Difference Between an Ingrown Nail and Paronychia

If you’ve ever experienced an ingrown nail, you know the pain that this injury can cause. What you might not know is that a simple ingrown nail can also lead to an infection called paronychia. Both conditions are painful, but treatment options will vary. Knowing the difference between these conditions and the health risks that come with them can ensure that you make healthy decisions for your hands and feet.

What Are Ingrown Nails?

An ingrown nail is a condition in which a nail grows somewhere it shouldn’t. For example, your toenail might start growing into the skin next to your toe. The result is chronic inflammation and pain. While ingrown nails most commonly affect the big toe, they can happen on any of your fingers or toes. No matter where it happens, your body will respond as if it’s being invaded by a foreign object. This is quite uncomfortable, and it can lead to a paronychia infection.

Ingrown nails have a variety of causes. One of the most common reasons is a pedicure that goes poorly. Whether you clip your nails or visit a salon, you can experience an ingrown nail if the edge of the nail is rounded instead of straight. You can also get an ingrown nail as a result of tight shoes or socks that put too much pressure on the big toe. This causes an injury to the nail bed. Other causes of this injury include ongoing friction, trauma, or a puncture to the side of the toe.

Some people are at higher risk for ingrown nails than others. For example, people with diabetes or circulatory issues may experience ingrown nails more often and more severely.

What’s Paronychia?

Paronychia is an acute infection that results from an abscess in the fold of the nail. Acute paronychia can become chronic, resulting in long-term pain and discomfort. One symptom associated with chronic paronychia is that the nail fold may become red and flaky as the cuticle disappears. This means your nail has no protection against fungi or bacteria. In fact, paronychia can prevent your nail from growing.

Often, paronychia begins with a small cut in the nail fold that becomes infected. A manicure can cause this small cut, but so can biting your nails or cuticles. Ingrown nails are also common causes of this infection. Those at higher risk for paronychia include those who work in wet conditions. This makes the skin much more vulnerable to tears and cuts.

You can reduce your risk of paronychia if you limit your exposure to moist environments. If you must work in moist environments, make sure that you wear waterproof footwear and socks. Water and chemicals can both prompt this kind of infection.

Paronychia may require medical attention if you also experience a fever and other symptoms associated with an infection. You should also consult a medical professional if you have diabetes or heart disease. Swelling that lasts longer than a week and joint stiffness can be indicators that you’d benefit from medical attention.

How Are Ingrown Nails and Paronychia Different?

While ingrown nails can lead to paronychia infections, these issues aren’t the same, even though the symptoms are quite similar. While you may be able to completely resolve an ingrown nail by removing part of the nail, the same isn’t true for paronychia. Paronychia is an infection that requires additional treatment.

How Can You Treat Ingrown Nails?

When you notice an ingrown nail, one of the first steps you can take is to bathe your nail in warm water to loosen up the nail and skin. You can also switch to footwear that fits more loosely so that you aren’t putting more pressure on your nails.

In the most severe cases, ingrown nail treatment involves partial nail avulsion. This procedure often involves local anesthesia, which means it can be a pain-free experience. Plus, a professional can perform the procedure in the clinic in less than an hour.

How Can You Treat Paronychia?

If you have a mild case of paronychia, you may simply need to bathe the nail twice each day. Some doctors recommend a potassium permanganate solution for these baths. Additionally, a doctor may recommend using a topical cream you can use each day. Antimicrobial therapy is also helpful. Antibiotics help fight off bacterial infections as well, preventing pain, redness, and swelling. Treatment may take up to 10 days.

Keep in mind that some paronychia infections result from a fungus rather than bacteria. In these cases, antibiotics won’t be helpful. Instead, you’ll need to use a topical antifungal or steroid cream. There are several oral treatments available too.

Paronychia treatment may involve draining an abscess with local anesthesia. Your doctor might recommend partial avulsion of the nail if the infection was caused by an ingrown nail. Your toe or finger will be numb so that you won’t feel the partial removal of the nail. This is an effective and trauma-free treatment option. In some cases, removing the nail root will prevent infection from occurring again.

How Can You Prevent These Common Conditions?

One of the best ways to avoid these issues is to care for your hands and feet before an issue arises. Make sure you’re visiting a trustworthy professional when you go in for a manicure or pedicure, for instance. Additionally, ensure that you wear the proper equipment for work to protect your hands from bacteria and fungi that may result in an infection. Keep your feet dry and wear comfortable shoes and socks as much as possible. A professional can provide more specific tips for your career and hobbies.

Do you think you’re experiencing an ingrown nail, paronychia, or another condition that affects your hands or wrists? Do you want to know how to spot the symptoms of these conditions early? The experienced team at the Hand and Wrist Institute in Dallas, Southlake, and now open in Frisco, TX, can provide more guidance on getting treatment and caring for these parts of your body. Your hands are delicate and essential, and proper care can make an enormous difference in your well-being.


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by Chelson Tamares is licensed with Unsplash License

Dr. John Knight
Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.