When seen early, some types of infection can be teated with antibiotics and local rest and soaking. However, many infections begin to cause severe problems even after a day or two if not treated with antibiotics, surgical drainage and removal of infected tissues.
Paronychia
A paronychia is an infection of the cuticle area around the fingernail (see Figure 1). Acute paronychia is caused by bacteria and presents with redness, swelling, pain, and later with pus. Early cases may be treated with soaks and antibiotics, but if pus is seen or suspected, drainage by lifting the cuticle and/or nail, or lancing the area, is required also. Chronic paronychia is caused by fungus, and the cuticle area becomes just mildly red and swollen, with scant or no drainage and mild tenderness. It occurs in people whose hands are frequently wet, such as bartenders. It may be treated with special medication and reduction or elimination of the constant exposure to moisture, which promotes this fungal infection. On occasion surgery is needed to remove infected tissue. It is commonly mistaken for a bacterial infection. Prolonged treatment is common with chronic paronychia.