MSD Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Chronic Paronychia


Chris G. Adigun

, MD, Dermatology & Laser Center of Chapel Hill

Last full review/revision Dec 2019| Content last modified Dec 2019
Click here for the Professional Version
Topic Resources

Chronic paronychia is recurring or persistent inflammation of the nail fold, typically of the fingernails.

Chronic paronychia occurs almost always in people whose hands are chronically wet (for example, dishwashers, bartenders, and housekeepers), particularly if they have hand eczema, diabetes, or an impaired immune system. The yeast Candida is often present, but its role in causing chronic paronychia is unclear because eliminating the yeast completely does not always cure the condition. Chronic paronychia may be the result of an irritant skin inflammation (dermatitis Overview of Dermatitis Dermatitis is inflammation of the upper layers of the skin, causing itching, blisters, redness, swelling, and often oozing, scabbing, and scaling. Known causes include dry skin, contact with... read more ) in addition to the presence of Candida.

The nail fold (the fold of hard skin at the sides of the nail plate where the nail and skin meet) is painful, tender, and red as in acute paronychia Acute Paronychia Acute paronychia is a bacterial infection of the cuticle. In acute paronychia, bacteria (usually Staphylococcus aureus or streptococci) enter through a break in the skin resulting from a hangnail... read more Acute Paronychia , but pus usually does not accumulate. Often there is loss of the cuticle (the skin at the base of the nail) and separation of the nail fold from the nail plate (the hard part of the nail). A space then forms that allows irritants and microorganisms to enter. The nail can become distorted.

The doctor makes the diagnosis of chronic paronychia by examining the affected finger.

Treatment of Chronic Paronychia

  • Avoiding excessive exposure to water

  • Corticosteroids or tacrolimus

  • Sometimes corticosteroid injections into the nail fold

  • Sometimes antifungal drugs

  • Sometimes surgery

Keeping the hands dry and protected can help the cuticle re-form and close the space between the nail fold and nail plate. Gloves or barrier creams are used if water contact is necessary.

Corticosteroid creams applied to the nail may be helpful. Corticosteroids may also be injected into the nail fold. Tacrolimus cream may also be given.

Antifungal drugs (such as fluconazole taken by mouth) are given only if people are at risk of being colonized by Candida.

Surgery on the nail fold may be needed for people who have a severe disorder or whose disorder is hard to treat with other methods.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Others also read
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Test your knowledge
Ichthyosis is a form of severe dry skin that causes it to scale (build up excessive dry skin cells) and flake. Ichthyosis ranges in severity from mild to disfiguring, and may be either inherited or acquired. During which of the following time periods does inherited ichthyosis usually first manifest?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID