Under the Microscope: Paronychia
Paronychia is an infection that occurs when there is breakdown in the seal between the skin and the nail plate.
What is it?: There are two types of paronychia: acute and chronic. Both are caused when the seal between the nail fold and the nail plate is broken and infection gets in. Which bacteria enter the broken seal is one of the factors that determines if the condition is acute or chronic. Techs can tell the difference between chronic and acute paronychia because acute paronychia will be accompanied by pain and swelling within a couple of days of an injury and pus may be present at the site of the infection.
How do you get it?: Many outside factors can cause acute paronychia, including improper manicuring that breaks the seal between the skin fold and the nail plate. Clients can innocently break the seal themselves, and without understanding the problems that puncturing the seal can cause, they can let it go untreated for days as it worsens. Once the seal is broken, it’s easy for infection to get in from dirt, food, nail biting, etc. With chronic paronychia, the condition is the same in that a broken seal is still the culprit, but the agents that break the seal are different. For example, moisture from hands that are in the water too often can cause the seal to break. Cosmetics, harsh soap, or even frequent handling of raw foods could also damage the seal.
How is it treated?: In the case of trauma, the affected area can be treated with Polysporin and kept covered 24 hours a day. The nail should look normal after three or four days. If the paronychia doesn’t clear up in a couple of days, and certainly if a tech sees paronychia in two consecutive appointments, refer the client to a doctor. Paronychia may have to be tested for cultures. Yeast could be present in the infection, and the doctor may need to write a prescription to treat the yeast in addition to the area of infection. This may even involve an oral medication if the doctor feels that the yeast is a systemic problem.
What can a tech do?: If you suspect that you have broken the seal during a service, clean the area, but don’t apply new product to that nail. If the client is pain-free over the next few days, she can return before her next scheduled appointment so you can complete the service. The same caution should be taken if the client comes into the salon complaining of pain at her cuticle and reliving a story of how she hurt herself. If the client complains of pain, or if you see swelling, do not apply product to that nail. Instead, recommend she apply Polysporin to the infection and keep the area covered and dry. Suggest she see a doctor if the pain and swelling do not go away. If fever results, it is imperative she see her doctor.
What else?: Clients with paronychia should avoid all irritants and moisture, keeping the area dry and covered. In some cases, they should wear cotton gloves with waterproof gloves over them to avoid getting their hands wet during cleaning or washing dishes.
Dr. C. Ralph Daniel contributed to this article.
