By Gary M. White, MD

Acute Paronychia This grew out Candida.


The skin about the nail is inflamed and tender acutely. By definition, the condition is recent, as opposed to chronic paronychia. Pus may be seen. Infection by Staphylococcus is usually found. If involving the proximal nail fold, the nail may ultimately fall off. (Hopefully it will regrow normally.)

Antibiotic-Resistant Acute Paronychia

In a study of antibiotic-resistant acute paronychia [JAAD Jan 2014], the following diagnoses were found:

Common risk factors included finger- or thumb-sucking, nail-biting, contact with animals, frequent hand washing, immunosuppression, playing with water, ripping the hangnail, trauma, and prolonged use of antibiotics.


Inquiry should be made as to whether the patient is manipulating the cuticle. S/he should be told that the cuticle is an important "seal" between the nail and the skin and destroying this seal allows bacteria to enter and infect. Thus, no manicures please and no manipulating the cuticle. The patient should avoid prolonged water contact with the hands, e.g., use gloves when doing the dishes. A culture should be performed if possible. Many times, the patients is able to express fluid/pus from the area of the cuticle. An oral antistaphylococcal antibiotic should be given initially. A topical antibiotic is an alternative. If antibacterial treatment fails, an oral antifungal (e.g., fluconazole) may be given, although Candida infection is more common in chronic paronychia. A topical agent that has broad spectrum activity is 4% thymol in alcohol applied to the tissue about the nail BID.

Additional Pictures

A patient on isotretinoin with a Staph paronychia and a pyogenic granuloma.
Acute Paronychia with a pyogenic granuloma

Acute Paronychia


Homepage | FAQs | Contact Dr. White

It is not the intention of to provide specific medical advice, diagnosis or treatment. only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.