Inflammation of the nail bed on the toe


If the nail bed is inflamed (Panaritium) an inflammation of the nail fold occurs, which can spread to the entire nail bed and the surrounding structures. The inflammation is caused by the immigration of pathogens, which mainly occur via small tears in the skin (Rhagades) can immigrate.

The spectrum of pathogens is mostly bacterial staphylococci or streptococci, but nail bed inflammation can also occur due to a fungal infection or an infection with the herpes virus.

The symptoms

Usually you notice an inflammation of the nail bed on the toe due to an increased sensitivity to pain in the affected toe. The affected toe is usually very red, swollen and overheated.

The pain is often perceived as pulsating. The entire inflammation usually begins with the inflammation of the nail wall (Paronychia) and then progresses as inflammation of the nail bed (Panaritium subungunale). At this stage you can usually see a pus blister under the nail or in the nail wall.

If the nail bed inflammation is not treated, it can spread to the adjacent tissue (Panaritium subcutaneous). In very severe cases, this superficial form of the can continue and lead to a detachment of the upper skin layer (Panaritium cutaneum). Here you can see blistered swellings of the skin. The forms of nail bed inflammation enumerated up to now are the superficial forms, which are to be distinguished from the deep forms.

The deep forms occur when the inflammation can advance freely into the surrounding tissue. This shape can spread to the bone (Panaritium ossale) or on the tendons (Panaritium tendinosum). The inflammation can also spread to the toe joints (Panaritium articular).
General signs of inflammation such as fever and chills only appear when the nail bed inflammation is very advanced.

The pain can also be the cause of problems walking in the lighter, superficial forms.

Find out more about the topic here: Inflammation of the nail bed

Pus as a symptom

Pus results from inflammation caused by bacteria. The body reacts to the pathogens with cells of the immune system that kill the bacteria. The pus consists of decomposed bacteria and dead defense cells. Therefore, the symptom of pus associated with nail bed inflammation on the toe is a sign of a bacterial cause.
It is important that the pus can drain well in the event of an inflammation so that it can heal.

If pus forms under the nail plate, drainage through it may be impeded. In such a case, a small surgical procedure must be performed to create a way for the pus to drain. This can be done either by drilling a hole or by removing part of the nail plate under local anesthesia.

Wild meat as a symptom

Wild meat (known medically as granulation tissue) is created when open wounds heal.

In the case of nail bed inflammation on the toe, for example, an ingrown toenail can lead to constant damage to the surrounding tissue. As a result, germs such as bacteria or fungi repeatedly invade, so that chronic inflammation with open areas can develop. In the area of ​​these open areas, the body forms wild flesh.

Actually, it is an intermediate stage of wound healing, but the chronic inflammation does not overcome it.

Special features of the nail bed inflammation on the big toe

In principle, all toes or fingers can be affected by nail bed inflammation. A special feature of the big toe is that the nail plate grows the slowest there due to its size.

As a result, germs such as fungi or bacteria can settle in there best and, on the other hand, it can take significantly longer for an inflammation of the nail bed to heal. This is especially true if part or even all of the nail had to be removed. It can take over six months for the nail plate to grow back.


As a rule, a visual diagnosis is sufficient for the superficial forms; the patient's information is very important here, as only the patient himself perceives the pain and can therefore describe it.

In the case of deeper inflammation of the nail bed, an examination of the blood can also be useful. If the inflammation continues to spread throughout the body, it will cause the rate of blood flow to increase (BSG) and C-reactive protein (CRP value). These values, however, are not specific examinations in the case of nail bed inflammation, but general inflammation parameters that are increased with every generalized inflammation. If the inflammation has already reached the bone or joint, an X-ray image shows that the affected joint space has enlarged.

Which doctor treats nail bed inflammation on the toe?

In the case of nail bed inflammation on the toe, the family doctor should usually be the first point of contact. In the case of simple findings, the doctor can often carry out the treatment and, if necessary, control himself. If the inflammation is more severe and requires special therapy, the family doctor can refer you to a resident surgeon or a dermatologist (Dermatologist) issue.

Treatment of nail bed inflammation on the toe

In the deeper and rarer forms of nail bed inflammation, you should definitely consult a doctor. This can surgically remove the inflammation of the nail bed (Debridement) and prescribe an antibiotic if necessary. In the deeper forms of nail bed inflammation, intravenous administration of an antibiotic can also be considered in order to avoid further spread of the pathogen. It is important here that antibiotics only work, of course, if the trigger of the nail bed inflammation is a bacterium. If it is a fungal infection, fungicidal agents (Antifungal drugs) are given. However, if it is an infection with the herpes virus, antiviral drugs such as acyclovir (Aciclobeta®, Zovirax®) should be given.

Depending on the stage and the pain, immobilizing the foot for a certain period of time can be useful and necessary for recovery.

Read more on the topic: Treatment of inflammation of the nail bed

Which ointments can help?

Various ointments can help with inflammation of the nail bed. These can be divided into three groups according to their effect.

On the one hand, there are those with anti-inflammatory effects that contain either pain relievers or herbal ingredients such as arnica. They serve to reduce symptoms such as pain and swelling and are intended to promote the healing process.

The so-called pull ointments have a different effect. These accelerate the maturation of a purulent nail bed inflammation so that the pus can drain away more quickly.
The third type of ointment that can help with nail bed inflammation on the toe are those with a direct active ingredient against germs. These types of ointments usually need to be prescribed by a doctor and should only be used on the advice of a doctor.

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  • Pull ointments
  • Betaisodona® solution


Treatment with homeopathic remedies can be tried in the case of mild inflammation of the nail bed. The choice of preparation depends on the type of symptoms.

  • In the case of throbbing pain, a hot bed of nails and slight reddening, globules with belladonna should be taken.
  • Apis mellifica is recommended for more sharp pain and a bright red and swollen nail bed.
  • In the case of sharp pain and the onset of suppuration, Hepar sulfuris can be taken.

However, for these symptoms, conventional medical treatment through surgical relief may be indicated. In general, an inflammation of the nail bed on the toe should no longer be treated with homeopathy alone if the inflammation does not subside after several days, a lot of pus forms, there is severe pain or the general condition deteriorates. In such a case, a doctor should be consulted immediately.

Which home remedies can help?

In the case of mild inflammation of the nail bed, various home remedies can be used to relieve discomfort and accelerate healing.

These are mainly herbal products that have an anti-inflammatory or germicidal effect. For example, preparations made from arnica, onion extract or horseradish are suitable. Another common home remedy is tea tree oil, which can be applied undiluted to the inflamed area several times a day. A bathtub with a warm chamomile bath, in which the foot is held for about ten minutes, is also suitable.

If the inflammation continues to increase, causes severe pain or pus forms, treatment with home remedies alone is no longer indicated. Instead, you should consult a doctor early on.

Tea tree oil

Tea tree oil is a popular home remedy that can be used to treat a wide variety of inflammatory skin conditions. It has a germicidal effect and can be applied thinly to the affected toe if there is inflammation of the nail bed. The application should then take place twice a day. In rare cases the skin reacts irritably to the tea tree oil. If there is an increase in pain or burning sensation, the oil should be washed off and no longer used.

If the inflammation of the nail bed does not subside after a few days or if the symptoms increase, a doctor's visit is also indicated.

Read more about the Effect of Tea tree oil

When do you need an operation?

An operation for a nail bed inflammation on the toe is necessary, for example, if a pus focus has formed. Depending on the extent, the doctor must drill an opening in the nail under local anesthesia, remove part or all of the nail plate so that the pus can drain off properly. A bandage is then applied.

The toe needs to be examined and the bandage replaced at regular intervals. This can usually be done in the doctor's office. Even if the procedure sounds easy, you should never try to open the pus in a nail bed yourself. This can otherwise lead to the spread of germs into deeper tissue layers.

Surgery may also be necessary if the nail bed inflammation is caused by an ingrown toenail. In such a case, the nail plate is reduced in size during the procedure. In extreme and advanced cases, inflammation of the nail bed can spread to the bone. Then a more extensive surgical procedure must be carried out. In the worst case, the toe has to be amputated. However, such courses are very rare.

Find out more about the topic here: Surgery for a nail bed inflammation

Duration of nail bed inflammation

The duration of an inflammation of the nail bed on the toe depends on the extent of the inflammation, the trigger and the time of the start of treatment.

An uncomplicated inflammation of the nail bed that is recognized and treated in good time usually heals within three days. However, if the disease is not recognized or treated, it can lead to a protracted inflammatory reaction which, in the worst case, can spread to other tissue structures such as tendons or bones.
The duration also depends on the circumstances and illnesses of the patient. A circulatory disorder in the feet and diabetes mellitus (diabetes) result in poor wound healing and an increased susceptibility to further inflammation. Direct and consistent treatment is therefore important for these patients in order to prevent a chronic course with consequential damage


As a good one prophylaxis has become a good one Nail and foot hygiene proven. Similar to athlete's foot, you should take care that you are in swimming pools and public showers Wear bathing shoesif you are prone to nail bed inflammation. Regular nail cutting also protects against certain parts of the nail bed inflammation, because it then does not cause the nails to tear minor injuries can come, which as a gateway for the Pathogens can serve. In addition, care should be taken to ensure that the nails do not grow in, because here too the surrounding tissue is unnecessarily irritated.

Risk factors

As with any other disease, there are also factors that promote the development of nail bed inflammation. People who have a weakened immune system are less able to defend themselves against pathogens and therefore suffer more often from nail bed inflammation.

A weakened immune system can have many reasons, some of which are the consequences of chemotherapy for cancer, hereditary immune deficiencies (SCID) or an infection with the HI virus.The affected people can not only suffer from increased nail bed inflammation, but also from many other infectious diseases.

Another predisposing factor, also for more severe forms, are neuropathies in the legs; these can be diabetic or directly neurological. The problem with neuropathies is that those affected not only have a reduced sense of vibration, but also a reduced sense of pain. This means that the superficial inflammation of the nail bed is only noticed later than in other people. This additional time for the pathogen in which it is not treated can mean that the inflammation can spread further. It is therefore particularly important for people who suffer from neuropathies to pay particular attention to their foot hygiene. If you no longer trust yourself in foot care alone in this situation, medical foot care can also be a good solution. Fortunately, consequential damage from nail bed inflammation is very rare.


In general, numbers are difficult to findin order to make an epidemiologically correct assessment of the occurrence of nail bed inflammation on the toe, since many people who suffer from a Inflammation of the nail bed suffer, do not go to the doctor, but treat them successfully yourself. It can be said, however, that the lighter, superficial forms, which are easy to treat, are more common than the more severe, deep forms, which also have consequential damage such as stiffness in the affected person joint may result. Due to the Pain When walking, the nail bed inflammation is usually recognized in the early stages, so it is quickly and effective treatment The disease does not even spread further.