Infected Finger: When It's Dangerous

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

How a Felon Could Make You Lose a Finger

A paronychia

This is a paronychia—an infection that stays around the fingernail. It’s not as dangerous as a felon (another type of finger infection), but it still needs proper treatment so it doesn’t get worse.

by James Hubbard, M.D., M.P.H.

If you’ve ever had a hangnail that got a little infected, you discovered you have a lot of nerve endings in your fingers. And you found out you use your hands for just about everything. Hands you’ll especially need during disasters.

Fortunately, most infected hangnails heal well as long as you keep the area dry and clean. (Gloves? Band-Aids?) But sometimes, rarely, an infected finger can get serious.

The infection can run up the finger, into your hand’s tendons, and you have a dangerous mess on your hands—literally. Or the fingertip can become so swollen that it starts cutting of the circulation, putting you in danger of losing that finger. This type of infection is called, perhaps appropriately, a felon.

Here are some tips to help you kinda know what you’re dealing with and what to do.

Paronychia: An Infection Around the Fingernail

Unless there’s a cut or scratch, most infections spring up around the cuticle, where the bacteria worked its way in. If the infection stays there—around the fingernail—it’s called a paronychia (pa-ruh-NIK-ee-uh). Who knows why? To treat a paronychia if you can’t get to a doctor:

  1. Use warm soaks on it. You can dip it in warm water or use warm, wet cloths. Do this often, for ten to twenty minutes at a time.
  2. If you’re bumping it, cover it with a adhesive bandage. Wear gloves. Splint it with a stick if you need the extra protection.
  3. Within a day of heat, it’ll either heal or come to a head, meaning the redness will localize in one corner around the nail, and a small white spot will form.
  4. Sterilize a sharp object, such as a safety pin, by holding the tip under a flame until it’s red. Or at least dip the tip in alcohol.
  5. Lightly prick the white spot. It shouldn’t hurt because you don’t stick the needle deep, just enough to let the pus out. There’s no need to stick it if there’s not that white spot. You’ll only get blood—and a risk for more infection.
  6. Apply antibiotic ointment or honey (not for babies) and an adhesive bandage.  It should be healed in another day.
  7. If this doesn’t do it, start oral antibiotics, if available.

Pretty easy stuff.

Felon: A Serious Infection in the Fingertip Pad

Rarer is the more serious felon. No, not the criminal type. This is when infection gets deep into the fingertip pad. The fingertip swells and throbs. The circulation could cut off and you could lose a finger, or the infection could spread into the hand.

To treat a felon:

  1. Get to a health-care provider if you can. Many times a felon has to be surgically opened up. The fingertip pad must be cut open to relieve the pressure. A pin’s not going to do it here.
  2. Until you can get expert treatment, start oral antibiotics.
  3. Elevate the finger about at your heart level.
  4. Warm soaks are worth a try.

Something similar to a felon is a herpetic whitlow. It’s caused by the herpes virus. As with a fever blister and genital herpes, a whitlow is recurrent and tends to cause pain and blisters, run its course, and go away. The finger pad is usually not as swollen as it is with a felon. If you catch a whitlow early, prescription antiviral medications may shorten the course.

Unless you’ve had a whitlow before, it’s going to be hard to tell the difference between that and felon. If you couldn’t get to a doctor, I’d treat it like a felon.

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Photo by Chris Craig.

  • Nicole Smith

    my finger doesn’t seem to want to heal…I assumed it was “bar rot”…but it has now been a couple of months. every once in a while some puss can be squeezed out of the cuticle line….slight tenderness if I feel around the side of my finger….the discoloration is what seems off to me…any insight?

    • James Hubbard, MD, MPH

      After this long you should see a physician, NP, or PA. to see if it needs antibiotics, drainage, is MRSA or all of those.

    • Nicole Smith

      this is a pic of it

  • @emmaleechase

    There can also be a ‘red line’ that forms and travels up toward the body. I understand that this means infection is spreading (e.g. cellulitis). It’s really important to get oral (or stronger)
    antibiotics at that point. I had badly infected carpal tunnel stiches and they used 3 days of IV antibiotics with me. The ER doc freaked about my GP’s office giving me oral antibiotics, saying the infection can hide and go deep into the arm’s tendon, climbing. He said it’s more known among surgeons than GP docs and RNs. Could have lost my hand.

  • Christiana Key

    Pretty sure I’ve got paronychia. The picture with the white background was taken a week ago, and the green background was taken just now. There has been a lot of pus and it’s been draining just fine. I’ve ben doing warm water soaks and apple cider vinegar soaks and putting tea tree oil on it, but I think the infection has moved underneath the nail bed now. It does hurt nearly as bad as it did when the infection was on top of the nail, and the swelling is much, much less. Is it possible to lance an abscess underneath the fingernail?

    • James Hubbard, MD, MPH

      It is. But you could also make things worse especially if you’re wrong. Instead of doing that I’d see a doctor. On the other hand you said it was getting much better …

  • Mohamed

    Look at mine I tried getting the fluids outside but there was nothing.

  • Souraya Christine

    I have been trying to figure out and understand this weird problem. It began at 18 after being poked with something in my finger. Thant landed me in the hospital for 5 days with blood poisoning. Then, this exact same thing recurred for the following 4 years. Each time I’d have to go in for antibiotics. Here, now age 41, it has again returned, with no new injuries or anything. Just seems like it was laying dormant all this time. Any ideas? Your information above is great. My doctors have always been baffled.

    • James Hubbard, MD, MPH

      Sorry. MRSA or a nonbacterial infection such as a virus or fungus come to mind. But I’ll bet they’ve already ruled those things out.

      • Souraya Christine

        Nobody has ruled anything out unfortunately. They have just placed me on an antibiotic, just like all the last times.

        • James Hubbard, MD, MPH

          Another possibility is that it could be some foreign body introduced during the needle stick. In that case it might be too tiny to find.

  • Remy

    Hey Doc! I went to urgent care last night actually cuz my toe (not finger sorry) was so swollen and painful it was starting to affect my ability to walk! Before last night, I had been doing warm soaks, cleaning up the pus that was leaking out 2-3x/day, and elevating it as much as I could… The PA removed a large portion of the nail but we kind of “disagreed” on draining it. I wanted her to drain it because pus had been leaking out for a few days already and was so painful! I thought there may be a pocket, she thought the pain and swelling was just caused by the ingrown nail, and the “pressure” I was feeling would be relieved upon removal of the nail piece that was poking into my toe. So my question is… It’s WAYY worse this morning!! I didn’t fill the pain meds she gave me because I thought that was ridiculous but around 2am I woke up with my foot throbbing and had to send my husband out for them. My toe is more swollen, pain is worse, I DEFINITELY can’t walk– no pressure what-so-ever. Do you think that’s normal after having a nail removed? Or should I go back to urgent care?

  • Allissa G

    Hello, I have had plenty of infected finger nails and I always care for them at home with the methods you mentioned. However, the one I have now won’t go away. I’ve had it 2 weeks now and I’ve drained it several times, soaked it in epsome salt, put antibiotic ointment on, cut the dead skin away from it and it just keeps looking worse. Now my finger nail is dying and pulling up and my finger tip is red and painfully tingling. My husband says this happens to him all time time and It’ll go away on its own but I’m skeptical. Any suggestions? If I keep up my home treatment will it go away? I don’t want him to waste his time taking me to the dr if he is right and it will just go away.

    • James Hubbard, MD, MPH

      2 weeks seems rather long. I think I’d have it checked out.

  • Frank Agnich

    I too, have been bothered lately with paronychia, with some slight differences than I’m reading from others. I get a redness and slight swelling around 1/2 of the nail on my right middle finger. It becomes tender to the touch. Here’s the difference. No pus so far. And also, it has occurred about four different times in about the last month and a half. It becomes inflamed, lasts for about a few days and then goes back to normal, only to return again. My doc told me to soak it in warm water with Epsom salt twice a day, put Noesporin on and cover it with a bandaid.. Today is day one. So far so good. I hope this gets rid of it for good and keeps it from coming back.

  • Chelsea Cherry

    I am at the point i want the tip of my finger amputated. 3 weeks ago i woke up and the index finger on my right hand hurt. I have herpetic Whitlow. So i went to the ER and they gave me anti virals. 2 days later I had a huge abcess on the top and side of my finger. Went in and had it lanced and was given 2 different oral antibiotics. I even went to another doctor after that because i thought under my nail needed drained, he said no. Now the antibiotics are gone and my fingernail is still white, puss is still leaking and i cant feel the tip of my finger. Its 3am, in thhe morning I’m going back to the ER. I’ve searched online, I havnt seen any infection as intense as my finger.
    Im scared its in my bone and/tendon now. Im sick of not being able to work, i feel like this is never going to get better.

    The first picture is how it looks right now

    • James Hubbard, MD, MPH

      I”d call your regular doctor and get seen soon.

    • Chelsea Cherry

      My finger right now

  • Kristen Helling-Myrick

    I went to a local urgent care last night with a paronychia on my middle finger, and pain in my armpit and down the same arm (all on my right side.) While there the doctor opened and drained the spot on my finger and prescribed me Augmentin (sp?) To take for 10 days. The doctor only really address the spot on my finger, and not the pain in and under my arm. This morning I woke up the pain was not as bad as the night before, but as the day went on the pain became stronger. So my question is, when, or should I go back to see a doctor? Should I continue to give the medicine a go for a few days or should I be seen asap?

    • James Hubbard, MD, MPH

      You should call the doctor’s office and see what they advise. This is only speculation but one scenario would be the finger infection being bad enough to drain up to the lymph nodes in your armpit. This is one of the body’s defenses against infection and should get better as the infection gets better in a few days. However I would need an exam to say whether that, or whether actual infection in the arm, and not lymph nodes, is causing the pain. The examining doctor would be the one to ask.