Nail bed inflammation

Nail bed infection: description

A nail bed infection is an infection of the nail bed. The nail bed is the skin that is under and around the nail. Generally, a nail bed infection can affect toenails and fingernails.

Medically, a nail bed infection is also referred to as onychia. If, in particular, the nail fold (or nail wall) is inflamed, this means paronychia. Depending on whether the inflammation affects the nail bed itself or the skin around the nail, two types of nail bed inflammation are distinguished:

• Panaritium paraunguale: Here the skin behind and to the side of the nail is affected by the inflammation. The Panaritium paraunguale is also called a true circulation because the inflammation circulates the nail almost once.
• Panaritium subunguale: Here the nail bed itself is affected by the inflammation. It may accumulate pus under the nail at such a nail bed infection.

In addition to the localization can be distinguished between a chronic and an acute nail beditis. Acute nail bed infection can affect anyone without the need for special risk factors.

A chronic nail bed infection usually have people who have a damaged immune system due to chronic diseases (for example, in diabetes mellitus) or come repeatedly in contact with substances that damage the skin.

Physicians speak of a chronic nail bed infection, if the inflammation despite treatment repeatedly occurs. It is important in the context that not only the nail bed inflammation treated, but the favoring factors are included in the treatment.

Overall, a nail bed infection is common, for example, they represent about 30 percent of infections that occur on the hand.

Nail beditis: symptoms

If the nail bed is inflamed, this usually manifests itself first by a strong redness of the affected skin. Especially in the initial stages of nail bed infection, the skin itches around the nail. Then the skin swells and shines reddish. Local overheating is also a classic sign of inflammation.

This can also cause moderate to severe pain. In the beginning, they only occur when pressure is applied. But even after a few days, the affected fingers or toes hurt, too, without being exposed to irritation. At the latest, if severe pain without pressure is added, consult a doctor.

In a subarctic panaritium, pus accumulates under the nail over several days. This purulent swelling usually causes severe pain. It can burst open by itself, pus then empties on the side edges of the nail. If the pus accumulation does not open by itself, it may be necessary to open it up surgically.

If a nail bed infection remains untreated for a long time, the growth of the nail may be disturbed. If there is additional pus build-up under the nail plate, the nail may detach from the nail bed.

From an acute can develop a chronic nail bed infection, usually there are other risk factors, such as an ingrown toenail. Chronic paronychia is usually less painful than acute nail beditis. However, the nail plate may be yellowish or greenish in color. In contrast to the acute form, more than one finger or toe are usually affected.

Nail Bed Infection: Causes and Risk Factors

The most common causes of paronychia are staphylococci. In addition, yeasts or herpesviruses can cause paronychia. Other microorganisms are rarely responsible for a nail bed infection, so they have little medical significance.

On healthy skin, these pathogens do no harm. Only through small wounds, which are located on the nail fold, the skin or the Nagelwall, the pathogens can penetrate the skin and cause acute inflammation. Entry points for pathogens are therefore often caused by so-called minor injuries, for example in nail care. Ingrown nails or intense skin irritation (for example, cleaning and cleaning products) may also become entry sites for pathogens.

Most affected by an acute nail bed infection are women who operate an exaggerated or incorrect nail care. Even people with dry skin more often have a nail bed infection. Also at risk are persons with chronic atopic dermatitis or diabetes mellitus and persons with circulatory disorders. Other risk groups include those with a weakened immune system and cancer patients receiving EGFR agonist or tyrokinase inhibitor therapy.

Nail bed infection: examinations and diagnosis

Not every nail bed infection must be treated immediately by the doctor. Many people daily have minor injuries and nails that heal on their own. With a healthy immune system and no other illnesses, you can wait a few days before seeing a doctor with nail bed infection. But you should go to a doctor at the latest if there is no improvement within three days or the symptoms get worse quickly. People who are known to have a weakened immune system should consult a doctor for small signs of inflammation.

If a nail bed infection is suspected, the family doctor or dermatologist is the right person to contact. In a first conversation, the doctor records the history of the patient (anamnesis). In order to narrow down the nature and development of the symptoms, the doctor can then ask questions such as:

• Do you suffer from such complaints more often?
• What do you do for a living?
• Are allergies known to you?
• Do you suffer from other known illnesses?

After the anamnesis, a physical examination takes place. The doctor examines the affected skin thoroughly. By palpation, he determines if pain persists. In most cases, the obvious symptoms of nail bed infection are already sufficient to make a first diagnosis.

To confirm the diagnosis and to differentiate, for example, from squamous cell carcinoma, the doctor takes a smear from the inflamed place. Under the microscope, it can be seen which form of pathogens is responsible for the infection (fungi or bacteria). In order to determine the exact pathogen, a culture of the smear can be created in the laboratory. However, the evaluation of such a culture takes one to several weeks.

Nail bed infection: treatment

A nail bed infection treatment may be performed by affected persons themselves or by a physician, depending on the stage of the inflammation. In the initial stage of inflammation (less than three days of inflammatory signs) you can try to treat a nail bed infection yourself. If there is no improvement, a doctor’s visit is appropriate.

Nail bed infection – what to do?

There are several ways to treat a nail bed infection yourself. First, start bathing your feet or fingers in warm water several times each day. These baths loosen the cornea on the feet and make it easier for pus to drain. Additives like camomile support this effect. After such a bath you should apply a disinfecting solution. Sometimes it also helps to connect the finger so that it can not be moved. Immobilization supports the healing process.

The pharmacy has several over-the-counter medications available for nail bed inflammation. When choosing the right remedy it is important in many cases to know which pathogens are responsible for the inflammation. For example, naftifine and nystatin only work on fungal infections on the skin. They do not help with bacterial infections. If the pathogen is unknown, you should rather avoid such targeted drugs.

A drug that generally works against germs on the skin is burn and wound gel. It contains the active substances benzethonium chloride, urea and polidocanol. Another remedy for several types of germs is povidone iodine. It is the most commonly used nail bed infection remedy. Ointment, gel or cream containing povidone iodine is used for disinfecting.

On highly festering areas, you can apply ammonium bituminosulfonate, a general anti-inflammatory agent. This is available as a tincture or ointment in the pharmacy. Ointment containing ammonium bituminosulphonate is also called train ointment. Nail inflammation and other inflammations are disinfected and the skin softened. This can help drain the pus more quickly. In some cases, however, the anti-inflammatory effect of the train ointment is too low. However, treatment with stronger active ingredients can only be prescribed by a doctor.

Nail bed infection: home remedies

Home remedies for nail bed inflammation are primarily natural substances such as chamomile, arnica or savoy cabbage. They have an anti-inflammatory effect. Also, substances containing onion extract, horseradish or tea tree oil are used to treat the nail bed infection. However, all of these home remedies only provide relief for mild inflammation and can not replace a medical treatment.

Medical Panaritium treatment

In the initial stage of the inflammation, the doctor also tries to treat the nail bed infection purely externally with antiseptic agents. If the inflammation over a very large area or severe pain, there is an additional antibiotic therapy. Here, mainly active ingredients from the class of penicillins are prescribed. These help particularly well against staphylococci, which are responsible in most cases for a Nagelbettentzündung.

If a nail bed infection does not resolve after several weeks, an X-ray is used to determine whether the inflammation has already spread to surrounding structures.

For large-area paronychia and stubborn pus buildup, surgical intervention must be considered. In this case, the pus or heavily affected tissue are removed. A surgical procedure for a nail bed inflammation takes place under local anesthesia. After surgery, the affected hand or foot is immobilized. Depending on the size of the surgical procedure, it may take one to several weeks for the wound to heal completely.

In case of chronic nail bed infection, which does not improve despite repeated therapy, the doctor will try to determine the triggering factors. If the common nail bed inflammation is based on a chronic disease, it must be treated primarily. In cases where frequent handling of harsh substances or cleansers causes nail bed infection, these risk factors must be eliminated.

Nail beditis: disease course and prognosis

The course of the disease and the prognosis of paronychia depend on the severity of the infection and the time at which an inflamed nail bed is detected and treated. If a nail bed infection is not treated, the inflammation may continue to spread (panaritium). It can also differentiate from the skin to the tendons that surround the finger joints and from there even reach over to the bones. Inflammation of the tendon sheaths or bones (osteomyelitis) is very painful and treatment usually takes a relatively long time.

If you have a nail bed infection treated, the inflammation usually heals completely within a few days. It is important to ensure that no irritants on the inflamed skin.

You can prevent a nail bed infection in the first place by maintaining the nails well. For dry and chapped skin around the nail bed, you should use greasy cream for creaming and also nourish the nails regemäßig. If the nails are heavily loaded, provide appropriate protection. In general, you should wear shoes in which the feet have enough space and sweat as little as possible. In addition, the Fußnagelkanten must not be cut around, which increases the probability of a ingrowing toenail. For people who often come into contact with harsh substances or strong cleaning agents, gloves are mandatory.

When taking care of the nail make sure not to injure the surrounding skin. People with very soft and brittle nails can use magnesium and folic acid tablets to strengthen their nails. So you can do one Nail bed inflammation mostly avoid.