What to do when nothing works for whitlow

It usually begins with a slight pain, redness and swelling close to a nail. In a matter of hours or days, a pus-filled blister surfaces accompanied by a throbbing excruciating pain that could deprive one of sleep.
When you share your pains and discomfort with people around you, all kinds of suggestions emerge as to how to treat it and you are left in a dilemma. What then should you do?
What it is
Dr Paul Adebayo said “what we usually refer to as whitlow is known as paronychia in medical terms. It is an infection of the edge of the fingernail or sometimes toenail. It is actually a very common infection but if not properly handled, it can lead to more severe infection.”
Cause
It can be caused by bacteria or fungi. Certain people are more predisposed to contracting it from a fungal source. Dr Adebayo said, “Those who already have a fungal nail infection, those who suffer from diabetes and those who put their hands in water a lot have a higher chances of fungal paronychia infection. In the case of bacterial paronychia, the culprit is the staphylococci. When there is trauma to the skin in the nail area, maybe from nail biting, finger sucking, biting off or picking a hangnail or from trimming or pushing back the cuticle, there is a chance of the staphylococci bacteria entering the broken skin and causing infection. When it occurs suddenly, it is called acute paronychia and is usually caused by bacteria. On the other hand, when it occurs gradually and more slowly, it is called chronic paronychia and is usually caused by fungi.” 
How safe and effective are home remedies?
In this part of the world, several home remedies have been in circulation claiming to treat whitlow. Some of them include putting the infected finger in either very hot water, bleach, petrol, battery acid or petrol. Some go as far as suggesting using a pin to rupture the boil so as to drain pus. While most people feel comfortable and actually prefer home remedies before visiting the hospital, medical experts say it may be the best for one who is infected to go to a hospital for a possible incision and drainage of the pus and proper prescription of medication. “Some of these so-called remedies can cause more complications and lead to severe infections. Immersing the finger, whether infected or not, in something as corrosive as battery acid is obviously not a smart decision. Using needles and pins at home can introduce more microorganisms and even cause more complications. But because people are looking for relief, they may want to go to any length. Some also self-medicate on antibiotics, but this is wrong because you are yet to know if the cause is bacterial or fungal. And abusing antibiotics has its numerous adverse effects. The best thing is to see your doctor.” 
Treatment
Paronychia usually responds well to treatment when properly done. Depending on the type, bacterial or fungal medication may be prescribed. If an abscess has developed, incision and drainage would be performed. To speed up healing, the hands must be kept clean and dry. One should avoid wet work or use totally waterproof gloves with a cotton liner. 
Prevention
To prevent paronychia, the United States of America’s National Institutes of Health recommend
Proper care for the nails and the skin around the nails.
Avoid damaging the nails or fingertips. Because the nails grow slowly, an injury can last for months.
Do not bite or pick the nails.
Protect the nails from exposure to detergents and chemicals by using rubber or plastic gloves. Gloves with cotton liners are best.
Bring your own manicure tools to nail salons.
To minimise the risk of damage to the nails:
Keep the nails smooth and trim them weekly.
Trim the toenails about once a month.
Use sharp manicure scissors or clippers for trimming fingernails and toenails, and an emery board for smoothing the edges.
Trim nails after bathing, when they are softer.
Trim fingernails with a slightly rounded edge. Trim toenails straight across and do not cut them too short.
Do not trim cuticles or use cuticle removers. Cuticle removers can damage the skin around the nail. Trimming the cuticle damages the skin at the base of the nail. This can allow germs to enter, which can lead to infection.

Reference:

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