What should I do if the area beside my fingernail is swollen and painful?

Redness, swelling, and pain around the fingernail may indicate paronychia—also known as a perionychial abscess or nail fold abscess. Bacterial infection is the most common cause, although fungal infections can also lead to paronychia. Typical symptoms include redness, swelling, warmth, and tenderness of the tissue surrounding the nail; in severe cases, pus formation may occur. So, what should you do if your fingernail area is swollen and painful? Below, we address this question.

What to Do for Swelling and Pain Beside the Fingernail

1. Pharmacological Treatment

If the condition results from bacterial or fungal infection, antimicrobial therapy is required. Topical anti-inflammatory agents may be applied to alleviate inflammation. Alternatively, chlorhexidine or chlorhexidine acetate solution may be used for irrigation or soaking, combined with topical antibiotics such as mupirocin, fusidic acid, or polymyxin B.

2. Incision and Drainage

If significant fluid or purulent accumulation, elevated local skin temperature, marked swelling, and pain are present around the fingernail, surgical intervention under local anesthesia is indicated—namely, partial or complete nail avulsion followed by incision and drainage of the abscess. Postoperatively, iodophor-impregnated gauze dressings are applied locally, and intravenous administration of anti-inflammatory antibiotics—such as cefamandole or cefmetazole—is initiated for 5–7 days to reinforce antimicrobial therapy until local inflammation gradually subsides.

3. Nail Avulsion

If topical medications alone prove ineffective, partial or complete nail avulsion may be considered. Partial nail avulsion involves excising only the portion of the nail that has penetrated the skin, often combined with a “string-tension” technique to restrict nail regrowth and prevent recurrence. Complete nail avulsion generally provides definitive cure, effectively eliminating recurrent redness and pain.

The above outlines management strategies for swelling and pain adjacent to the fingernail. We hope this information proves helpful.