Key takeaways:
Nail bed infections are very common and usually minor and easy to treat.
Pus-filled bumps, blisters, or worsening pain and swelling can be signs of a more serious infection that needs medical attention.
Treatment can include warm soaks, medications, or surgical drainage. You can lower your risk of infection by keeping your hands and feet clean and dry, avoiding nail trauma, and not sharing nail-grooming tools.
Infection of the skin around the nail (called paronychia) is one of the most common medical conditions of the hand. This usually happens when the cuticle (a thin fold of skin around the nail) gets disrupted, allowing germs to get in and cause an infection. The cuticle normally helps keep germs (bacteria, viruses, and fungi) from invading the underlying tissues. But trauma to the skin fold can lead to an infection. It can happen spontaneously too.
Recognizing the signs of infection can help differentiate it from other nail conditions, like squamous cell cancer or psoriasis. Having the right diagnosis is important so you can get proper treatment for your nail bed condition. Let’s take a closer look at what an infected nail bed looks like.
What does an infected nail bed look like?
Infected nail beds can look different depending on what’s causing the infection and how long the infection has been developing. Early in an infection, changes may be barely noticeable or very mild. As the infection develops, changes may be more dramatic and present more symptoms.
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Some of the most common symptoms of a nail bed infection include:
Swelling around the nail
Red or violet discoloration at the nail fold, which can extend down the finger or toe
Pain and tenderness
Pus- or fluid-filled pockets or blisters
Loss of cuticle
Discoloration of the nail (white, yellowish, or brown)
Nail ridging or detachment
Nail bed infection pictures
These nail bed infection pictures show some of the common signs of an infected nail bed, including redness, swelling, and changes around the nail.
How can you tell if a nail bed infection is bacterial, fungal or viral?
A healthcare professional can usually identify the cause of your nail infection, based on your medical history and a physical exam. Some clues that can help distinguish the different types of infection include:
How fast it develops: Bacterial and viral nail bed infections usually come on suddenly and worsen quickly. Fungal infections develop slowly and can last for weeks to months.
How it looks and feels: Bacterial paronychia often causes redness, swelling, pain, and pus around one nail. Viral infections (like herpes) can cause painful fluid or pus-filled blisters. Fungal infections tend to cause less pain and may affect more than one nail.
Risk factors: Nail biting, picking at hangnails, and nail trauma can increase the risk of bacterial infections. Regular wet work (like dishwashing) is more likely to lead to fungal infections.
Laboratory testing: If the cause isn’t clear or the infection doesn’t improve with treatment, a healthcare professional may test a sample of the nail or blister fluid. The type of test depends on the suspected cause.
How do you get rid of an infected nail bed?
Treating paronychia depends on what’s causing the infection and how severe the symptoms are. Your dermatologist might recommend treatments like:
Warm soaks with soap and water 3 to 4 times a day
Antibiotics, like amoxicillin / clavulanic acid (Augmentin), clindamycin (Cleocin), or cephalexin (Keflex)
Antifungal medications, like terbinafine or itraconazole
Surgical treatment, such as abscess drainage
Will a nail bed infection go away on its own?
Some mild cases of paronychia may improve on their own, especially if it’s a minor bacterial or fungal infection. But some infections can worsen or form an abscess that needs medical treatment. You should seek medical care if you have:
Severe or worsening pain, redness, or swelling
Pus or other drainage from the area
Bleeding from the infected area
Fever
Nail bed infections can also be more serious in people with certain medical conditions. It’s less likely that a paronychia will go away on its own if you have these conditions, including:
Overweight or obesity
What else can cause nail bed changes besides paronychia?
Not all changes in nail beds are caused by infection. Other medical conditions can also change the appearance of your nails. Some conditions that can cause nail bed changes include:
Cancer
Vascular disease
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Frequently asked questions
Nail bed infections (paronychia) can develop when bacteria, fungi, or viruses enter through breaks in the skin around the nail. Certain activities can damage the cuticle and make an infection more likely, including:
Nail biting
Picking at hangnails
Nail trauma
Frequent exposure to water
Acute paronychia usually develops quickly and may improve within a few days with the right treatment. Chronic paronychia develops more slowly. It can last for weeks or months, especially if you’re regularly exposed to water or other irritants.
Under a microscope, nail fungus can appear as threadlike structures called hyphae. A healthcare professional can examine a nail clipping or scraping under a microscope to look for these structures. Other laboratory tests may be needed to identify the specific type of fungus causing the infection.
Nail bed infections (paronychia) can develop when bacteria, fungi, or viruses enter through breaks in the skin around the nail. Certain activities can damage the cuticle and make an infection more likely, including:
Nail biting
Picking at hangnails
Nail trauma
Frequent exposure to water
Acute paronychia usually develops quickly and may improve within a few days with the right treatment. Chronic paronychia develops more slowly. It can last for weeks or months, especially if you’re regularly exposed to water or other irritants.
Under a microscope, nail fungus can appear as threadlike structures called hyphae. A healthcare professional can examine a nail clipping or scraping under a microscope to look for these structures. Other laboratory tests may be needed to identify the specific type of fungus causing the infection.
The bottom line
Nail bed infections, also called paronychia, are common and can be quite painful. Fortunately, most infections are minor and respond well to treatment. Some may even go away on their own. More serious infections may need antibiotics or surgical drainage to treat them.
Symptoms of a nail bed infection include severe pain, redness, and swelling, plus drainage. You may also experience fever. If you notice these symptoms, seek medical attention right away. Your healthcare professional can help determine what’s causing the infection and recommend the right treatment.
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Images used with permission from VisualDx (www.visualdx.com)
References
American Academy of Dermatology Association. (n.d.). 12 nail changes a dermatologist should examine.
DermNet. (2009). Mycology.
Dulski, A., et al. (2023). Paronychia. StatPearls.
Familydoctor.org. (2025). Paronychia. American Academy of Family Physicians.
Hon, A., et al. (2017). Paronychia. DermNet.
Relhan, V., et al. (2022). Acute and chronic paronychia revisited: A narrative review. Journal of Cutaneous and Aesthetic Surgery.
