From the Guidelines
To treat paronychia at home, it is recommended to start by soaking the affected finger or toe in warm water with Epsom salt or antibacterial soap for 15 minutes, 3-4 times daily, as this can help reduce bacteria and promote drainage of any infection. After soaking, gently dry the area and apply an over-the-counter antibiotic ointment like Neosporin or Polysporin, then cover with a clean bandage. Take ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) as needed for pain and inflammation, as suggested by general medical guidelines. Avoid manipulating or cutting the affected nail or cuticle, as this can exacerbate the infection. If pus has collected, a warm compress may help it drain naturally. Keep the area clean and dry between soakings, and avoid activities that may irritate the infection.
According to the most recent and highest quality study available, which is the ESMO clinical practice guidelines from 2021 1, the management of paronychia involves gentle skin care, avoidance of trauma, and the use of topical treatments such as povidone iodine and antibiotics. The guidelines also suggest that for grade 1 and 2 paronychia, topical treatments and monitoring are sufficient, while for more severe cases, oral antibiotics or even surgical intervention may be necessary.
Some key points to consider when treating paronychia at home include:
- Keeping the area clean and dry to prevent the spread of infection
- Avoiding activities that may irritate the infection, such as biting or cutting the nail
- Using topical treatments such as antibiotic ointments to reduce bacteria and promote healing
- Seeking medical attention if symptoms worsen or do not improve within 2-3 days, as this may indicate a more severe infection that requires prescription antibiotics or drainage of an abscess.
It's also important to note that people with diabetes, weakened immune systems, or severe infections should consult a healthcare provider promptly rather than relying solely on home treatment, as they may be at higher risk for complications. The treatment approach should prioritize reducing morbidity, mortality, and improving quality of life, and should be based on the most recent and highest quality evidence available, such as the ESMO clinical practice guidelines from 2021 1.
From the Research
Paronychia Treatment at Home
- Paronychia is inflammation of the fingers or toes in one or more of the three nail folds, and treatment can be done at home with warm soaks with or without Burow solution or 1% acetic acid 2.
- Topical antibiotics should be used with or without topical steroids when simple soaks do not relieve the inflammation 2.
- For chronic paronychia, treatment is aimed at stopping the source of irritation while treating the inflammation with topical steroids or calcineurin inhibitors 2.
Home Remedies
- Warm soaks can be used to relieve inflammation and pain 2.
- Burow solution or 1% acetic acid can be added to the warm soaks for better results 2.
- Topical antibiotics and steroids can be used to treat bacterial infections and reduce inflammation 2.
Prevention
- Patient education is paramount to reduce the recurrence of acute and chronic paronychia 2.
- General preventive measures can be useful in maintaining health, especially for people with occupational diseases 3.
- A new combination of topical medications, including an insulating polymer, antifungals, and anti-inflammatory molecules, can be effective in treating and preventing paronychia 3.
Important Considerations
- The presence of an abscess should be determined, which mandates drainage 2.
- Oral antibiotics are usually not needed if adequate drainage is achieved unless the patient is immunocompromised or a severe infection is present 2, 4.
- Systemic antibiotics should not be used systematically, and their use should be limited to cases where infection is proven 4.