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The Distinction: Paronychia vs. Ingrown Toenails
Foot pain can literally stop you in your tracks, and there happens to be a systemic reason for this. Whether brief, recurring or relentless, pain is the body’s way of commanding your attention to an underlying cause. When you have a burning or stabbing pain in your foot it is likely to inhibit your ability to walk comfortably and may even disrupt your sleep — not something you can afford to ignore.
Though paronychia may occur in tandem with an ingrown toenail, both conditions have unique symptoms, treatments, prognoses, and preemptive measures. In order to ensure a proper diagnosis and prompt medical treatment, SLC Podiatry offers same-day visits every weekday for new and existing patients.
Now, let’s explore the distinguishing factors of paronychia and ingrown toenails.
What is Paronychia?
Paronychia is an infection that develops underneath or adjacent to the nail. Both the cuticle and lateral nail folds are important protective barriers between your toenail, its plate, and the surrounding tissue. When these boundaries are compromised it allows for the infiltration of infectious bacteria and fungi.
There are two separate categories of paronychia and each of them differs in their symptoms, urgency, causes, and prevention:
Acute Paronychia
An acute paronychia infection is most frequently brought on by staphylococci bacteria after an ingrown toenail has been allowed to invade the lateral fold tissue — or following a pedicure which involved cutting the cuticle.
Although prescribed antibiotics may provide fast relief for the intense pain of acute paronychia, its festering condition will usually require drainage. Why just treat the discomfort, when the underlying cause can also be eliminated during a single visit to your local podiatrist?
If the pustule is allowed to remain it may spread to the opposite side, creating a ‘runaround abscess.’ Unfortunately, this development can necessitate the removal of your entire toenail to effectively drain the area and apply curative care.
Chronic Paronychia
Chronic paronychia (as opposed to the acute version) develops and heals slowly, though medication may provide quick relief from the pain. Those exposed to a moist local environment are subject to contact dermatitis from irritants and allergens. The condition of chronic paronychia eventually breaks down the cuticle — causing it to separate from the toenail skin — giving organisms a free pass to colonization.
If you have contracted a fungal infection then antibiotics won’t help — your treatment will include topically applied antifungal and steroid creams. If unresponsive, oral versions may follow, and the severity of your condition may require the nail fold to be surgically removed.
Wear waterproof footwear when your career requires that your feet be in contact with water or harsh chemicals — such as a pool cleaning technician. Leather tennis shoes can be waterproofed by applying a layer of Vaseline after a thorough cleaning.
By completing curative care and correcting specific habits, you can prevent a recurrence of chronic paronychia altogether. Change your socks daily, and alternate the shoes you wear (giving them time to air out and dry thoroughly).
Red Flags for Paronychia Medical Attention
- You are experiencing a fever along with other symptoms
- You are high-risk with diabetes, inflammatory or heart disease
- Tenderness and minor swelling lasts more than 1 week
- Redness and swelling starts to spread up your toe
- The joints in your toe become stiff or immovable
- An accumulation of pus develops near your toenail
- The nail plate is discolored or thickened
Why Ingrown Toenails are Dangerous
According to Dr. Elizabeth E. Auger, “The most obvious symptom of an ingrown toenail is a one that has grown where it does not belong — into the lateral nail fold of skin alongside your toe.”
Most ingrown toenails begin in the large toe when the nail has grown laterally and invades the adjacent skin. The body’s usual response to this ‘foreign invasion’ will be excruciating pain and discomfort. Unfortunately, an ingrown toenail is often the harbinger for an acute paronychia infection. Antibiotics handle the redness, pain, and swelling, but an in-office procedure to remove the nail root is generally necessary to prevent the recurrence of the infection.
The cause of an ingrown toenail is often the result of improper pedicures; rounding the edges instead of making the cut go straight across, or cutting into the outer corners. Another common reason an ingrown toenail appears is when poorly fit shoes have consistently put pressure on the outer sides of the big toe, injuring the nail bed.
Ingrown toenails can present a serious problem for people with diabetes or circulatory issues. Remember to choose shoes that provide enough room at the toes for movement, do not wear socks which are too tight, and be sure to clean under your nails regularly. Cut your nails straight across with a toenail clipper. For more insight, see our defining interview with Dr. Elizabeth Auger about ingrown toenails on this Ask a Podiatrist post!
Choose SLC Podiatry for All The Right Reasons
It’s not often that you cross paths with a medical doctor who ‘practices what they preach.’ In the case of Elizabeth Auger, Doctor of Podiatric Medicine, you have someone in your corner living the same way she encourages others to achieve optimal health.
SLC Podiatry maintains three foot care clinics for the convenience of our community, treating all patients from infants to the elderly. Dr. Elizabeth Auger is a specialist in improving athletic performance, and equally passionate about inspiring her patients with the healing power of food. Dr. Auger’s personal commitment to ‘keep people moving’ makes her the perfect choice for your successful outcome in Salt Lake City, Utah!
