Paronychia (Child)

Paronychia is an infection alongside the fingernail or toenail. The infection causes a red, swollen, painful area around the edge of the nail. It can include the border of the finger or toe. Or it can extend away from the nail. The infection may include a pocket of fluid (pus).

Paronychia can occur when the skin is damaged around the nail, the cuticle, or the nail fold. This lets bacteria get under the skin. Common causes include:

  • Ingrown toenail

  • Injury, such as a splinter

  • Sucking, chewing, picking, or biting the nails

  • Cutting the nails too close

  • Pulling out a hang nail

The area may be treated with wound care and topical or oral antibiotics. If there is pus, the area may need to be drained.

Home care

Your child’s healthcare provider may prescribe an oral antibiotic to treat the infection. Follow all instructions for using it. Don’t stop giving your child this medicine until it is gone. Antibiotics must be taken as a full course. Give your child pain medicine as directed by the healthcare provider. Don’t give your child aspirin or any over-the-counter medicine unless told to by the healthcare provider. Your healthcare provider may prescribe other creams, including topic steroid creams.

To prevent recurrence, avoid cutting the nails too short. Never cut or push the cuticles.

General care

  • Twice a day for the first 3 days, help your child clean and soak the toe or finger. Soak the area in warm (not hot) water for 5 minutes. Clean away any crust with soap and water using a cotton-tipped swab.

  • Change the dressing daily, or when it becomes wet or soiled.

  • If the infection is on your child’s toe, avoid putting shoes on that foot until the toe has healed. Or, make sure your child wears open-toed shoes or comfortable shoes with plenty of room.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Redness or swelling that gets worse

  • Fussiness or crying that can’t be soothed

  • Pain that gets worse

  • Red streaks in the skin leading away from the wound

  • Warmth, redness, or swelling

  • Foul-smelling fluid leaking from the skin

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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