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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  • 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.

  • Stephanie

    Thank you for this article! Besides bandaging and keeping clean I also did warm soaks as you mention. Within a day a white area formed on side of nail. I used sterilized safety needle, poked near side of nail bed, and pus came out. I was shocked! I’ve never had this happen. Today it feels so much better – less swollen and painful.

    • James Hubbard, MD, MPH

      Glad it helped.

  • bruce

    i have had surgery to remove the paronychia from my finger and now is in a dressing and on antibiotics. Can i smoke while in recover mode?

    • James Hubbard, MD, MPH

      Smoking is never a good idea, and it delays healing. But, for your specific case, check with your doctor.

  • adeel

    Hi there ive got a swollen red finger next to the nail for three weeks, it feels something inside to draw out. Ive bought magnesium sulphate paste can this help?

    • James Hubbard, MD, MPH

      I assume we’re basically talking Epsom Salts. Some probably swear by it for infections. I know of no studies that back that up. At this point, 3 weeks, it sounds like you should have it checked to see if you need antibiotics.

  • Molly

    My finger has been like this for the past 2 days almost. It does hurt if I were to apply pressure to it. What do you think I should do?

    • James Hubbard, MD, MPH

      I can’t specifically tell you what do. Did you read the part of the post about paronychia?

  • Sonya

    My nail started hurting a couple weeks ago . Cut the hang nail, waited about a week. It got worse so I cut about an 1/8 of the nail. Squeezed but blood only came out. The nail bed has a red bump on it. Very painful, throbbing. I’m soaking in Epson salt warm water. How long should I wait before I have to go to the dr.?

    • James Hubbard, MD, MPH

      Sounds like it’s time to make an appt.

  • Alex

    Hi Doc – I had a cold for the past 4-5 days, and yesterday this white spot appeared on the tip of my forefinger. It’s bigger today than it was yesterday (I just took this photo) and it hurts when I touch it or type with it. I’m trying to figure out if it’s an infection from the cold, or an unrelated blister or something. Your thoughts? Thanks in advance.

    • james caldwell

      My thumb is killing me it swollen so bad it’s been this way for 3 days now it unbearable it is hurting so bad what can I do or take for pain until I get to doc and it burns to idk what to do it hurts

      • James Hubbard, MD, MPH

        Keep it heart level or above and call your doctor. He/she should be able to see you today or tell you where to go. If you don’t have a doctor, go to an urgent care.

    • James Hubbard, MD, MPH

      A cold doesn’t cause skin infections. Sorry, but I can’t diagnose specifically without an exam. All I can suggest is read the general information in the post and, if it gets worse or is painful, or you have concerns, see a healthcare provider.

  • Allan March

    I have had a diagnosed paronychia starting Jan 4 (10 days ago) I have been to urgent care twice in last 3 days. On Jan 11, started me on Cephalexin 500 Mg 3 x daily. Soak in warm water with Epson Salt 3 x daily, otc antibiotic ointment. Very painful, swollen and black under nail and at thumb pad. Has not improved in past 3 days with this treatment. Any ideas on if I should stay the course, wait or be re evaluated

    • James Hubbard, MD, MPH

      In general, I usually give someone a good 72 hours before considering another antibiotic or before if the problem starts looking worse. You say it’s black under the nail so If you go back, ask if they think they could make a hole in the nail and drain some fluid off. I really couldn’t say without a direct exam.

  • Crystal Lynn Davis

    My 3yr old bites her finger&toe nails. The one of her index fingers and one of the second toes on her foot are infected. They look similar to the picture Hope posted. Currently I’m putting peroxide, triple antibiotic, and a band-aid on both. With her being 3yrs old do you think I should go ahead and make her an appointment with her Pediatrician or continue with my cycle? Her toe looks like it may gave blistered up over night and popped but it’s still bright red, heated, and swollen.

    • James Hubbard, MD, MPH

      Sounds like she should be seen. Or call the pediatrician’s office and ask what they think.

  • Flaming Boobie

    Hi there, am hoping you might help. I developed a VERY sudden thumb infection – a felon, it seems – while en route to a different city. Swollen, hot, red and beyond painful. Went to ER, where the MD froze my hand and inserted needles in thumb pad to see if pus came out. None emerged, I was told; only blood. She prescribed me Bactrim for 7 days, which helped to a degree, put there is still a slight swell, some warmth & tenderness. Have gone to 2 clinics since finishing the Bactrim 3 days ago with concerns that the antibiotic was not enough and that perhaps I need drainage. Both clinic MDs seem to think that all I need is more Bactrim, but that doesn’t seem right. At this point shouldn’t my thumb be back to normal if drainage was not necessary?
    Am also going on a trip out of country for a week this coming Tuesday, so am quite nervous as to what may become of my thumb while away, so perhaps you might recommend some precautions I might take before leaving? I’ve been given a script for Bactrim to take with me, but I don’t want to keep plying my system with antibiotics just to keep an infection at bay. Thanks v much in advance

    • James Hubbard, MD, MPH

      I’d follow up with the ER to see if the blood was cultured. If it was, they can tell you what sort of bacteria grew out and which antibiotic is best to kill it. Otherwise, I’d go back to one of the clinics you’ve already been to, or check with your family doctor about the next step.