NAIL IT BEFORE IT'S AN ABCESS

A sore little finger can turn into a bigger problem fast.

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1. Counselling Conundrum: a real question from a patient

2. Concise Conclusion: a straight-forward patient-friendly answer 

3. Quick Wrap-up 

Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with helpful counselling tips which often draw from multiple sources or those which are not commonly accessed by busy healthcare providers serving the community.

Counselling Conundrum: "My 6 year old son's finger has been getting more red and swollen around the nail for the past two days and now there's some pus coming out. He says it really hurts. Can I just put some Polysporin on it?"

Concise Conclusion: This sounds like paronychia, an infection of the skin around the nail fold, and Polysporin alone will not cut it here. First line treatment is oral antibiotics, not topical, so unfortunately you'll want to head to the walk-in clinic.

Quick Wrap-up: Paronychia in kids usually follows minor trauma like a hangnail or nail biting, which lets bacteria such as Staph aureus and Strep get in. Classic signs are redness, swelling, and tenderness at the nail fold, sometimes with a visible pocket of pus. While waiting to be seen, an antiseptic soak (diluted iodine or chlorhexidine) a few times a day plus a topical antibiotic can help hold things over, but they are not a substitute for the real treatment. He needs to see a walk-in for systemic antibiotics covering Staph and Strep, and if there is a true abscess, it will need to be drained. Note however that in adults, topical treatment is the gold standard.

Dive Deeper

1) Acute Paronychia - Dermatology - Merck Manual Professional Edition

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