If you notice that your child has redness or swelling around the nail, they may have paronychia. This fingernail infection in children is a common condition that can usually be treated at home. Learn more about the symptoms and causes, and how to treat this inflammation of the periungual fold in children.
What is paronychia?
Paronychia is an infection of the skin surrounding the nail. Although in adults it can also affect the toes, in children it is usually limited to the hands. Paronychia occurs around toenails only if the child has an ingrown toenail, which is quite rare and mostly occurs in teenagers.
Inflammation usually develops on the periungual roller, where the skin comes into contact with the nail on the side or at the base of the nail.
There are two types of paronychia: acute and chronic.
An acute nail infection occurs suddenly and does not last long. Usually appears only on the nails.
Chronic paronychia can show up on a child’s fingernails or toenails and last longer. You may notice that the infection either lasts a long time, or does not go away at all, or subsides and reappears.
Causes of paronychia
Paronychia can develop in a child after some kind of injury or damage to the skin around the nail, cuticle, or nail fold (where the skin comes into contact with the nail). When this area is damaged, bacteria and germs gain access to the tissues and can enter under the skin. In children, the most common causes of initial lesions around the nail are:
- Injury, such as a stuck splinter.
- Biting nails or sucking, biting or chewing on the skin around the nails.
- Breaking off burrs.
- Trimming or pushing back the cuticle.
- Too short cut nails, or if they are cut so that sharp corners form.
- Ingrown nail.
In addition to bacteria, other causes of paronychia can be Candida (a type of yeast) or fungi. Moreover, it can be both a bacterial and a fungal infection at the same time.
Fungal paronychia can develop if a child has nail fungus or if their hands often come into contact with water.
Chronic paronychia that keeps coming back can be caused by irritant dermatitis. It makes the baby’s skin red, itchy and irritated. The irritated skin can then be attacked by germs, causing paronychia.
Paronychia usually occurs on only one nail, not several. Usually the disease begins to appear two to five days after the injury around the nail.
Symptoms of paronychia
The symptoms of paronychia are usually easy to notice and recognize.
- The area around the nail, or the area of the child’s original injury, usually becomes red and swollen.
- The child himself will probably say that the finger hurts or is sensitive.
- When you touch the infected area, you can feel that it is warmer than the surrounding areas.
- In some cases, if the cause is a bacterial infection, a pus-filled blister forms at the site of inflammation.
You may notice that the nail also looks different. It may have a strange color or shape, or it may start to look like it has come off the skin. If the nail infection is bacterial, these changes happen more quickly. Fungal infections take longer to develop symptoms.
Scientists at the State Medical University of the Ministry of Health and Social Development found that most often such an infection affects the leading hand and the thumb or index finger.
Why is paronychia dangerous? This is a special case of panaritium, a more extensive inflammatory process. When the nail infection spreads to other parts of the body, the child may show signs of a dangerous systemic infection. These include:
- Pain in muscles or joints.
- Red streaks on the skin.
- General malaise.
With such symptoms, the child needs urgent hospitalization in a hospital. So, from a small wound near the nail, a dangerous pathology, phlegmon, can begin.
Treatment of nail infection at home
Treatment for paronychia depends on how severe the infection is. In most children, fingernail infections can be treated at home and no special treatment is needed.
Home care. To treat paronychia at home, “soak” your child’s finger in warm salt water several times a day. Each procedure should last from 10 to 20 minutes. After the bath, dry your finger with a clean towel. If you notice any fluid dripping from the infection site, clean it carefully.
If the child is uncomfortable or complains of pain, check with the doctor — as a rule, in such cases, a common pain reliever such as ibuprofen or paracetamol is prescribed.
While you are treating your child’s infection, remind him to leave the area alone. This means not biting the nail or chewing on the skin around it, as this can be the cause of the initial infection.
While paronychia is healing, take care of your child’s nails by trimming them weekly. Subsequently, the child’s nails need to be trimmed less often. Keep them smooth so that the edge of the nail is not sharp or uneven, and don’t cut the nail too short.
With this approach, the nail infection should go away on its own within a few days.
When to see a doctor?
While most cases of paronychia are mild and resolve with home treatment, some cases may need to see a doctor. For example, if the infection persists after one week of home treatments, a specialist consultation is needed. Not only will it help get rid of the infection, but it will also ensure that the infection does not spread to other parts of the child’s body.
If you notice that an abscess or accumulation of pus has formed around your child’s finger, a doctor will need to drain it. After drainage, the infected toe usually heals fairly quickly and without complications. In some rare cases, it may be necessary to remove part of the nail: according to a study by doctors from the Karpogory Central District Hospital, almost one in three patients who visit a doctor with paronychia require surgery.
To make sure the child’s infection is gone, the doctor may prescribe a course of antibiotics. In this case, it is important that the child completes the entire course of treatment. The doctor may also prescribe a steroid cream to apply to the inflamed area to help with healing.
If the doctor thinks the infection is caused by a fungus, he or she will prescribe antifungal drugs. It can be an oral medication, cream or ointment.
If your child has chronic paronychia, keep their hands and nails clean and dry, and stay away from any harsh chemicals that can irritate the skin. To keep your child’s hands dry, you can ask them to wear gloves when in contact with water, or to apply a drying cream as the infection heals.
Paronychia without treatment often turns into panaritium. Read about this pathology in the article “Panaritium: causes and symptoms of inflammation.”
Diagnosis and treatment of purulent diseases of the hand and fingers in adults and children / Barsky A V. // Publishing House of Samara State Medical University - 2004
To the question of conservative treatment of panaritium / Petrushin A. L. // Perm Medical Journal - 2010 - Number 3
Comprehensive treatment of purulent diseases of the hand in a surgical hospital / Kraynyukov P.E., Knyazeva N.S., Zhilenko E.V., and others. // Chief Physician of the South of Russia - 2011 - #2