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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  • 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.

  • Megan Haynes

    I see this thread goes quite a ways back…. But I am going through paronychia at the moment. I was prescribed cephalexin 500 my every twelve hours. 28 quantity. This is day five of my infection and I now have a pus pocket that I don’t know if I should try and poke/pop or not, and it appears the swelling is going up my finger along with some redness. It stops before the center knuckle. Because I am already on antibiotics is this worrisome? Should I go back and ask them to lance it? Picture attached. (Sorry for the bad lighting).

    • James Hubbard, MD, MPH

      If the pus pocket is not superficial and you think you could easily prick it, you should see go back and see if it needs lancing.

  • Fraser ross

    Hi had 2 poison fingers just below nail line, swollen and red thin red line started to go up my arm took antibiotics for a couple of days fingers have healed but have pain deep in top of my hand

    • James Hubbard, MD, MPH

      Taking antibiotics for only a couple days and stopping is never a good idea.

  • caroline allard

    What about this? The one near the thumb was just a little cut, like we do all the time when we cook. And the one on the finger was just a little burn from when we light a gas stove with a match and the stove is hot. In a couple of day it turned to red and leeking. Then a week later, it looks like this. It does not seem to get better. The aloe vera, did not do good. The salted water baths neither. It seems to get worse and worse.

    • James Hubbard, MD, MPH

      It may be infected. You should get checked to see if you need antibiotics.

  • Aliza Kessler

    I have a Paronychia on my thumb. Been on Omnicef for a week. The doctor poked a whole by the swollen area and blood came out. Ever since then,nothing has come out. My finger is still swollen. Dr said there’s probably no pus underneath. Now I am feeling pain in my hand and muscle. Dr put me on Bactrim for 5 days. Hopefully should help within a few days. Is it normal to have hand and muscle pain? Does that mean the infection spread?

    • James Hubbard, MD, MPH

      It could. Usually the hand would be tender, swollen, and red. If you have concerns that it might be, call your doctor’s office or go back in.

      • Aliza Kessler

        My hand is not tender, swollen or red. It hurts . I will keep an eye on it though and if necessary, I will call the doctor’s office

  • Jeremiah Rivera

    So i cut my finger with a razor blade (The Top of my thumb close to the nail on the first “bend”) pretty deep its been four days and its very swollen, red and pus oozing out by itself. Iv squeezed some hard push out its felt like a pimping popping when they came out (down this three times now) and they were pretty big, Should i seek medical Attention ?

    • James Hubbard, MD, MPH

      Yes, and don’t squeeze anymore.

  • Billy

    No pus , but skin pealing , swollen , with a throbbing pain . bleeding when skin cracks . Started soaking today in warm water .Thinking I would go get so antibiotic cream tomorrow . Question will this be enough or do I need Antibiotics from the Doc.

  • loo

    Help i have this and I feel sick with it and its for a funny smell

    • James Hubbard, MD, MPH

      Hopefully you read my post on what to do for a paronychia. If that doesn’t cure it you should see a doctor.

  • Darlene

    Thank you so much for this article. I followed your instructions precisely and it feels so much better. An added bonus: I did not have to make a trip to the Dr’s office!

    • James Hubbard, MD, MPH

      Glad to hear it, Darlene.