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.

  • Amirah

    my brother had this kind of infection (look like that but we not really sure if it is paronychia or not) but we try to treat it by using a needle but after we remove some of the liquid at the area of my brother nail, my brother suddenly feel dizzy and faint for a few second and his body freezing for a second and then his wake up. Can i know why?. im very worried about that because when i read on internet about Paronychia. it does not tell about faint etc.. can you explain to me?

  • Stella Elliston

    I cut my finger with a razor blade on the razor that you shave with on the tip of my thumb I handle dirty money from the casino so with it being two weeks it’s really painful throbbing I can feel the heartbeat of the tip of my thumb it’s starting to turn purplish red white on the top and it’s starting to go a little numb went to the doctor she told me it wasn’t stolen so she wasn’t worried but its no swelling what should I do??

    • James Hubbard, MD, MPH

      If you went several days ago, sounds like you should go back and see if you need some antibiotics, or call. Elevation to heart level or above can help the pain. A little heat might bring infection to the surface. Just make sure you don’t burn yourself. If there’s an open wound, raw honey or MediHoney can help with infection.

  • Shaun Greatrix

    I’m an excessive nailbiter so I get felon’s pretty often when the corner rips too deep and it gets a nasty bacteria in there. If you’ve done the same, you’re lucky and you’ve got yourself a tunnel down to the pocket where the infection is, if you get one. Leave it till it starts to hurt. That’s when you’ve got the pressure building… then rotate/ball the skin around next to the nail so it loosens any healed skin blocking said tunnel. Soak it in warm water to loose the skin some more. Now the worst part… squeeze the painful part till either blood or pus comes out. If a little comes out, good job. If it doesn’t hurt so much you go a little dizzy, you’re not doing it properly. When you’ve done a good job and squeezed it out, your infected are should be not-so-painful when you touch it, or even numb. Now soak it in handwash cream + warm water for five minutes, dry it, slap some antibiotic cream on that sucker and wrap a band aid around it tightly (so, imagine that this is now squeezing the pocket tight so pus isn’t filling it). You’ll probably have to do this a few times, but if it’s still happening after about 3 days and hasn’t gone, your immune system/antibiotics are shite and you’ll need a doctor. Good luck!

  • Vitor Leur

    This is very easy to cure without cutting a finger or taking antibiotics.
    Bacteria that cause this inflammation can not tolerate higher
    temperatures. Just put hot water in a glass and dip finger into it.
    Water has to be as hot as you can tolerate it. Keep replacing hot water
    every 5-10 minutes for few hours. You will see results the next day and in few days inflammation will be completely gone.

  • Johnny El

    Hi luckily I saw this. Please help, I already cutoff the nails after the Paronychia infection. I think this is the after effect. My nails are now in the middle part. Will my nails grow back as before? Or should I just remove it? Thank you Doc…

    • James Hubbard, MD, MPH

      Sorry, Johnny, I’m not even sure what you’re talking about. Paronychia infections don’t require anything to be done to the nail. But anytime the nail is involved–by infection or cutting, it grows back unless there has been a lot of damage to the nail bed which is the tissue to which the nail is attached.

  • macy

    About 3 weeks ago I pulled a hangnail and as usual it affected some of the skin and started to bleed, but I had a manicure the same day. It has not healed properly and now its swollen with deep throbbing pain. There doesn’t appear to be a puss pocket but I have tortured my finger in trying to poke it, soak it and bandage it properly. Nothing is working and its going on 4 weeks and there is still a little hard mass that’s very sensitive and is making my finger red with heat. It almost feels like there is something stuck in there. what should I do?

    • James Hubbard, MD, MPH

      Quit poking and see a doctor. You’ve given it long enough trying on your own.

  • alex

    I couldn’t find my older comment, sorry! At two days it seems to be healing on its own albeit gradually. It seems to come and go, hot and cold, but gradually the pain and swelling is less than before. I’m guessing I should give it a week to heal completely. I’m kinda glad I didn’t have insurance this time, its not good to rush to antibiotics when one can wait a day or two with epsom soaks before deciding if its needed. I also get freqient uti and always have a bottle of uva ursi and d mannose in my bag for that. Works wonders.

    • James Hubbard, MD, MPH

      Thanks for sharing, Alex.

  • alex

    I have a paronychia on my right finger after having to spend the night in a cheap motel. Its been 26 hrs. It ha s no white pus tip, but its not healed either. After a few more days I will go to a doc if its not healed. I think I would have been better off sleeping in my car than at that damn hotel! Lol

    • James Hubbard, MD, MPH

      Good luck

  • MsRain

    I just found your site, and am thankful that I did.
    To add my experience with this topic.
    Some years back, I bought some used shoes from a thrift store and ended up with toe nail fungus :P
    Now, that toe nail get’s ingrown often.
    I cut it back, and into the side & pull the “bur” out which is very painful.
    Sometime it would get infected. One time It wasn’t getting better after several weeks I finally had to go to the clinic for antibiotics.
    Since then I bought just plain old iodine (cost less then $2 for a small bottle), and now I use it every time whether I think the skin is broke or not, and have not had an infection since.
    One drop is all it takes.
    I use it on regular hang nails as well, and never get an infection.
    I hope this helps :)

  • Rev

    Greetings Doctor. I had infected my toe, paronychia most likely, after a harsh pedicure. I think this is its second week and the infected wound as greatly improved. I am currently not in any pain at all, like it’s not there unless I sqeeze the lateral nail fold against the nail. I am currently taking Clindamycin and it’s my 4th day taking them. My concern is that I am not seeing any puss/abcess and not feeling any pain, but the swelling and the dark pinkish color is still not going away. Would like to ask an advice if this is normal and what I should and should not do. Thank you for your service.

    • James Hubbard, MD, MPH

      I can’t give specific advice without seeing you as a patient. But, in general, not all infected wounds have evident pus, especially drainage. They just get better. And, usually the only reason to worry about no pain is if you have decreased feeling in your toes (such as with diabetes) and you can’t use pain as an indicator of injury. Certainly if pain were there initially and now gone, that’s a good sign. Hopefully your doctor gave you a time to follow up (3 days? a week? 2 weeks?) if you were still having symptoms or before if you started getting worse.

      • Rev

        Oh, thanks for that helpful information. The slightly numb ones are the pinkish portion of my toe. I can still feel them, but normally like I use to since it’s a numb feeling. I hope this one will come back to normal. I think I don’t have diabetes (I hope), I got my annual physical exam last month and my blood sugar is normal. Yes, our office doctor gave me two weeks. Will get back to him Friday next week. Hopefully my toe is cleared of any risk of ingrown, or else, he said that he has no choice but to remove the entire nail. I went and pulled out a small pointed nail at the side that is sticked inside the flesh in my lateral nail fold. Removing it gave me a relief since the stinging pain I am experiencing when I press the left side of my toe is now gone. I think because the flesh is not pushing itself to a nail anymore. Do you think I have chances for my ingrown issue to be cleared? Thanks again for your service.

    • Rev

      and the yellowish part are remains of betadine :)

    • Rev

      Please note that the swollen part of my big toe are just the top part. My toe ‘sole’ and the half-bottom of the toe is not swollen.