Protect your skin during these winter months

Posted 1/29/18

During the winter months, patients come to me with skin issues on their hands such as dryness, fissures, eczema, and often acute paronychia. Para-what, you say? Let me explain.

The skin on …

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Protect your skin during these winter months

Posted

During the winter months, patients come to me with skin issues on their hands such as dryness, fissures, eczema, and often acute paronychia. Para-what, you say? Let me explain.

The skin on the sides of your fingernails and toenails is called your paronychium (your cuticle is at the base of your nail). Paronychia is an infection of the paronychium that usually starts with redness and swelling but can evolve to abscess formation.

According to the American Academy of Family Physicians, paronychia is one of the most commoninfections of the hand. Aggressive manicuring, dry skin, splinters, hangnail removal, and picking are all common ways to cause a break in the skin and create a port of entry for bacteria.

Finger sucking and nail biting can also contribute to developing paronychia. As the skin breaks down, mouth bacteria can create an infection. When the skin is exposed to moisture for extended periods of time, the skin weakens, and a moist environment is the perfect breeding ground for bacteria and fungus.

Folks whose daily activities require repetitive exposure to water or irritants (caregivers, bartenders, housekeepers, hairdressers, dishwashers, etc.) are at especially high risk for paronychia.

This time of year, spending a day on the slopes in wet gloves or boots can increase your risk! So keep your hands and feet as dry as possible.

Even with all of these known causes and profiles, paronychia is stubborn and annoying. In some cases, this has been known to occur with no apparent cause at all.

If you are experiencing red, tender, swollen, and generally painful skin around the nail that sometimes drains pus, you may have paronychia.

Oftentimes paronychia will resolve after a few weeks of applying Aquafor, sometimes hydrocortisone, and covering with a band-aid. Warm Burow’s solution or white vinegar solution soaks are also valuable treatment tools.

When symptoms persist, adding an antibacterial and/or anti fungal solution or ointment three times daily can be quite helpful.

It is important to note, if the skin around the nails are discharging pus, you need to see a health care provider to have your finger or toe cultured. This involves a quick swipe of the site with a Q-tip-like swab that is sent to the lab for testing. Once the organism causing the problem is identified, it can usually be treated with antibiotics pills.

What happens if your paronychia persists? This likely means your paronychia is being caused by something other than bacteria. You will need to see a dermatologist or hand surgeon to evaluate your condition, possibly drain a formed abscess or, perhaps, biopsy or x-ray the site to make sure there is nothing else going on (malignancy).

Avoiding the potential causes listed above is advisable. Pinpointing what caused your paronychia is important in preventing recurrence.

As with anything, if you ever have questions regarding your skin, just give me a call.

Meighan Dingle Blanco, FNP-BC is a nurse practitioner with South County Dermatology.

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