What to Know About Fingernail Infection in Children

Medically Reviewed by Dan Brennan, MD on July 26, 2022
5 min read

If you notice that your child has pain or swelling around their fingernails, they might have a fingernail infection. Fingernail infection in children is a common hand infection that can usually be treated at home. Learn more about the symptoms and causes, as well as how to treat your child’s fingernail infection.

Paronychia is an infection of the skin that grows around your child’s fingernail. While some people can experience paronychia around their toenails, this usually doesn’t happen to children. Paronychia usually only occurs around the toenails if your child has an ingrown nail. It’s a common hand infection that’s noticeable where the skin meets the nail at the side or base of the fingernail.

There are two types of paronychia: acute and chronic. An acute fingernail infection happens suddenly and doesn’t last long. It usually appears only on fingernails. Chronic paronychia can show up on either your child’s fingernails or toenails and lasts longer. You’ll notice that the infection either takes a long time to clear up, doesn’t go away, or keeps recurring.

Your child may get paronychia after some kind of trauma or injury to the skin around the nail, the cuticle, or the nail fold (where the skin meets the nail). Once this area has been damaged, bacteria and germs can then find their way in and get under the skin. In children, the most common causes of the initial damage around the nail are:

  • An injury, like a stuck splinter or thorn
  • An ingrown nail
  • Biting the nail or sucking, biting, or chewing on the skin around the nails
  • Pulling on a hangnail
  • Trimming or pushing on the cuticle
  • Getting manicures
  • Cutting their nails too short

Besides bacteria, other paronychia causes can include candida (a kind of yeast) or fungi. It’s possible to have both a bacterial and a fungal infection at the same time. Fungal paronychia can happen if your child has a fungal nail infection or if their hands are frequently exposed to water.

Chronic paronychia, the kind that keeps coming back, can be caused by irritant dermatitis. This makes your child’s skin red, itchy, and irritated. Irritated skin can then get infected by germs, causing paronychia.

Paronychia usually only happens in one nail, not several. It typically starts to show up two to five days after the trauma around the nail happened.

Paronychia symptoms are usually easy to spot and recognize. The area around the nail or the area of your child’s initial injury usually becomes red and swollen. Your child will probably tell you that it hurts and it’s tender to the touch. When you touch it, the infected area will probably feel warm. In some cases, a pus-filled blister forms at the infection site if the cause is a bacterial infection.

You may notice that your child’s fingernail looks different too. The nail may have a strange color or shape or start to look like it’s detached from the skin. If the fingernail infection is bacterial, these changes come about more quickly. Fungal infections take place over time.

In the rare case that the fingernail infection spreads to other parts of the body, your child may show other signs of infection. This includes:

  • Chills
  • Fever
  • Muscle or joint pain
  • Red streaks along the skin
  • Feeling ill overall

Treatment for paronychia depends on how serious the infection is. For most kids, fingernail infections can be treated at home and don’t require medical treatment.

Home care. To care for paronychia at home, soak your child’s finger in warm, salty water several times a day. Each soak should last 10 to 20 minutes. After soaking, dry off the finger with a clean towel. If you notice that any liquid is draining from the infection site, clean it off gently. If your child is uncomfortable or complaining of pain, you can give them a common painkiller like ibuprofen or paracetamol.

Tips. While you’re caring for your child’s infection, remind them to leave the area alone. This means not biting the nail or chewing the skin around it, since this could be the cause of the initial infection. During the paronychia healing stages, maintain your child’s nails by trimming them weekly. Toenails only need to be trimmed once a month. Make sure to keep them smooth so that the nail doesn’t have a jagged edge, and be sure not to trim the nail too short.

Following these care tips, your child’s fingernail infection should heal on its own within a few days.

Even though most cases of paronychia are mild and go away with home treatment, there are some cases in which you might want to see a doctor. For example, if the infection persists after one week of home care, you should call your doctor. Not only can they help you clear up the infection, but they can also help ensure that the infection doesn’t spread to other parts of your child’s body.

If you notice that an abscess, or collection of pus, has developed around your child’s finger, it will probably need to be drained by a doctor. After it’s drained, the infected finger usually heals pretty quickly with no complications. In some rare cases, part of the nail might have to be removed.

To make sure that your child’s infection goes away, your doctor might prescribe a round of antibiotics. In this case, it’s important that your child finishes the entire course of antibiotics. Your doctor may also give you a steroid cream to apply to your child’s infection sight to help with healing.

If your child’s doctor believes the infection to be fungal, they'll provide you antifungal medications. This can be an oral medication or a cream or lotion. If your child has chronic paronychia, be sure to keep their hands and nails clean and dry and away from any harsh chemicals that can irritate the skin. To make sure your child’s hands stay dry, you can have them wear gloves or apply a skin-drying cream as the infection heals.