A painful, red nail fold

Nail-fold pain may be caused by inflammation or the way the nail is growing. I examine the nail and assess which local treatment or procedure is suitable.

Common causes

Redness around a nail does not always mean the same problem

Ingrown nail edge

The side of the nail presses into the skin and causes pain, swelling or granulation tissue.

Paronychia

Inflammation or infection can follow a small skin break, nail treatment or persistent moisture.

Retronychia

A new nail grows beneath the old plate and pushes at the nail base, often causing persistent proximal swelling and pain.

Trauma or pressure

An impact, tight footwear or repeated loading can damage the nail without a primary bacterial infection.

Examination

The nail plate and surrounding tissue are assessed together

I examine where the pressure comes from, whether there is pus or an abscess, whether the nail is detached or layered, and whether inflammation is spreading. Diabetes, circulation, immunosuppressive treatment and previous procedures are also relevant.

Treatment options

Treatment may be local, or the problematic part of the nail may be removed

Local care

Reducing pressure, protecting the area and improving footwear may be enough in a mild case.

Drainage

A clear collection of pus needs drainage; antibiotics alone do not empty an abscess.

Partial nail removal

A repeatedly ingrown edge can be removed under local anaesthetic. The growth area may be treated to reduce recurrence.

Complete nail removal

This is needed less often, for example in selected cases of retronychia or extensive nail damage.

Antibiotics are useful when the findings fit spreading bacterial infection or another clinical indication. They do not remove mechanical pressure from the nail.

Seek faster assessment

Spreading redness, fever or rapidly worsening pain need prompt review

Call Medical Helpline 116117 if redness is spreading quickly, pain is clearly worsening, you develop fever or there is a large collection of pus. Seek assessment earlier if you have diabetes, severe circulation problems or significant immunosuppression.

Booking notes

Tell me which nail is affected and whether the problem is recurring

duration and whether this is the first or a recurrent episode
pus, fever, trauma or detachment of the nail
diabetes, circulation problems, blood-thinning medication and major allergies
whether you hope a possible nail procedure can be assessed during the same visit

Sources

What this page is based on

Website content: Markus Huotari, general practitioner. The sources below provide background information.

Page updated 8 September 2026 · Markus Huotari website