What should you know about newborn paronychia?

The skin beside or behind a nail may become red, puffy, tender, or warm. A small pocket of fluid or pus can form. A tiny break in the skin, nail biting by an older child, or irritation around a nail edge can allow germs in. Yeast can also affect moist skin, especially when there is a broader rash; see [Skin Yeast Infection](/conditions/cutaneous-candidiasis/).

A newborn cannot describe pain, so watch for pulling away when the finger is touched, crying during care, reduced use of the hand, or trouble feeding because the baby is unsettled. The clinician will assess the finger, nearby skin, and the baby’s general condition.

Keep the finger clean and dry. Wash your hands before touching it, rinse gently with clean lukewarm water if soiled, and pat dry. Do not squeeze, pierce, cut the nail fold, or apply leftover antibiotics, antiseptics, or herbal products. Keep sharp nail edges trimmed safely and cover the hand only if a clinician recommends a dressing that will not restrict circulation.

Arrange medical advice promptly if swelling or redness remains, a fluid pocket appears, or the baby is increasingly irritable. Treatment may involve [Antibiotics For Skin Infection](/treatments/medical-dermatology/antibiotic-therapy-for-skin-infection/); a collection of pus may need [Abscess Drainage](/treatments/minor-procedures/abscess-drainage/).

Seek urgent assessment for fever, poor feeding, unusual sleepiness, rapidly spreading redness, red streaks, marked swelling, a blue or pale finger, or pus extending beyond the nail fold. A newborn who seems generally unwell should be assessed without waiting for the finger to improve.

Is the nail fold irritated or infected? Is there a drainable collection? How should we clean and protect the finger, and what signs would mean the infection is spreading?