Paronychia
An infection in the skin beside the nail Bacteria get through a break in the fold of skin that seals the edge of the nail. Your body walls them off and pus collects.
← All comparisons
Dermapedia / CompareConditions
Paronychia vs Ingrown Toenail
Paronychia is an infection of the skin fold beside a nail. The fold turns red, puffy and tender, often with a bead of pus, and it happens on fingers as well as toes. An ingrown toenail is a nail edge growing into the skin, on a toe, almost always the big toe. They overlap more than most pairs: an ingrown nail breaks the skin, and a break in the skin is exactly how paronychia starts.
At a glance
| The difference | Paronychia | Ingrown Toenail |
|---|---|---|
| What it is | An infection in the skin beside the nail | The nail corner grows into the skin |
| What it looks like | A swollen, shiny fold, often with pus | Red, puffy skin on one side |
| Does it hurt | Yes, and it throbs | Yes, and quickly |
| What it does over time | Builds over days, then needs draining | Worse until the pressure changes |
| Treatment | Release the pus, then treat the cause | Take the pressure off the edge |
Ingrown Toenail
Side by side
The differences that matter
What it is
Paronychia
An infection in the skin beside the nail
Bacteria get through a break in the fold of skin that seals the edge of the nail. Your body walls them off and pus collects.
Ingrown Toenail
The nail corner grows into the skin
The edge of the nail pushes into the soft skin fold beside it. The skin reacts like it would to a splinter. Nothing is infected at the start.
What it looks like
Paronychia
A swollen, shiny fold, often with pus
Redness that follows the curve of the nail fold. The skin looks tight and glossy. A yellow or white pocket often shows through, and the fold may lift away from the nail.
Ingrown Toenail
Red, puffy skin on one side
The nail itself looks normal. The skin next to it is swollen and shiny, sometimes with a small bead of fluid at the corner.
Does it hurt
Paronychia
Yes, and it throbs
Pain builds over a day or two and beats on its own, not only when touched. A large pocket of pus is tender to the lightest pressure.
Ingrown Toenail
Yes, and quickly
Throbs in a tight shoe, hurts when a bedsheet presses on it, and is tender to touch on that one side.
Where it shows up
Paronychia
Any finger or any toe
Most often a finger. Thumb and index finger are common, because they take the most nail biting, hangnail picking and manicure work.
Ingrown Toenail
One edge, usually the big toe
Almost always the outer or inner corner of the big toe. One side at a time.
What starts it
Paronychia
A break in the skin
Nail biting, picking a hangnail, aggressive cuticle trimming, a splinter, or hands that are wet all day.
Ingrown Toenail
Pressure from the nail itself
Cutting the nail too short or rounding the corners, narrow shoes, a knock to the toe, sweaty feet, or a naturally curved nail.
What it does over time
Paronychia
Builds over days, then needs draining
An acute infection worsens quickly and settles fast once the pus is released. The chronic finger version comes and goes for months and leaves a ridged, dull nail.
Ingrown Toenail
Worse until the pressure changes
Days to weeks. The skin can pile up over the nail edge and start to weep. It settles fast once the nail stops digging in.
Treatment
Paronychia
Release the pus, then treat the cause
Warm soaks help early. A collected pocket needs a clinician to numb the area and drain it, which relieves it immediately. Antibiotics are added when redness spreads. The chronic version needs the hands kept dry more than it needs antibiotics.
Ingrown Toenail
Take the pressure off the edge
Warm salt-water soaks, roomier shoes, and a clinician lifting or trimming the offending corner. A stubborn one is treated by numbing the toe and removing a narrow strip of nail edge.
How long until it settles
Paronychia
Days, once it is drained
The chronic hand version takes weeks to months, and the nail looks rough for longer.
Ingrown Toenail
Days to a few weeks
How to keep each one away
Paronychia
Paronychia comes back from what you do to your cuticles. Clip hangnails rather than tear them, and ask for cuticles to be pushed back, not cut. If your hands are wet all day, gloves are the treatment.
Ingrown Toenail
Ingrown nails come back from how the nail is cut. Cut straight across, no shorter than the tip of the toe. Rounding the corners leaves a spike of nail that the skin grows over. Roomy shoes matter as much as the trimming.
See a doctor if
Ingrown Toenail
- There is pus, or the fold is swelling by the day
- Redness is spreading up the finger or across the foot
- The nail is lifting away from the bed
- Lumpy pink tissue has grown over the nail edge
- The same toe goes ingrown again and again
- A finger infection is spreading into the fingertip pulp, which becomes tense and very painful
- You have diabetes, neuropathy or poor circulation, in which case do not treat either one at home
Common questions
Questions Patients Ask
How do I know if I have paronychia or an ingrown toenail?
Look at the nail edge. If the corner of the nail is buried in the skin, it is an ingrown toenail. If the nail edge sits where it should and the fold beside it is swollen with pus, it is paronychia.
Can an ingrown toenail cause paronychia?
Yes, and it often does. The nail edge cuts the skin fold, and that break lets bacteria in. When this happens you have both problems in the same toe, and the nail edge is the cause.
Can you get paronychia on a finger?
Yes. Fingers are the most common site. It usually follows nail biting, a torn hangnail, or cuticle trimming at a manicure. Fingernails do not go ingrown the way toenails do.
Will antibiotics fix an ingrown toenail?
Not on their own. Antibiotics treat the infection, not the nail edge. If the buried spike of nail stays where it is, the skin keeps getting injured and the infection comes back.
What is chronic paronychia?
A long-running swelling of the nail folds on the hands, driven by hands that are wet all day and by yeast rather than a single bacterial infection. It flares for months and leaves ridged nails. Keeping the hands dry matters more than antibiotic courses.
Can I drain it myself?
No. Squeezing or cutting into a nail fold pushes bacteria deeper and risks a much worse infection. A clinician can numb the area and release it properly in a few minutes.