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.

  • Ricky Rodriguez

    Two weeks ago, I slammed my finger between the car door. I popped it with a pin to release the blood. My finger is now swollen. Is my finger nail infected and will it fall off?

  • Robert Braddock

    The area around cuticle is red and swolen but painless. Fingernail bordering the cuticle is also red. Just noticed this.

  • Vicky Ring

    So in the last three weeks my husband and I both had a infected finger which we started antibiotics for and now my daughter has the same. Could there be any relation?

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

      Sure. Maybe staph. If it recurs it may need to be cultured to make sure it’s not MRSA.

  • Glenn

    I had a badly infected finger that was lanced. It was so bad the doctor had to make two cuts with a small razor to get all the pus out. It has been a week since then, and it is still slightly swollen and the cut has not fully healed. Is this normal?

    It currently looks like this after 6 days

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

      It’s not unusual for a wound to take more than a week to heal but usually I’d ask a patient to come back for a follow up.

      • Glenn

        Thanks a lot. It has been a week now, and the main problem is the pad of the finger is still slightly swollen and sensitive. The only worry is I had the lancing done 3 days before leaving the country to work abroad, so now I have to find a doctor overseas.
        A bit worried because the doctor originally said it was one of the worst he had seen, and a week more (Before it was lanced) and I could have lost circulation in my finger and had to have it removed.
        Is there any chance the lancing may have left my finger still infected? Any chance I could still lose it?

        Thanks again for your help.

        • Glenn

          Also the skin around the nail and finger is peeling off. But nail is slightly yellow. Is this a good or bad sign

          • Glenn

            So now looks like this. The skin is a lot further away from the start of the nail/cuticle

  • Vicky D.

    Hi
    I got an infection after I pulled out a small loose piece of nail on the side of my thumb. It’s been over 2 weeks, at one stage it seemed to get better after I started using antiseptic cream, but not quite, and then I had to do some gardening on the weekend, it got worse again. I seems like it’s under the skin, no blister but red tender swelling. I’ve been now soaking for two days with no change – no localization or while spot. Could you explain how exactly the soaking works? I am skeptical and maybe this is sabotaging my healing. Thanks

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

      Heat dilates the blood vessels increasing the blood supply, and the antibodies and white blood cells it brings with it. Warm soaks ensure the heat comes in contact with more skin surface.

  • 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??

    • http://thesurvivaldoctor.com/ 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…

    • http://thesurvivaldoctor.com/ 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.