Toenail paronychia is a bacterial infection causing stabbing pain and pus buildup near the toenail. It includes two main types: acute paronychia, caused by bacteria such as staphylococcus aureus or streptococcus, and chronic paronychia, which develops slowly due to the candida bacteria. Early treatment by a health care expert, like a podiatrist, is crucial to prevent complications. This article explains what paronychia is and how to cure it.
3 Phases of Toenail Paronychia Progression
Toenail paronychia, though often linked to fingers, can also infect toes. The infection generally advances through three phases:
- The inflammation phase: Early inflammation where infection is reversible with prompt treatment.
- The “colonization” phase: Symptoms intensify; pus accumulates requiring podiatrist intervention to prevent worsening.
- The complication phase (infection): Untreated infection can spread to other foot structures, requiring more invasive diagnosis and treatment.
Symptoms of Toenail Paronychia
When bacteria penetrate the skin near the toe, the infection spreads rapidly. Early symptoms include:
- Redness around the nail;
- A sensation of heat;
- Swelling of the toe;
- Pain on touch.
If untreated, symptoms worsen with:
- Throbbing pain;
- Pus accumulation;
- Fever above 38°C.
Further delay can lead to complications like infection spreading to tissues, joint infection, tendon damage, osteitis, nail matrix destruction, and tissue necrosis, necessitating emergency care.
Similar Foot Diseases
Symptoms of toenail paronychia resemble other bacterial infections such as:
- Onychocryptosis (ingrown toenail);
- Fungal nail infections;
- Athlete’s foot (tinea pedis).
A podiatrist uses diagnostic tools like visual inspection, digital x-rays, and ultrasound imaging to confirm diagnosis and differentiate conditions.
Causes and Risk Factors
Toenail paronychia begins with an open wound around the toe, commonly due to:
- Poorly done pedicure;
- Foot trauma causing skin separation;
- A foreign body under the nail (e.g., splinter, rock);
- Cutting nails too short or ingrown toenail;
- Insect bites;
- Wearing tight shoes too tight.
People with diabetes or a compromised immune system are more vulnerable. Cleaning wounds or removing foreign bodies causing toe pain should be immediate actions.
Medical Treatments for Toenail Paronychia
Treatment by a podiatrist is generally necessary in advanced stages. After diagnosis, treatment might include:
- Foot care with antiseptic baths, nail trimming, and protective bandaging;
- Antibiotic prescriptions targeting streptococcus and staphylococcus aureus.
For more severe cases, options include:
- Surgical drainage of abscess under local anesthesia;
- Partial or total nail removal;
- Removal of foreign bodies causing infection;
- Rarely, excision of necrotic tissue.
FAQ – Common Questions About Toenail Paronychia
What’s the difference between toenail paronychia and an ingrown toenail?
Paronychia affects the skin around the nail, while ingrown toenails involve the nail piercing the skin.
When should I see a podiatrist?
Consult a podiatrist if symptoms worsen within days or if pus appears.
Can I treat paronychia at home?
Early infections may improve with warm soaks, but medical care is often needed.
Is toenail paronychia contagious?
It is usually not contagious but good hygiene is important to prevent spreading bacteria.
PiedRéseau – Learn more
For more information on toe infections like paronychia, PiedRéseau regularly publishes useful content. However, nothing replaces a consultation with a PiedRéseau-affiliated podiatrist. If you notice symptoms of toenail paronychia, seek care promptly from a podiatrist in Quebec to prevent worsening. Find a clinic near you.
Remember to take care of your feet, they are precious!