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Paronychia Guide: Causes, Symptoms and Treatment Options

Medically reviewed by Last updated on May 13, 2019.

What Is It?

Harvard Health Publications

A paronychia is an infection of the skin that surrounds a toenail or fingernail. There are two different types of paronychia, acute and chronic:


  • Acute paronychia — This usually appears as a sudden, very painful area of swelling, warmth and redness around a fingernail or toenail, usually after an injury to the area. An acute paronychia typically is caused by an infection with bacteria that invade the skin where it was injured. The injury can be caused by overaggressive manicuring (especially cutting or tearing the cuticle, which is the rim of paper-thin skin that outlines the outer margins of your nail). It can also result from biting the edges of the nails or the skin around the nails, picking at the skin near the nails or sucking on the fingers.

  • Chronic paronychia — This is an infection that usually develops slowly, causing gradual swelling, tenderness and redness of the skin around the nails. It usually is caused by Candida or other species of yeast (fungus). It often affects several fingers on the same hand. People who are more likely to get this infection include those with diabetes or workers whose jobs constantly expose their hands to water or chemical solvents. Such jobs include bartending, house cleaning, janitorial work, dentistry, nursing, food service, dishwashing and hairdressing.


An acute paronychia causes throbbing pain, redness, warmth and swelling in the skin around a nail. In some cases, a small collection of pus forms under the skin next to the nail, or underneath the nail itself. Often, only one nail is affected.

A chronic paronychia usually causes less dramatic symptoms than an acute paronychia. Typically, the area around the nail is tender, red and mildly swollen; the cuticle is missing; and the skin around the nail feels moist or "boggy." Several nails on the same hand may be affected at the same time.


If you have a mild acute paronychia, you usually can make the diagnosis yourself. Look for throbbing pain, swelling and redness in an area of damaged skin around a nail.

If you are diabetic, have several affected fingers or toes, or have severe symptoms (pus, fever, severe pain), you must be evaluated by a doctor. In most cases, your doctor can make the diagnosis by examining the affected area. However, if there is an accumulation of pus, the doctor may take a sample of the pus to be tested in the laboratory for bacteria or fungi.

Expected Duration

How long a paronychia lasts depends on the type of paronychia. With proper treatment, an acute paronychia usually heals within 5 to 10 days. A chronic paronychia may require several weeks of antifungal medication. Even after proper medical therapy, a paronychia may return if you injure the skin again or forget to keep the nail area dry.


To prevent paronychia, try the following:

  • Keep your hands and feet dry and clean.

  • Wear rubber gloves with an absorbent cotton lining if your hands are exposed routinely to water or harsh chemicals.

  • Be gentle when you manicure your nails. Avoid cutting your cuticles or pushing them back.

  • Avoid biting your nails and picking at the skin around your nails.

  • If you have diabetes, keep your blood sugar levels within a normal range by following your diet and taking your medications.


The type of treatment depends on the type of paronychia:

  • Acute paronychia — You can begin treating yourself by soaking the finger or toe in warm water. Do this for at least 15 minutes, two to four times a day. If your symptoms do not improve with this treatment, or if pus develops near the nail, call your doctor. If you have a moderate or severe paronychia, your doctor may treat it with an oral antibiotic. You also will be told to elevate the injured finger or toe, and to soak the infected area in warm water two to four times a day. If pus has accumulated near the nail, the doctor will numb the area and drain the pus. If necessary, a small part of your nail will be removed to make sure that the area drains completely.

  • Chronic paronychia — Since most cases of chronic paronychia are caused by fungi, your doctor will treat the infection with antifungal medication that is applied to the skin, such as clotrimazole (Lotrimin, Mycelex) or ketoconazole (Nizoral). You may have to apply the medicine every day for several weeks. You also will be reminded to keep the skin clean and dry. Rarely, in severe cases, you will need to take antifungal drugs or steroids by mouth.

When To Call A Professional

Call your doctor if you have symptoms of a paronychia and:

  • You have diabetes

  • You have an accumulation of pus near your nail or under it

  • You have a fever

  • The area of redness near your nail begins to spread up your finger

  • You have milder symptoms (tenderness, mild redness, minimal swelling) that last for seven days or more


With proper treatment, the outlook is usually very good. In most cases, an acute paronychia heals within 5 to 10 days with no permanent damage to the nail. Rarely, very severe cases may progress to osteomyelitis (a bone infection) of the finger or toe.

Although a chronic paronychia may take several weeks to heal, the skin and nail usually will return to normal eventually. However, you must remember to apply medication as directed, and to keep the affected area dry.

Learn more about Paronychia

Associated drugs

IBM Watson Micromedex

External resources

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Information Clearinghouse
1 AMS Circle
Bethesda, MD 20892-3675
Phone: (301) 495-4484
Toll-Free: (877) 226-4267
Fax: (301) 718-6366
TTY: (301) 565-2966

American Academy of Dermatology
930 E. Woodfield Rd.
Schaumburg, IL 60173-4927
Phone: (847) 330-0230
Toll-Free: (888) 462-3376
Fax: (847) 330-0050

American College of Foot and Ankle Surgeons
515 Busse Highway
Park Ridge, IL 60068
Phone: (847) 292-2237
Toll-Free: (800) 421-2237

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Ingrown toenails / fingernails - symptoms and causes
Ingrown toenails symptom causes

In most cases ingrown toenails are happening only to your toes but also there are some cases in which fingernails can be also ingrown. They occur less frequently in fingers because you are not squeezing your fingers into shoes that do not fit well. Also the shape of our fingernails makes them less likely that they will become ingrown. But ingrown fingernails can happen and they can become infected. This can make your everyday tasks painful such as when you wash dishes or when you type on a keyboard.

The most common symptoms of ingrown toenails are

  • Bulge beneath the skin
  • Pus around the skin
  • Discoloration
  • Swelling
  • Redness
  • Sensitive skin

ingrown toenails / fingernails

Causes: Long nails, sharp nail edges, nail deformity, curved nail shapes, nail biting and poor nail maintenance are the most common causes of ingrown fingernails. Also in many cases the incorrect trimming and cutting of nails lead to ingrown nails.

Ingrown toenails: An ingrown toenail is a toenail which has grown into your skin instead of over it. This is a common condition in which the side or corner of a toenail grows into the soft flesh. The result is a swelling, redness, pain and in some cases an infection. In the most cases the big toe is affected by ingrown nails. In many cases you can take care of your ingrown toenails on your own. If the pain is spreading or severe, then you should ask your doctor about the best treatment which can give you a relief from the discomfort and also it will help you to avoid complications of ingrown toenails. If you suffer from diabetes or another condition which causes poor blood to your feet, then you have increased risk of complications of ingrown toenails.

The most common symptoms of ingrown toenails are:

  • Infection of the tissue around your toenail
  • Swelling of your toe around the nail
  • Redness around your toenail
  • White or yellow pus coming from the affected area
  • Pain and tenderness in your toe along one or both sides of the nail
  • A build-up of fluid in the area surrounding the toe
  • Inflammation of the skin at the end of the toe
  • Bleeding
  • An overgrowth of skin around the affected toe

If you experience severe discomfort in your toe or if you have a pus or redness that seems to be spreading, then you need to talk with your doctor. Also if you suffer from diabetes or another condition which causes poor blood flow to your feet and you experience any foot infection or sore, then you need to ask for medical help. Your doctor will make a physical exam to diagnose an ingrown toenail. Your doctor will look at your toe where the nail has grown into your skin. You should always trim your toenails straight across. You should not curve your nails to match the shape of the front of your toe.

Causes of ingrown toenail

The big toe is often affected, either on one or both sides. There are many different causes which can lead to ingrown toenail. Rounding the edge of your nail or cutting your toenail too short can cause it to grow into your skin. When you wear socks or shoes which do not fit well, they can also lead to ingrown toenails. If your shoes are too tight, then they can press your nail into your toe and this can cause it to grow into your skin. Also when you hurt your toe, such as stubbing your toe, then you can also get an ingrown toenail. This can lead to your nail to grow inward. Also when you repeat some activities such as kicking a soccer ball, then this can also lead to ingrown nail.

  • Genetic predisposition
  • Improper foot hygiene, such as not keeping your feet clean or dry
  • Poor posture
  • Toenail injury, including stubbing your toe, dropping something heavy on your foot or kicking a ball
  • Footwear that places a lot of pressure on the big toes, such as socks and stockings that are too tight or shoes that are too tight, narrow or flat for your feet
  • Irregular, curved toenails
  • Cutting toenails incorrectly (cut straight across, since aging the sides of the nail can encourage the nail to grow into the skin)

Above are the most common causes for ingrown toenails.

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