Diagnosis
In most cases, the classic symptoms of nail bed inflammation are sufficient for a doctor to make a reliable diagnosis. In order to obtain precise information about the pathogen present, he can also take a smear of the affected area. If a chronic form of nail bed inflammation is suspected, the physician should take a detailed medical history in order to exclude underlying diseases such as diabetes mellitus (nail bed inflammation treatment).
Therapy
Acute nail bed inflammation, which is characterized by slight redness, swelling and throbbing pain in the area of the toe, can first be treated with lukewarm foot or hand baths with curd soap or chamomile solutions. They have a calming effect and support the natural healing process. Washing also loosens the horny layer and makes it easier to remove pus.
After the bath the nails should be carefully dabbed dry. In addition, the application of disinfectant ointments, which contain, for example, antibacterial iodine, is also helpful, as they can particularly help with a bacterial cause of nail bed inflammation and alleviate the itching that frequently occurs. (e.g. Ilon® ointment) The affected area should be immobilized by elevating it, using cooling compresses or by means of small splints.
In the case of acute nail bed inflammation of the foot, shoes that are too tight should be avoided; instead, shoes that offer enough room for the toe are recommended to avoid further irritation of the affected area.Contact with cleaning agents and other chemicals should also be avoided (wear shoes and gloves, e.g. when cleaning with cleaning agents). If the pain is very severe, painkillers can help temporarily. It is advisable not to touch the area around the nail bed yourself in the case of acute nail bed inflammation, as self-therapy can make the situation even worse.
If the inflammation lasts for several days, a doctor should be consulted in any case. If the nail bed inflammation has not subsided after the first treatment (e.g. by baths and ointments), swelling, overheating or pus occurs or the symptoms increase, a doctor should be consulted. However, if the inflammation has progressed so far that fever, chills, swelling of the lymph nodes and a general feeling of illness occur, antibiotic treatment may also be necessary.
The active ingredient group of penicillins is suitable for this purpose, as they are particularly effective against staphylococci, the bacteria that most frequently cause nail bed inflammation. If an ingrown nail is the cause of nail bed inflammation, the nail can be surgically reduced by a doctor. In some cases, the nail plate must also be removed completely.
Before choosing a surgical therapy for nail bed inflammation caused by an ingrown nail, some other measures can be tried out. For example, a brace can be inserted between the nail and the skin, absorbent cotton inserts can be placed, or the lateral nail wall can be pulled away with a patch. If a nail bed inflammation is treated late or not at all, growth disturbances of the nail can occur or the nail can be rejected.
A nail bed inflammation usually occurs acutely and disappears after about a week. The infection takes place in the superficial part of the skin. In rare cases, the inflammation may progress to deeper layers.
There is a risk that the infection will spread to the bones or blood vessels. If an inflammation of the nail bed does not subside by itself after a few days or even gets worse, a visit to the doctor is unavoidable. The doctor decides whether antibiotics, a surgical opening or both are necessary.
Usually antibiotics from the group of penicillins are prescribed. The treatment of a nail bed inflammation depends mainly on the symptoms, the severity of the inflammation and the result of the medical examination. A distinction must be made as to whether the inflammation was caused by bacteria, yeast fungi or viruses.
Depending on the pathogen that caused the nail bed inflammation, different ointments and medications may also be considered. Basically, anti-inflammatory baths and ointments have a calming effect on nail bed inflammation and can even support the natural healing process. For this purpose, disinfectant solutions or ointments containing iodine or other antibacterial substances are particularly suitable.
Especially if bacteria were the cause of nail bed inflammation, these ingredients can help to accelerate the healing process. In order to find out which ointments and measures are most suitable in an individual case, it is advisable to talk to the treating physician. Under certain circumstances, experimenting with ointments on your own can have a negative effect on the course of the disease.
It is particularly important not to manipulate in the area of the nail bed inflammation and to try to drain the pus with unsuitable tools. If the inflammation is more advanced and severe, the use of ointments containing antibiotics may be necessary in some cases. If the inflammation spreads with swollen lymph nodes and fever, an antibiotic in tablet form can be prescribed additionally.
If the inflammation of the nail bed is not caused by bacteria but, for example, by an infection with yeast fungi, ointments containing an antifungal agent are effective. Certain viruses can also cause nail bed inflammation. An infection with herpes viruses can be treated well with an ointment containing so-called virus statics, i.e.
ingredients that fight the virus (e.g. Aciclovir). It should be remembered that in the case of mild nail bed inflammation, applying an ointment and sparing the affected nail (e.g. by wearing appropriate footwear) is usually sufficient to heal the inflammation.In more severe cases, a small operation may be necessary, during which the nail may have to be removed to allow pus to drain. A disinfectant ointment bandage is then applied so that the wound can heal well.
In the case of chronic nail bed inflammation, it may be advisable to avoid certain irritants. Some ingredients in ointments or (hand) creams can also be responsible for the constantly recurring nail bed inflammations and should be avoided. People who come into contact with aggressive substances a lot should regularly apply sufficient fatty ointments to the hands to prevent nail bed inflammation.
In the case of nail bed inflammation, the application of pulling or pulling ointment can be helpful. In medicine, pulling ointment is used for inflammatory skin diseases, abscesses, boils, acne, as well as for splinters and nail bed inflammation. The ointment has an anti-inflammatory, antibacterial, blood circulation-promoting, pain-relieving effect and softens the uppermost skin layers, so that foreign bodies and pus can be more easily removed to the outside.
The latter is also the reason why pulling ointment is often used for nail bed inflammation. The pus present, for example under the nail, causes painful pressure, which can be relieved by removing the pus. Betaisodona® is a trade name used in Germany for “povidone-iodine“.
Povidone-iodine is a disinfectant containing iodine, which is often used in medicine. Iodine damages the shell of microorganisms such as bacteria, viruses, fungi and bacterial spores and thereby kills them. Besides Betaisodona®, numerous other disinfectants containing iodine are used in medicine.
However, Betaisodona® has the advantage that it is particularly suitable for use on sensitive areas such as mucous membranes and wounds. Betaisodona® is applied in a usually 10% dilution over a large area of the area to be disinfected. Betaisodona® can also be used for nail bed inflammation, especially if the cuticle is infected or dirty.
Disadvantages are itching, rashes, and frequently occurring allergic reactions. Products containing iodine should never be used for thyroid diseases, as they can have a very strong influence on the metabolism of the thyroid gland. A slight inflammation of the nail bed often occurs and usually heals after a few days, when the nail is relieved and possibly treated with supporting, antiseptic baths or ointments.
It can be useful to show a strongly inflamed nail bed inflammation to a doctor before taking self-measures, as the inflammation can be aggravated by this. As a rule, one first contacts the family doctor who treats the nail bed inflammation. Depending on the severity of the inflammation, the family doctor may issue a referral to a dermatologist (dermatologist) or a surgeon.
Nail bed inflammation is more common in chronic underlying diseases such as diabetes mellitus. In this case, the treating physician should visit the underlying disease. The family doctor usually recognizes an inflammation of the nail bed when examining the affected area.
Nevertheless, the doctor will first take a medical history (anamnesis) of how the injury occurred in order to be able to infer the possible pathogen or give advice on how to prevent recurring nail bed inflammation (e.g. wearing suitable footwear). In some cases it may be useful for the doctor to take a smear of the inflamed tissue to determine the pathogen. At an advanced stage, the doctor may consider an X-ray (or possibly magnetic resonance imaging / nuclear spin) of the hand or foot necessary to determine whether the inflammation has already spread to deeper tissue, bone or bone marrow.