The doctor will ask about your symptoms and medical history. A physical exam will be done. In most cases, paronychia can be seen on examination. If you have an abscess, your doctor may take a sample of the pus to identify the specific cause of the infection.
Treatments are different for acute and chronic paronychia.
A mild case of acute paronychia is usually caused by bacteria. Minor swelling or redness near the nail may be treated by soaking the affected nail in warm water. This treatment can be repeated 2-4 times daily, for 15 minutes at a time.Topical antibiotics can be used on the area between soaks. In most cases, this type of paronychia heals within 5-10 days.
In cases where a build up of pus is suspected, your doctor may also cut the area with a scalpel to drain it. It is possible that your doctor will need to remove part of the nail. If your condition does not improve, or is severe, your doctor may prescribe oral antibiotic medication.
Since some chronic cases might be caused by fungi, your doctor may give you an topical antifungal medication. It may be given in a liquid form that you apply directly to the infected area.
Chronic paronychia may also be caused by a mixed bacterial infection, which can be treated with antibiotics. You may need to take the medication for several weeks. Some dermatologists believe that chronic paronychia is often caused by inflammation rather than by either bacterial or fungal infections. For such non-infectious paronychia, the use of cortisone creams can be helpful.
Whatever treatment is prescribed, it is important to keep the skin clean and dry. It is also important to avoid getting irritating substances, such as strong cleaners or certain foods, on the area. Surgery may be recommended in some cases of chronic paronychia that do not respond to other treatments.
Symptoms may subside with treatment. However, permanent damage to the nail or surrounding tissue sometimes results.