Onychomycosis and paronychia

Onychomycosis is a fungal infection within the nail, often causing thickening, crumbling, lifting, or yellow-white discolouration. Paronychia is inflammation or infection of the skin edge beside the nail, with tenderness, redness, swelling, or sometimes fluid. They can occur together, but a sore nail fold is not proof of fungus. Athlete's foot can coexist with or spread organisms toward the nails, while trauma, biting, and wet work can irritate the fold.

Keep nails short and dry, avoid biting or cutting the cuticle, and wear gloves for prolonged water exposure. Do not squeeze a swollen nail fold or share clippers. A clinician may inspect the nail and take a sample before recommending topical antifungal treatment or oral antifungal treatment. Laser treatment or nail surgery may be discussed in selected situations, but neither replaces identifying the cause. If the fold has a collection of pus, drainage may be needed.

Arrange review for persistent discolouration, thickening, lifting, or repeated nail-fold inflammation. Seek prompt care for severe pain, rapidly increasing swelling, pus, fever, or redness moving along the finger or toe. People with diabetes, poor circulation, or reduced immunity should seek advice early for a broken or infected nail fold.

Ask whether the nail and nail fold show one problem or two, whether a sample is needed, and which treatment is intended for each area. Ask how to prevent recurrence during wet work and what change warrants urgent review.