Having beautiful hands is not only a beauty ideal, but also has a health aspect that should not be underestimated. The consequence of insufficient hygiene or lack of care can be a painful nail fold inflammation.
What is nail fold inflammation?
The nail fold is the area of the finger that is the space between the nail and the adjacent skin. Due to the permanent contact of the fingers with objects, the risk of inflammation is particularly high, which is summarized under the generic term of nail fold inflammation. In this case, the nail fold becomes inflamed, which can have various causes, but is often due to the fact that the affected person has touched objects contaminated with pathogens with his hands, or more precisely with his fingers. Direct contact of the hands with such pathogens is considered the main cause of nail fold inflammation. A distinction is made between acute and chronic nailfold inflammation in terms of the number of recurrences, the recurrence of symptoms after successful treatment.
Causes
Possible causative agents of nail fold inflammation include all pathogens that are otherwise responsible for infections of the skin. Staphylococci often play a role in acute nailfold inflammation. They are by far the most frequently responsible for acute nail fold inflammation. In chronic nail inflammation, on the other hand, they tend to play a subordinate role; the main focus here is on yeast fungi. Precisely because fungi are much more difficult to combat than staphylococci and therefore cause the clinical picture to flare up again and again, doctors first assume a yeast infection in the case of chronic nail fold inflammation. Regardless of whether the infection is bacterial or yeast-related: An infection does not occur solely through contact with the pathogen. Only when the skin barrier, consisting of the pathogen-hostile skin flora, is impaired or skin lesions are present, can the pathogens enter the body and ultimately trigger an inflammation. Furthermore, a weak immune system also plays a supporting role in whether simple contact with corresponding pathogens can also lead to the outbreak of nail fold inflammation.
Symptoms, complaints and signs
An inflamed nail bed can usually be detected by the affected person himself. Typically, the inflammation is manifested by a noticeable redness in the area of the affected nail bed. At the beginning, itching occurs in the affected area. Subsequently, the skin under the nail bed swells. There is hyperthermia and redness of the nail bed. Nail fold inflammation is often also associated with pain, which initially occurs only on contact and eventually persists permanently. After a few days, however, the discomfort subsides, provided that the nail bed is spared and treated with a suitable preparation. If no treatment is given or if the inflammation is based on a serious cause, the disease can progress further. In this case, severe pain, pressure irritation and itching occur, combined with movement restrictions and sensory disturbances. In individual cases, panaritium subunguale develops. Pus forms under the nail, resulting in a painful swelling. After a few days, the swelling opens and the secretion empties in the area of the nail fold. In the long term, nail fold inflammation can affect the growth of the affected nail. Detachment of the nail bed is also possible as a result of severe inflammation. In the chronic form, the nail bed takes on a yellowish or greenish color.
Diagnosis and course
As with all inflammations, the clinical picture of the inflamed area is sufficient for experienced physicians to diagnose nail fold inflammation. Only in cases of doubt or if a previous treatment has failed, further diagnostic measures are resorted to. In order to determine the specific pathogen, a smear must be taken from the inflamed area, which is examined histologically. This is relevant insofar as not every pathogen responds equally to the same antibiotic. Knowledge of the exact pathogen allows the choice of an appropriate antibiotic as a treatment measure against nail fold inflammation.
Complications
Nail fold inflammation primarily causes severe aesthetic discomfort in the affected person.Most people no longer feel beautiful with this disease and thus also not infrequently suffer from a significantly reduced self-esteem or further also from inferiority complexes. Social discomfort or depression can also occur due to the nail fold inflammation and significantly reduce the quality of life of the affected person. In many cases, the nails are significantly swollen and also reddened in the process. When pressure is applied, very strong and throbbing pain occurs, so that the patient is considerably restricted in his everyday life by the disease. Even the performance of usual activities is usually no longer possible for the affected person without further ado. The treatment of nail fold inflammation is usually carried out with the help of antibiotics. No complications occur and the course of the disease is positive. Complications usually occur only when treatment is not started early and the inflammation spreads to other regions of the hands and body. However, the life expectancy of the affected person is not affected by nail fold inflammation.
When should you go to the doctor?
In many cases, there is no need to consult a doctor for nail fold inflammation. If the impairments are rather weak and the affected person has sufficient knowledge in dealing with the inflammation, he can take care of the discomfort himself. Usually, the site is opened with a sterile tool, the fluid is carefully removed and healing occurs within a short time. This all happens normally without medical care. However, if the inflammation increases in extent and intensity, a doctor should be consulted. If sterile wound care cannot be provided, the affected person runs the risk of blood poisoning. This can lead to a sudden threat to life, which must be prevented in good time. In the event of painful swelling, severe discoloration of the affected nail or persistent complaints, clarification by a physician is recommended. If there are permanent disturbances of the heart rhythm, a loss of the gripping function or if the mobility is strongly limited, a doctor is needed. If the body is malpositioned or there are restrictions in the range of movement, consultation with a physician should take place. If the daily requirements can no longer be met or if redness of the surrounding skin increases, a doctor should be consulted. If persistent emotional irregularities occur in addition to physical impairments, consultation with a physician should be sought.
Treatment and therapy
As mentioned earlier, it depends on which pathogen is involved. In the majority of nail fold inflammation, acute nail fold inflammation, antibiotics are used. Systemic administration spreads the antibiotic agent over the entire organism and thus also in non-inflamed areas, where pathogens might nevertheless reside. After successive killing of all pathogens, wound healing is left to the body itself. In case of chronic nail fold inflammation, where yeast fungi are the most frequent causative agents, antibiotics are of no use; fungicidal agents, i.e. agents that kill fungi, are required. If the treatment is not started in time and the inflammation spreads further and further, in the worst case it can lead to the fact that the nail fold inflammation must be treated surgically. However, this is only necessary in the rarest cases of nail fold inflammation, as the available conventional antibiotics and fungicides are effective enough to treat even severe cases of nail fold inflammation with them.
Outlook and prognosis
The prognosis depends primarily on the severity of the condition and when nailfold inflammation is recognized and treated properly. In addition, if an infection is not treated, it can become increasingly widespread. It can then additionally spread to neighboring tendon sheaths and from there even jump to the bones. This dreaded inflammation of the bones or tendon sheaths is very painful for those affected. In most cases, the treatment of such complications takes a relatively long time. However, if nail fold inflammation is treated, the infection usually heals completely within a few days. It is particularly important to ensure that no irritants come into contact with the already inflamed skin. If the affected nails are subjected to heavy loads, appropriate protection should be provided.In general, affected persons should only wear shoes in which their feet find enough space and also sweat little. In addition, the toenail edges should not be cut off round in any case, because this increases the probability for a recurrence. Affected persons who often come into contact with strong cleaning agents or sharp substances should in any case wear gloves. When caring for the nails, affected individuals should be careful not to injure the cuticles, as this could cause the infection to flare up again.
Prevention
To prevent nail fold inflammation from occurring in the first place, injuries to the hands or fingers should be avoided to prevent pathogens from entering the body. Possible “gateways” are not only mechanical injuries to the hands, but also softening. Above all, those who work with their hands in humid places have an increased risk of catching nail inflammation. The reason is that the humid environment not only softens the skin, but also thins the skin flora protective film. Incidentally, the general rules for immune system strengthening can effectively prevent nail fold inflammation to kill even invaded pathogens before the outbreak of nail fold inflammation.
Aftercare
Aftercare for nail fold inflammation includes measures aimed at optimal healing of the inflammation and prevention of future symptoms. As long as the nail fold inflammation has not completely healed, increased precautionary measures must be taken. For example, the infected nail should be kept dry, and mechanical stress and strenuous hand movements with the affected hand should be avoided. The inflamed nail fold should not come into contact with soaps, cosmetics or even irritating chemical substances. After successful therapy of nail fold inflammation, care should be taken to use the knowledge of the causes of the inflammation for aftercare. For example, if the inflammation was caused by wet hands on cleaning staff, gloves can provide relief. In some cases, nail fold inflammation is caused by impurities or injuries during manicure or artificial nails. In this case, nail care should be carried out more carefully in the future. Artificial nails should be avoided in case of recurrent nail fold inflammation. A dermatologist can monitor and optimize aftercare measures for long-term treatment success. To prevent future inflammation, patients refrain from nail biting whenever possible. A suitable nail cream from the pharmacy can also help protect the cuticles and prevent further infections. If nail fold inflammations nevertheless become chronic, the habits in occupation, everyday life and household are to be reconsidered and changed if possible, in order to prevent a continuing new illness.
Here’s what you can do yourself
In the case of nail fold inflammation, a doctor does not have to be consulted in every case. Often, the condition can be treated independently by following a few tips. First of all, it is important to alleviate the condition by paying attention to adequate foot hygiene. Those affected can use appropriate care products from the pharmacy or drugstore. Home remedies such as foot baths with tea, cooling compresses or wraps also help to heal the inflammation. The affected toe must not be loaded for a few days. Sufferers are best to rest and not wear too tight shoes during the acute phase of the disease. The inflammation itself can be treated with a special plaster so that the cuticle does not stick to the socks. If the above measures do not have any effect, the doctor must be informed. Possibly, the nail fold inflammation is based on a serious cause, which must first be determined. The inflamed area must not come into contact with aggressive shampoos or lotions. Women should refrain from painting the nails of the affected foot for the first few days to avoid an increase in inflammation.
