Treatments for Bacterial Paronychia

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Bacterial paronychia, a common infection around the nail of a finger, occurs when bacteria enter. Bacteria readily enter small injuries caused by nail biting or picking at the fingers. Thumb sucking can cause paronychia in small children. The area of infection turns red, swollen and painful, and pus may be visible. Several treatments help cure bacterial paronychia.

Warm Soaks

Soaking the infected area in warm water 3 to 4 times a day may cure bacterial paronychia if an abscess (a collection of pus under the skin) hasn’t already developed, states Pamela Rockwell, D.O. in the March 2001 issue of American Family Physician (AFP). Vinegar or Burow’s solution (aluminum acetate) also help heal the infected area, lead author Dimitris Rigopoulos, M.D. states in the February 2008 issue of AFP. Warm soaks are also used after surgical drainage.

Drainage and Culture

The infected area in bacterial paronychia requires lancing to allow the infected fluid to drain and cure the infection if an abscess forms. Local anesthesia blocks feeling in the nerves for the procedure. A small sterile surgical blade is inserted under the nail bed to incise the abscess and allow pus to drain out. The area may be irrigated with sterile water and packed with gauze. Cultures to determine the type of bacteria present may be collected and sent to the laboratory.


Topical antibiotic creams applied to the infected areas cure mild bacterial paronychia. Combining an antibiotic with steroids in cream and applying appears to promote faster healing, Rigopoulos states. Bacterial paronychia may require oral antibiotics if warm soaks and topical antibiotics alone aren’t enough to cure the infection. Some practitioners prefer to drain the wound and culture the fluid to determine the type of bacteria present, so antibiotics can be chosen to treat a specific infection, Rockwell states. Penicillin family drugs are effective against bacteria that come from the mouth; Clindamycin or Augmentin may also be used.