nail infection

Nail infections can affect your toenails and fingernails and lead to discomfort, potential complications and infection if not treated. There are three different types:

Bacterial: Also known as paronychia, this form of nail infection is caused by bacteria, a type of yeast called Candida or a combination of both bacteria and yeast. The infection usually starts when you bite your nails and may either appear slowly and last for weeks or suddenly show up and last for just a day or two.¹

Fungal: The fungal infection that impacts your nails is called onychomycosis (tinea unguium). While fungi can be present in and on the body alongside various bacteria, you only get an infection when they begin to overgrow. This infection develops slowly and any difference in how your nail looks or feels may be too subtle to notice at first.²

Viral: These infections are caused by a virus being spread to the nail or a reaction to another viral infection such as periungual warts or herpetic whitlow, which is caused by an infection of the herpes simplex virus (HSV). Other viral infections of the nails may lead to symptoms such as Beau’s lines or onychomadesis.³

If you believe that you have a nail infection, see your provider to begin a care plan.

For your convenience, we accept most major insurance. To verify that your insurance is in-network, visit the Plan Your Visit page. We also offer a discount to those patients who choose to pay in full for their visit at the time of service. Self-pay services are $199.

What are the Symptoms of a Nail Infection?

What are the different types of nail infections and how do they differ in terms of treatment and symptoms? Let’s start with the three basic types and how they impact your nails:

Bacterial:¹

• Changes in nail color, shape or texture
• Detached nail
• Pus-filled blisters
• Red and tender skin around the nail

Fungal:²

• A nail that is lifted away from the nail bed
• An odor from the nail
• A thick or brittle nail

Viral:^4,5

• Blisters or warts near the nail
• Disfigured nails and cuticles
• Interrupted nail growth
• Pain and tenderness
• Split skin near the nail bed

What Causes a Nail Infection?

What are the common causes of nail infections? The answers vary depending on what type of infection you have:

Bacterial:¹

• Acute Paronychia: Some form of trauma, such as biting or picking your nails, introduces the bacteria to the area around your nails.
• Chronic Paronychia: Candida yeast and/or bacteria infects the area around your nails. Often, this happens when your hands or feet are often in water or moist environments.

Fungal:²

• Dermatophytes: Similar to ringworm , jock itch and athlete’s foot , this form of fungal infection most often comes from being in contact with warm, moist environments.
• Yeast: This type of infection most often affects those with weakened immune systems.
• Non-dermatophyte molds: While rare, these often impact those with underlying health conditions or previous nail trauma.
• If you encounter someone else who has a fungal infection, you may also get one.
• Toenail fungal infections are the most common, as your toes spend most of their time inside the warm, moist environment of your shoes.

Viral:^4,5

• Herpetic whitlow: You can be impacted by this infection if you already have HSV or your finger comes in contact with type 1 or type 2 HSV. This often happens when an open sore or cut on your finger comes into contact with blisters or sores on your or someone else’s face or genitals.
• Periungual warts: This infection is caused by HPV 1, 2, 4, 5, 7, 27 and 57. If you bite your nails, you are at risk as it enters your body through small cuts around your nails. Those who frequently have their hands in water, such as dishwashers, are at a higher risk of viral nail infections.

Is a Nail Infection Contagious?

Yes. Infections can be spread in the following ways:

• Manicure tools, like nail clippers and emery boards, can spread fungal infections if they’re not properly sanitized.²
• Viral nail infections can be transmitted by sharing towels, gloves, toys and personal items used by an infected person.⁴
• Viruses may remain on wet surfaces, such as showers and pools. While rare, this may spread the infection if touched.⁴

How Do You Diagnose a Nail Infection?

In some cases, your provider may be able to diagnose a nail infection with a visual or visual examination.

They may also want to send a scraping of your nail and examine it under a microscope or send a sample of any bacterial culture or pus out for a lab test.

How Do You Treat a Nail Infection?

Depending on what type of infection you have, your provider will determine a care plan to treat you:

Bacterial:¹

• Often, soaking the infected nail in warm water several times a day and drying it thoroughly will cause the area to drain and heal.
• Your provider may prescribe an antibiotic if you have a more severe infection or if your infection doesn’t respond to other treatment.
• If you have blisters or abscesses near your nail bed, your provider may want to drain them to speed healing and decrease your risk of spreading the infection to others.
• If you have a chronic case of paronychia, your provider may prescribe antifungal medication and in extreme cases, recommend surgery to remove part of your nail.

Fungal:²

• Instead of an over-the-counter solution which generally does not work, your provider will prescribe an oral antifungal medication such as terbinafine, itraconazole, fluconazole or griseofulvin.
• Fungal infections may last for some time and complications often occur.

Viral:^4,5

• Herpetic whitlow: This infection usually heals on its own within a few weeks. However, your provider may prescribe an antiviral drug to shorten the duration of the outbreak as long as you are within 24 hours of developing symptoms.
• Periungual warts: These warts are difficult to treat and may spread even after treatment. Much like traditional warts , they can be treated with salicylic acid, cryotherapy, antigen injections or with laser surgery.

How Can You Manage Symptoms of a Nail Infection?

Depending on the type of nail infection that you have, your provider will give you a care plan to get you on the path to feeling better. Here are some ways to manage the symptoms:

• Remember to take all of your medication and follow all of your provider’s instructions.
• Soaking the nail in a warm water soak may speed healing.
• Take acetaminophen or ibuprofen for pain.
• Use a cold compress to reduce swelling.
• Your provider may also recommend painting your nails with prescription antifungal nail lacquer or a topical solution.

How Do You Prevent a Nail Infection?

• Don’t bite your nails or pick the skin around them.
• Don’t go barefoot in public places, gym showers, locker rooms and pools.
• Get a regular manicure or pedicure from a trustworthy salon.
• If your hands will be damp or wet for an extended period, wear rubber gloves.
• Make sure that your feet are dry after showering, bathing or swimming. Remember to dry between your toes!
• Reduce your use of nail polish and artificial nails.
• Speak to your provider about a healthy diet or a supplement that encourages nail growth.
• Thoroughly wash your hands frequently with soap and warm water. If you don’t have access to soap and water, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Don’t forget to properly dry them!
• To prevent future nail infections, you should start by keeping your nails clean and well-trimmed.
• Use antifungal powder or spray in your shoes.
• Wear breathable shoes and moisture-wicking socks.

Why is it Important to Treat a Nail Infection?

What are the potential complications of untreated nail infections?²

• Chance of spreading the infection to other people
• Developing the bacterial skin infection known as cellulitis
• Discoloration of the infected nail
• Permanent damage or loss of the affected nail
• Reinfection
• Spread of infection to other areas of the body and potentially your bloodstream

While a nail infection may not seem like a big deal, it may lead to further complications and even painful nail conditions. There’s also the chance that your nail infection is a warning of another health condition. Put your mind at ease and get treatment today at MedExpress. It’s so convenient – simply schedule a visit on our website or walk in any time from 8 a.m. to 8 p.m. seven days a week.

References:

1 Healthline. Paronychia. Last updated June 20, 2023. Accessed May 30, 2024.

2 Healthline. Fungal Nail Infection. Last updated May 8, 2023. Accessed May 30, 2024.

3 Disorders of the Hair and Nail. Chapter 10: Viral Infections of the Nail. Marcel C. Pasch; Matilde Iorizzo; Bianca Maria Piraccini. Accessed May 30, 2024.

4 Healthline. Everything You Should Know About Periungual Warts. Last updated May 19, 2023. Accessed May 30, 2024.

5 Healthline. What You Need to Know About Herpetic Whitlow. Last updated April 24, 2023. Accessed May 30, 2024.