifungal lotion for several months, and strict protection from water. If the doctor prescribes, use the prescription at a pharmacy near you.
Draining an abscess
When pus has collected, a doctor numbs the finger and makes a small cut to let it drain, and sometimes removes part of the nail. This is done in person.
What does not help
Squeezing or cutting into the swelling yourself can push the infection deeper. Pushing back or cutting the cuticles removes the seal between the nail and the skin and lets infection in.
How to prevent paronychia
- Do not bite or pick your nails, or pull at hangnails.
- Do not trim or push back your cuticles; they seal the gap between the nail and the skin.
- Wear gloves when using water, detergents or chemicals, ideally waterproof gloves with a cotton lining.
- Keep hands dry and warm, and use an emollient or barrier cream often.
- Take your own tools to a nail salon, and ask for your cuticles to be left alone.
- Do not cut your nails too short, and keep them trimmed and smooth.
- Avoid nail varnish and false nails until chronic paronychia has settled.
Special situations
Diabetes, poor circulation or a weakened immune system
Infections are more frequent and can be more severe, so see a doctor early rather than waiting to see if it settles.
Wet work
Chronic paronychia is common in people whose hands are often wet. Cotton-lined waterproof gloves for every wet task, including washing up and washing your hair, and drying the hands well, are a key part of treatment: it does not improve until the hands stay warm and dry.
Recovery from chronic paronychia
It starts slowly and clears slowly. Creams usually help within a few weeks, but the cuticle can take up to 6 months to grow back, and it can return until then. The nail can take up to a year to grow back normally.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When paronychia is treated online, and when you need in-person care
Treated online: early paronychia without a collection of pus, antibiotic cream or tablets, herpes infection of the fingertip, and chronic paronychia with creams and protection from water.
In-person care: draining an abscess, removing part of a nail, infection that spreads to the finger or hand, and paronychia that does not respond to treatment.
When to get in-person care
Call 112 or go to an emergency department now for:
- red streaks spreading up the hand, arm or leg, with a fever, chills or feeling very unwell
Get medical advice the same day for:
- a tense, very painful swelling with pus collecting under the skin
- a whole finger that is swollen, or painful to bend or straighten
- redness spreading beyond the nail fold, or a fever
- an infected nail fold if you have diabetes or a weakened immune system
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the nail: show it close up on camera in good light, and say when it started and whether pus has collected.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
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Frequently asked questions about paronychia
What is paronychia?
Paronychia is inflammation, usually infection, of the skin around a fingernail or toenail. It is acute when it lasts less than 6 weeks and chronic when it lasts longer.
What causes paronychia?
Acute paronychia usually follows a break in the skin from nail biting, a hangnail or a manicure, letting bacteria in. Chronic paronychia comes from hands that are often wet, with irritation of the nail fold.
What is the fastest way to get rid of paronychia?
For early paronychia, soak the finger or toe in warm water for about a quarter of an hour, 2 or 3 times a day, and dry it well. If it is not improving after a day or two, or pus has collected, see a doctor: it may need antibiotics, or the pus drained.
Does paronychia go away on its own?
Mild acute paronychia often settles with warm soaks. Pus that has collected may need draining, and chronic paronychia needs treatment and dry hands, because it can last for months.
What is a whitlow?
Whitlow is another name for paronychia, an infection of the skin around a nail. Herpetic whitlow is a different, viral infection of the fingertip, caused by the herpes simplex virus, with clusters of small, painful blisters.
Is it paronychia or something else?
Paronychia is redness, swelling and pain of the fold of skin beside or behind the nail, often with pus at the edge. A felon is a throbbing infection of the fingertip pad itself, tense and very painful; herpetic whitlow is a cluster of small clear blisters on the finger with burning pain and no pus; an ingrown toenail is the nail edge cutting into the skin of the big toe; and nail psoriasis thickens and pits the nail without infection.
Is herpetic whitlow an STI?
Herpetic whitlow is a herpes simplex infection of the finger rather than the genitals, not a bacterial paronychia, but in adults it is most often linked to genital herpes. It can also follow a cold sore, or contact with saliva at work. Keep the finger covered and avoid touching your eyes, mouth or genitals.
Do I need antibiotics for paronychia?
Not always. Mild early paronychia settles with warm soaks 2 or 3 times a day and keeping the finger dry between them. An antibiotic cream or a short course of tablets is used when the redness is spreading, the fold is very swollen or a yeast or bacterial infection is not settling, and a collection of pus needs draining, after which antibiotics are often unnecessary.
Should I pop a paronychia?
No. Squeezing, piercing or cutting a paronychia yourself can push the infection deeper into the finger, towards the tendon and bone, and introduce more bacteria. A collection of pus is drained safely by a doctor, often by lifting the nail fold with a sterile instrument, which gives quick relief; soaks before then can help it drain on its own.
How long does paronychia take to heal?
Acute paronychia usually responds well to treatment. Chronic paronychia can take months, and the nail can take up to a year to grow back normally.
What is chronic paronychia?
Chronic paronychia is long-lasting swelling and redness of the nail folds, often on several fingers, in people whose hands are often wet. It is treated with protection from water and creams.
Can paronychia turn into sepsis?
Rarely. A paronychia infection can spread to the finger, tendons, bone or bloodstream. Red streaks from the nail, a fever, chills or feeling very unwell need urgent care: call 112.
Can an online doctor treat paronychia?
Partly. A doctor can assess a paronychia on camera, judge whether pus has collected, and treat early or chronic infection with soaks, antifungal or antibiotic creams, or antibiotic tablets, with the prescription usable at a pharmacy near you. A collection of pus, a spreading infection or paronychia in someone with diabetes needs draining or examination in person.
- Paronychia, DermNet, New Zealand, updated August 2017.
- Paronychia, MedlinePlus, US National Library of Medicine, reviewed April 2025.
- Paronychia (nail infection), Cleveland Clinic, updated 16 August 2021.
- Chronic paronychia: patient information, Sussex Community Dermatology Service, accessed 15 October 2026.
- Herpetic whitlow, DermNet, New Zealand, reviewed April 2023.
- Paronychia: patient information, St George’s University Hospitals NHS Foundation Trust, March 2022.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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