Dr. Jacqueline Gerhart: No Nail Biting

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: I was biting the skin around my fingernail and now it's red and painful. Neosporin isn't helping. What should I do?


Dear Reader: Often when we bite the skin around a nail, we leave a small opening or "cut" in the skin that can cause swelling, redness, tight skin and pain. In some cases it can get very bad, causing bleeding or infection.


The medical term for infection around the nail bed is called paronychia. It is one of the most common hand infections, is usually short-lived and can be treated at home.


So how does the infection occur when you bite your skin? Well, the mouth is a dirty place. It has multiple types of bacteria that are not naturally occurring on the skin of your fingers. So it is easy for an infection to develop when the bacteria from your mouth enters a small cut around your finger. This also can occur if you cut your finger on a kitchen knife and then put your finger into your mouth.


The first line treatment for paronychia is soaking that finger in warm water for about 20 minutes, three times per day. Some people feel that adding Epsom salts to the water is helpful, too. Usually the pain, swelling and redness will clear up in a few days if you stick to this soaking regimen.


If you do not notice it clearing up, then antibiotics may be needed. And if you see that a small pocket of pus is forming - called an abscess - it may be necessary for a physician to drain the pus to allow for a more rapid recovery.


Of course, the easiest way to keep paronychia at bay is to treat the underlying problem: the breaks in the skin around your nails. This means not chewing or biting your nails or the surrounding skin. If this is a habit of yours, consider seeing your physician. You may have an underlying anxiety disorder that causes this behavior.


Other underlying causes of skin breaks include repetitive hand washing (as sometimes seen in obsessive-compulsive disorder), chronic dry skin or eczema, and surrounding fungal infections of the nails. Also, beware of "over-trimming" your nails. Getting manicures that pull away the cuticles and surrounding skin can cause breaks in the skin. And cutting the nails too short can cause ingrown fingernails or toenails and can increase your risk of bacterial or fungal infections.


Skin breaks around the nails also can happen in children who suck their thumbs or who bite their fingers when teething. If your child seems fussy for no reason, consider checking their fingers and toes for swelling or infection.


The bottom line: Leave the skin around your nails alone.


This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 05/29/2013

News tag(s):  jacqueline l gerhart

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