Suggestions on the treatment of paronychia

Health Description
Health Consultation Description: i have an infection on my toenail, most probably paronychia . It is very tender to the touch. I can see a small blood clot about 2mm x 1mm, just on the nail fold but it bleeds if i try to remove it. Already on azithromycin 500 mg / day for 5 days and fusidic acid locally applied 3-4 times a day, and hot compress and betadine wash thrice daily. Is this correct treatment?


Expert Reply

Condition analysis:
Hi there. The blood clot you describe could very well be what we in medical terminology call a pyogenic granuloma. The treatment you mention is fine but is it working is the question. Personally i prefer an antibiotic like metronidazole given the nail's unique position on the foot & the chance of gram negative organisms growing. You may choose to add this to the regime in addition to ibuprofen in a dose suited to your body weight. The lesion if pyogenic granuloma will need to be addressed separately & cauterised & all this will require the services of a dermatologist nearest you. 

Instructions:
1. Aloe Vera Gel
Aloe Vera is one of the best natural remedies used to kill fungus and bacteria. It is easily available everywhere and usually it doesn’t cost very much. Simply put on enough gel to cover the infected area. The gel is usually scent-free, so it won’t be annoying to keep on. Apply the gel seven or eight times a day until your infection goes away.

2. Apple Cider Vinegar
Apple cider vinegar is a great natural cure at killing infections. The first thing that the vinegar will do is kill off the dead skin surrounding the nail. Sometimes when people’s nails are infected they start to grow extra layers, and this can help to get rid of them.

This may sting a bit if you bite your nails. Mix two parts of water with one part of vinegar (any type can be used, but apple cider vinegar is usually preferred). Soak your fingers in it for at least fifteen minutes. Do this everyday until the infection goes away.



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 Key words:  Paronychia

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