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.

  • 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.

    • http://thesurvivaldoctor.com/ 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

    • http://thesurvivaldoctor.com/ 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.

    • http://thesurvivaldoctor.com/ 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

    • http://thesurvivaldoctor.com/ 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.

  • Tracy

    5 years ago I got a infection from a manicure. It swelled up & turned dark red & black. It seems to be coming back. Swollen tender red tip with a little black under the nail. No blisters

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sounds like you need to have it checked out.

  • harfe

    hello! two weeks ago i cut my hand pretty deeply, and went to the hospital and got it stitched up. all is well but today i noticed the skin around the cut turned yellow and it feels sort of tender with a bit of pain to the touch. not really all that painful, but i can see something that i recognise as pus underneath the skin and around the sutures… it’s kind of swollen too… do i need to go see a doctor asap

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sounds like it should be checked out. By the way, usually you’ve gone back to get the stitches out within 2 weeks anyway.

      • harfe

        my appointment is in a few days actually… thank you!

  • Janice Macon

    Here is a pic

  • Latrice

    I pulled a hangnail and its been sore and swollen for 2 weeks now….what should I do?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      See a doctor.

      • Janice Macon

        From the looks of the pic does it look bad to you? What do u think the doctor will do?

  • Donna

    Hi. I was diagnosed with an infection under my thumb nail. I was give two courses of antibiotics three weeks ago and then after the courses had finished my doctor drilled several holes in my nail. The nail has fallen off and all infection has disappeared. However for the last three days my thumb has been getting more and more swollen. It is only painful when pressure is applied, there is no sign of infection however the thumb is very swollen, red and is limited in its movement. Do you think this is just inflammation that will subside or do you think I need to go back to the doctors as there maybe something more sinister going on? Thanks

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      go back to have it rechecked.

  • kaley

    This is what my finger looks like after i popped it and soaked it in proccide. Is this normal?