Nail infections are more common than many people think. They can go from a small problem to something painful very quickly.
Knowing when to get care can help prevent bigger problems. Dr. Shahin Rezai, medical director for University Health ExpressMed urgent care clinics, shares what to watch for and when to seek urgent care.
What Is a Nail Infection?
A nail infection can affect the nail or the skin around it. Two common types are paronychia and onychomycosis.
Paronychia is an infection of the skin around the nail. It often happens when germs enter through a small cut near the cuticle or nail edge.
Onychomycosis is a fungal infection that affects the nail itself.
“Nail infections are common and can be treated with antibiotics or antifungal medicine,” said Dr. Rezai.
What Causes a Nail Infection?
There are two main causes of nail infections: fungi and bacteria. When either enters under the nail through broken skin, it can lead to swelling, redness and pain.
Fungi
Fungi are the most common cause of nail infections.
“The fungi that cause nail infections are called anthropophilic dermatophytes, meaning they only infect humans,” said Dr. Rezai.
Common fungal, mold and yeast strains associated with nail infections include:
- Trichophyton rubrum
- Candida parapsilosis
- Candida guilliermondii
Fungal nail infections happen more often in toenails. They can spread from person to person and typically do not go away on their own.
Bacteria
Bacterial nail infections are usually caused by:
- Staphylococcus aureus
- Streptococcus species
- Pseudomonas aeruginosa
Treatment for a bacterial nail infection may include:
- Soaking the nail in warm water
- Draining any pus
- Using antibiotic creams
- Taking antibiotics by mouth
The appropriate treatment will depend on how serious the infection is.
Ingrown Toenail
If you have an ingrown toenail, it can lead to infection. This happens when the nail grows into the skin, creating an opening for bacteria.
“An ingrown toenail can usually be treated at home, but may need medical attention if it is severe and causing symptoms of infection, like fever,” Dr. Rezai said.
Dr. Rezai stressed keeping the area clean and dry to prevent infection.
Risk Factors for Nail Infection
While anyone can get a nail infection, some people are at a higher risk, including those who:
- Have diabetes
- Bite their fingernails
- Have a weakened immune system
- Have poor circulation
- Are older adults
- Have frequent exposure to water ("wet work")
- Experience nail trauma
- Use artificial nails
- Practice aggressive manicuring
- Are athletes
Signs of a Nail Infection
Depending on the cause (bacterial or fungal), the symptoms may look a little different.
Common signs of a nail infection include:
- Changes in color and texture of the nail
- Redness and swelling of the skin around the nail
- Brittle nails
- Throbbing pain
- Slight odor
- Pus or drainage
- Separation of the nail from the nail bed
- Nail thickening or crumbling (for fungal infections)
When to Go to Urgent Care vs. Primary Care or At-Home Treatments
Urgent Care
Urgent care providers can treat nail infections and prescribe the necessary medications.
Go to urgent care if:
- Redness spreads beyond the nail area
- Pain is severe
- Pus is present
- You have a fever or chills
- You have diabetes, poor circulation or a weakened immune system
- Symptoms get worse even with home care
Urgent care can help you feel better quickly. If symptoms continue, schedule an appointment with your primary care provider (PCP).
Primary Care
If you have diabetes, circulation problems or are concerned that the infection is severe, Dr. Razai recommends making an appointment with your PCP. Your doctor can review your medical history and determine if more advanced care is needed to prevent complications.
Primary care may also be a better option if you have recurrent nail infections or persistent pain and want to discuss a more permanent solution.
How to Treat a Nail Infection at Home
Most nail infections do not go away on their own. While there are many home remedies online, medical care is often the best way to treat the infection.
Urgent Care at University Health
If you’re dealing with a nail infection that’s getting worse or just not improving, our urgent care team is here to help. University Health offers walk‑in care at six ExpressMed locations across San Antonio.
Our board‑certified family medicine doctors, physician assistants and nurse practitioners treat patients of all ages. For children who need specialized attention, our PediExpress clinic at the Robert B. Green Campus provides pediatric urgent care seven days a week from 7 a.m. to 8 p.m.
