Q: I have been suffering from infections in the nails for the past several months. One of my friends suggested it could be due to a manicure I had undergone at a salon. Is it possible?

A: Tender swellings around your fingernails are indicative of presence of acute inflammation together with bacterial or fungal infection, often both. This condition is medically known as paronychia. This can be either acute with 2-4 weeks duration of complaints, or chronic paronychia, where one can be suffering from recurrent attacks of the complaints over long periods of time.

The initial onset of paronychia is mostly seen after an injury to the nail folds (the skin in close proximity to the sides and front nail margins) or to the nail cuticle. This sort of injury can be inflicted through several ways. However, I believe that particularly in women, such an injury is most commonly caused during manicure/pedicure procedures.

Some salon and spa workers may not be properly trained in knowing the structural intricacies of the nail unit. As such, they are usually seen getting over-enthusiastic when working on the clients’ nails which should basically be a gentle cleaning of the nails. Cutting the nail margins very deep often results in causing a collateral damage to the skin around the nail. At the same time, cutting the cuticles is medically unadvisable as it is nature’s protective mechanism for protection of the nail matrix.

The nail matrix extends from the cuticle area upwards under the surface of the skin. This matrix acts as the nail generating factory and consists of soft keratins. Any injury to the naturally intact cuticle will allow water as well as chemicals like detergents to penetrate into the nail matrix zone which can later be invaded by either fungus or bacteria.

The same infection process can affect the 
side skin folds around and in front of the 
nail margins causing painful swellings of the affected areas.

There is a two-fold treatment plan to treat Paronychia. First, we have to treat the acute complaints by prescribing a course of oral antibiotics together with topical antiseptic and antibacterial solutions. In cases of Acute Paronychia, 1-2 weeks course of treatment usually resolves the issue. However, in cases of Chronic Recurrent Paronychia, this treatment duration can be much longer, and many require an inclusion of topical and oral anti-fungal medications as well.

During the entire treatment period until complete recovery, you should extremely minimize water and soap contact.

Stop doing aggressive manicure procedures which will result in restarting the complaints again. Select a reputable nail salon or spa, staffed with qualified and trained therapists.

Finally, many sufferers of chronic recurrent Paronychia end up having nail plate structure deformities because of the continuous insult to the nail matrix. Similar nail problems can also be faced by women using acrylic nail extensions.

Dr Ikramullah Nasir is a specialist dermatologist and medical director at Dermacare Skin Centre, Dubai. Got a problem? Our fantastic panel of renowned experts is available to answer all your questions related to fashion, well-being, nutrition, finance and hypnotherapy. Email your queries to friday@gulfnews.com.

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