How to Spot and Care for an Infected Hangnail

An infected hangnail is a form of paronychia, a condition in which the skin next to the nail is infected. If you have a small piece of torn skin hanging loose next to your nail, you likely have a hangnail.

While an infected hangnail is common and can become painful, you can often take care of it with home remedies. You also can prevent hangnails with good nail hygiene and reduce how often you get them. Never pull or at or bite off a hangnail. This may cause the skin to rip and become infected.

What Is a Hangnail?

Although hangnail has the word “nail” in it, a hangnail is specifically a skin condition where small portions of skin get a tear near the cuticle (the layer of clear skin at the base of the nail). Hangnails commonly appear on fingernails but are rarely seen on toenails.

Causes

Hangnails are commonly caused by conditions and substances that cause the skin to become irritated and dry. These include:

• Dry air (more frequently during the winter months when the air is cold and dry)
• Using alcohol-based hand sanitizers
• Frequent hand washing
• Picking at or biting around the nails
• Swimming in chlorinated pools

Signs and Symptoms of an Infected Hangnail

You should be able to notice the symptoms of a hangnail soon after it becomes infected. Infection occurs when bacteria or fungus get under the skin. Bacterial infections can produce symptoms almost immediately, while fungal infections may take longer to appear.

What Is Paronychia?

Paronychia is one of the most common infections of the hand. It's an infection between the nail and the skin, which affects the lateral nail fold and perionychium (the tissue surrounding the nail). It can occur in adults and children, but typically it is not serious.

There are two kinds of paronychia:

• Acute paronychia: Comes on suddenly and may not last long, usually occurs on fingers
• Chronic paronychia: Lasts longer and may occur on your fingers or toes, either doesn’t get better or keeps coming back

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Typical Symptoms

If you have an infected hangnail, common symptoms include:

• Redness
• Swelling
• Tenderness
• Throbbing pain
• A warm feeling
• A pus-filled blister in the infected area
  

How Do You Treat a Hangnail Infection?

If you have an infected hangnail, do not attempt to bite, rip, or pull it off. If you do, you may pull off additional skin that will open more inner skin layers to bacteria. This can also aggravate the hangnail area and cause it to become red and slightly inflamed.

Instead, use the following effective ways to prevent infection and irritation from hangnails.

Soak in Warm Water

Soak the nail in warm water and antibacterial soap for 15 minutes up to four times a day. This cleanses the area and increases blood flow. Warm water can also soothe any discomfort in the infected area.

Trim the Hangnail With Cuticle Clippers

Sterilize cuticle clippers or small scissors with rubbing alcohol. After the hangnail is soft from soaking in water, trim the edges with cuticle clippers to prevent further irritation and infection.

Use Topical Antifungal or Antibiotic Creams

Apply small amounts of antibiotic cream, such as Neosporin, on the infected hangnail. Your healthcare provider may also recommend topical steroids. If your infection has been diagnosed as being fungal, your healthcare provider may recommend an antifungal cream.

RICE Method

The acronym RICE stands for rest, ice, compression, and elevation. This can be an effective way to relieve a hangnail. Apply the following strategies to reduce pain and swelling from hangnails:

• Rest: Avoid tasks that cause you to use the finger.
• Ice: Apply a cold pack or ice wrapped in a cloth on your swollen finger to soothe the area and reduce inflammation.
• Compression: Apply a bit of pressure to your swollen finger by wrapping a bandage around it.
• Elevation: Lift your swollen finger higher than your heart to avoid any further swelling by improving blood flow and draining excess fluid more effectively.

Moisturize

After your infection has healed, use moisturizers to keep your skin well hydrated. This might help prevent more hangnails from developing.

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When to See a Healthcare Provider

Most infected hangnails will heal on their own with the appropriate treatment, which can be applied at home. However, talk to a doctor if your hangnail does not heal after about a week of treatment.

If the hangnail develops an abscess (a walled-off area of infection) or pus (thick fluid produced as a body's response to infection), it may need to be drained.

To drain an infected hangnail, your healthcare provider may:

• Numb the area with a local anesthetic
• Lift the nail fold with an instrument or make a small surgical incision to allow the pus to drain away
• Wash the area thoroughly
• Prescribe an oral antibiotic (rarely) to fight the infection if there is extensive redness around the abscess

Preventing Hangnails and Infection

Hangnails are easy to prevent. To keep your skin healthy and hydrated, implement the following steps into your skincare routine:

• Wear gloves when washing dishes.
• Don't cut your cuticles.
• Moisturize your hands daily.

How to Get Rid of Non-Infected Hangnails

You can easily remove or care for non-infected hangnails to help them heal and prevent an infection:

1. Wash and sanitize the area. Start by cleaning your hangnail with soap and warm water for at least five minutes. This will remove dirt, debris, and bacteria, which reduces the risk of infection.
   
2. Soften the skin. After drying your hands, use petroleum jelly or a good-quality moisturizer on your hands. Focus on the hangnail area to soften the skin.
   
3. Carefully trim the hangnail. Use a pair of sterile nail or cuticle clippers to gently trim the hangnail. As the area underneath the hangnail contains nerves and tiny blood vessels, be sure not to press too deep. Otherwise, you can cause bleeding. If bleeding does occur, apply pressure to the area until it stops.
4. Moisturize. To keep your skin hydrated, apply another layer of petroleum jelly or a good-quality moisturizer to the affected area. You can also use an antibiotic cream to help protect the hangnail area from infection.

Complications From Untreated Hangnail Infections

Hangnails that are left untreated may become dystrophic (discolored or distorted) over time. In rare cases, it may also cause a systemic infection that spreads to other parts of the body.

Chronic Paronychia

Untreated hangnails may lead to chronic paronychia, which is an inflammatory disorder of the nail skin fold. This is characterized as an infection that lasts longer than six weeks.

It typically occurs in people who have eczema (an inflammatory skin condition) and those whose occupation exposes their hands to harsh chemicals or constant moisture (for instance, housekeepers, dishwashers, bartenders).

Green Nail Syndrome

Green nail syndrome (GNS) is an infection by a species of bacteria (Pseudomonas aeruginosa) that produces a greenish pigment. This leads to a greenish discoloration of the nails known as chloronychia. GNS is not painful, but the skin around the nail, including the cuticle, may be swollen, tender, or red.

This syndrome is most common in people whose hands or feet are constantly wet (such as in sweaty footwear or waterproof dishwashing or medical gloves) or who have nails lifted from the nailbed (such as may happen to gardeners, janitors, or plumbers).

Fungal Infections

A hangnail can become infected if exposed to bacteria or fungus. If your hangnail is caused by a fungal infection, your symptoms may be more gradual than a bacterial infection. Fungal infections appear more frequently in people who have diabetes or spend a large amount of time with their hands exposed to water.

Infection That Spreads

Although rare, infected hangnails may spread to areas of the body if left untreated, which can cause complications. To prevent this from occurring, see your healthcare provider if your hangnail develops an abscess or pus that does not go away.

Coping With Hangnails

While hangnails are common, they are easily to manage. If you wash your hands frequently, pick your fingers, or frequently work with your hands, you're more likely to get hangnails. They usually go away after a few days as long as you don’t pick or pull at the skin.

Summary

Hangnails are common, easy to care for, and will often heal without complication. If you have an infected hangnail, home remedies such as warm water soaks and moisturizing the affected area are effective for mild infections. More serious infections require the draining of abscesses or pus, which should only be done by a healthcare provider.

Hangnails may be prevented by keeping the skin hydrated. This includes applying petroleum jelly or good-quality moisturizers to the affected area.

If you develop a hangnail, avoid ripping or pulling it off because that increases the risk of infection. Seek medical attention if your infected hangnail does not improve or becomes worse.