Lancing a paronychia toe nail infection - Nail Problems Message Board

Shakira · 11-20-2008, 09:48 AM

Has anyone had a paronychia toe nail infection lanced? I'm thinking of asking my doctor to do mine, as the antibiotics I took a few weeks ago did nothing. She said someting about draining the puss out once before, but didn't mention it last time. Would you recommend it?

Marti · 11-21-2008, 05:58 AM

Please follow the direction of your doctor. Antibiotics take a very long time to kill a paronychia infection - it can literally take months!

Marti · 11-21-2008, 06:04 AM

This is what I found:

Warm soaks can be used 3 or 4 times a day for acute paronychia to promote drainage and relieve some of the pain. Most cases of acute paronychia should be treated with antibiotics such as cephalexin or dicloxacillin. Topical antibiotics or anti-bacterial ointments do not effectively treat paronychia. If there is pus or an abscess involved, the infection may need to be incised and drained. Rarely, a portion of the nail may need to be removed.

Chronic paronychia is treated with topical antifungal medication such as ketoconazole cream. A mild topical steroid like hydrocortisone may be added to the antifungal medication to help reduce inflammation. Steroids should never be used alone on a chronic paronychia.

Shakira · 11-21-2008, 08:55 AM

Thanks Marti. I had the same problem with the big toe on my left foot for about 3 1/2 years. That sorted itself out after maybe one course of antibiotics say every 6 months (everytime it got infected with pus), but then in July this year, the big toe on my other foot started up. I'm trying for a baby now, so I've got to watch what I'm taking and can only take certain antibiotics. I really don't want to put off trying to conceive for another 4 years or so till this toe gets sorted. I don't have time for that, lol.

I soak my feet (seperately) in hot water and dead sea salt everyday and I've been applying hydrogen peroxide. Am I making it worse with the peroxide?

It's weird, because although it is swelled up everyday, some days it can be really painful and then the next couple of days it doesn't hurt at all etc.

The doctors keep saying there isn't really anything they can do about it, apart from antibiotics. I had clippings from both nails sent off and the results were that it wasn't a fungal infecton, so the doctor told me it was a bacterial infection.

Marti · 11-21-2008, 05:31 PM

It is usually cause by bacteria, but can also be a fungal skin infection. Keep it clean and dry. The peroxide will only help if the skin is broken - it cannot penetrate the skin. Just a suggestion - bacteria usually cannot grow in Thymol, so you might try applying small amounts daily; thymol is the active ingredient in Vicks Vaporub. Oral anti-biotics are your best bet and for the pain, try cold water soaks several times a day. If it is just starting and you are not pregnant yet, a round of oral anti-biotics shouldn't hurt, but check with your doctor first.