Hangnail Infection: Signs, Symptoms and Causes

A nail infection is a type of skin infection (paronychia) that happens when a hangnail—flaps of pulled or damaged skin at the base of the nail—becomes infected. This infection occurs when certain bacteria, viruses, or fungi enter the skin tissue of a hangnail.

Common signs of a hangnail infection are pain and swelling around the nail or nail. Using artificial nails or having diabetes can increase your chances of developing the condition.

Nail infections are common and typically acute (temporary), but can be chronic (long-term) depending on the cause and severity. Treatments can vary, with medications and medical procedures used for complex and advanced cases. There are several ways to treat an infected hangnail and manage its symptoms.

A hangnail infection can be classified as acute or chronic.

Acute nail infection

Acute (short-term) hangnail infections are the most common, and bacteria are usually the cause. Bacterial hangnail infections usually develop quickly and affect only one finger or toe at a time. Symptoms include pain, swelling, redness, pus, and skin that is warm to the touch. Symptoms usually disappear within a few days, but the infection can take up to six weeks to heal completely.

Biting nails, artificial nails or wounds usually cause acute nail infections. Children are particularly prone to acute nail infections due to sucking their fingers and biting their nails.

Chronic nail infection

Chronic (long-term) infections lasting more than six weeks tend to occur from viruses and fungi. Chemical irritation of the skin, known as irritant dermatitis, can also lead to chronic hangnail infection.

A chronic hangnail infection usually affects more than one finger or toe at a time, takes longer to develop symptoms and lasts longer. Symptoms of a chronic hangnail infection may include boggy (spongy or soft) tissue around the nail, thicker nails, or nail discoloration.

Candidaa type of yeast, sometimes causes chronic hangnail infections. Candidait lives naturally on the skin and only causes infection if it grows out of control.

You may be more likely to develop a chronic hangnail infection if you:

• Work in jobs where the hands are exposed to chemicals or immersed in water for long periods, including as dishwashers, bartenders, laundresses, housekeepers, florists and bakers.
• Take certain medications, especially those that suppress immune function
• Have conditions that affect immunity, including the human immunodeficiency virus (HIV/AIDS), cancer, or diabetes

How quickly the symptoms of hangnail infection develop depends on the cause. Bacterial infections progress faster, usually within hours or days, while fungal infections have a slower onset. It is possible to have a bacterial and fungal infection simultaneously.

The symptoms can be broadly divided into those that affect the finger around the nail, the nail itself and the rest of the body.

Symptoms around the nail

The main symptoms of a nail infection affect the nail fold – the area where the nail meets the skin at the sides (lateral nail folds) and the base (proximal nail folds) . Typical signs include:

• Pain, swelling and tenderness in the affected area
• Skin that is red and warm to the touch (erythema)
• An abscess, which is an accumulation of pus (creamy, white or yellow fluid) under the skin

Nail symptoms

In more severe cases, a hangnail infection can change the appearance of the toe or nail, including:

• Beau lines, which are deep grooves or ridges in the nail
• Discoloration of the nail, causing it to turn yellow or green
• Dry and brittle nails
• The separation of the nail from the nail bed, which can cause the nail to fall

Symptoms throughout the body

Rarely, hangnail infections spread to other parts of the body. These are known as systemic symptoms. You can experience:

• Fever and chills
• Red stripes on the skin
• Fatigue is a general feeling of malaise
• Joint pain and swelling
• Muscle pain

A hangnail infection occurs when bacteria, fungi, or other pathogens enter through the skin tissues surrounding the nail in the fingers or toes. This happens when the pathogens cross the breaks or ruptures in the barrier between the nail and nail fold, or cuticle, caused by the hangnail.

Staphylococcus aureusa skin bacterium, is the most common cause of acute hangnail infections. Other bacteria, such as Streptococcus(found in the nose and throat) and Pseudomonas (found in soil and soil), are usually present in chronic cases. Infection with yeasts, some fungi and the herpes simplex virus (HSV) can also cause hangnail infections.

Risk factors

Certain health factors, conditions and habits increase your risk of developing hangnail infections. These include:

• Hit your fingernail or toenail, resulting in trauma
• Nail biting
• Get manicures and pedicures that are done too aggressively
• Use artificial nails
• Sucks fingers or thumbs
• Have ingrown toenails
• Living with chronic diseases that impact immunity, such as HIV/AIDS or diabetes
• Work where your skin is exposed to chemicals, such as cleaning the house or washing dishes
• Swim often in chemically treated water

When diagnosing hangnail infections, healthcare providers work to rule out other potential causes of symptoms. Conditions that can present similarly to a hangnail infection include eczema, psoriasis, herpes, and dermatomyositis (an autoimmune skin disorder).

Along with an evaluation of your medical history, health professionals rely on several evaluations in the diagnosis:

• Physical Assessments:Health care providers can primarily diagnose hangnail infection by evaluating the affected areas and looking for the characteristic features of the infection.
• Imaging:The healthcare provider may use ultrasound imaging in rare cases to screen for an abscess (pocket of fluid) or deeper infection.
• Clinical tests:If there is fluid or pus, the provider can collect a sample and send it to the lab to screen for specific yeasts, fungi, or bacteria.

Most hangnail infections resolve on their own with home management techniques for discomfort. More severe cases call for antibiotics or medical treatment.

House management

Treatment of a hangnail or hangnail infection at home should be the first step before seeking additional care. Health professionals recommend the following techniquesto manage any discomfort and promote healing:

• Hot water soaks:Soaking the affected fingers in warm water and antibacterial soap helps promote blood flow and drain any pus. Do this for 10-15 minutes at a time for four times a day.
• Nail trimming:After wrapping an affected finger, use a cuticle clipper – a tool designed to cut off excess skin – to cut the hangnail. Be sure to disinfect the clipper in alcohol before use.
• Thematic treatments:Health care providers may recommend over-the-counter (OTC) steroid creams to manage inflammation. Antifungal agents are recommended if fungi are causing symptoms. Avoid drugstore triple antibiotic ointments that contain neomycin, such as Neosporin, because of possible allergic reactions.

Prescription Medications

You should seek medical help if your symptoms persist or worsen despite home management techniques.

Health care providers can prescribe topical antibiotics (applied to the skin), such as Bactroban (mupirocin) or Cipro (ciprofloxacin). In rare and severe cases, they may prescribe oral antibiotics (taken by mouth), such as Dycill (dicloxacillin), to fight the infection and prevent it from spreading.

If the infection is fungal, prescription antifungal medications can help.

Medical procedures

Health care providers may need to drain the fluid if there is an abscess. After cleaning and numbing the affected area, they used a scalpel to create a small cut, allowing the pus to escape. Then disinfect and bandage the area.

You should follow up with your doctor in 24-48 hours to make sure that the abscess drains well and the infection does not worsen.

There is a lot you can do to prevent hangnails and associated infections, including:

• Keep your hands clean, wash with gentle soaps to avoid damaging the skin
• Avoid nail biting or tearing or picking at any nails
• Moisturize your fingers, especially if you have dry skin
• Wear latex or protective gloves with a cotton lining to keep your hands dry when washing dishes, cleaning or working with chemicals.
• Bring your tools to manicure or nail salon appointments, and don’t let the manicurist cut your cuticles during your appointment.
• Trim your nails once a week and use an emery board (a type of nail file) to make sure the edges of your nails are slightly rounded.
• Trim your nails once a month, keeping the edges straight
• Avoid cutting cuticles or using cuticle removers

If a hangnail infection is severe and not treated, the condition can lead to more serious complications, including:

• Hand infection:Severe hangnail infections can spread to the surrounding tissues and tendons in the hand. Treatment may require surgery to remove the damaged tissue or even amputation.
• Sepsis:This is a severe bacterial infection that spreads to the blood. It is a rare complication that often arises in those with a compromised immune system.
• nail dystrophy (onychodystrophy):This is a chronic hangnail infection that damages the fingernails or toenails. It can lead to brittle and uneven nails if left untreated.
• green nail syndrome (chromonychia):This is an infection with a certain type of bacteria that can spread to cause fingers or nails to develop a green color. The surrounding tissues sometimes swell or become sore.

A hangnail infection occurs when bacteria or fungi spread to the tissues in the finger or toe near the nail. Tenderness, pain, discoloration and swelling of the affected area are common signs.

Nail infections tend to resolve on their own when managed at home. Home treatments include soaking the affected fingers in warm water and trimming the hangnail. Medications and medical procedures are reserved for the most severe cases.

Keep your nails clean, cut regularly, moisturize the skin, and wear protective gloves to help prevent a hangnail infection.