Pain Under the Nail: Causes and When to Seek Help - Dermatology

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Pain under the nail, particularly in the area where the nail meets the skin, can be caused by several factors, and understanding the underlying cause is essential for effective treatment. Given that you have been experiencing this pain for over a month, it is important to consider a few potential causes and when to seek medical help.


Possible Causes of Pain Under the Nail
1. Nail Trauma: One of the most common causes of pain under the nail is trauma. This could be due to an injury, such as hitting your finger against a hard surface or even repetitive stress from activities like typing or playing an instrument. If you have recently experienced any trauma to your finger, this could explain the pain.

2. Nail Fungus: Fungal infections can cause pain and discomfort under the nail. This is often accompanied by discoloration, thickening of the nail, or a foul odor. If you notice any of these symptoms, it may indicate a fungal infection.

3. Ingrown Nails: An ingrown nail occurs when the edge of the nail grows into the surrounding skin, leading to pain, redness, and swelling. This condition can be quite painful and may require medical intervention if it becomes infected.

4. Paronychia: This is an infection of the skin around the nail, often caused by bacteria or fungi. Symptoms include redness, swelling, and pain, and it can sometimes lead to pus formation. If you notice any signs of infection, such as increased redness or discharge, it is essential to seek medical attention.

5. Subungual Hematoma: This occurs when blood collects under the nail due to trauma, leading to significant pain and discoloration. If the pain is severe and the nail appears dark, this could be the cause.

6. Psoriasis or Other Skin Conditions: Conditions like psoriasis can affect the nails and cause pain and discomfort. If you have a history of skin conditions, this could be a contributing factor.


When to Seek Help
Given that your pain has persisted for over a month, it is advisable to seek medical attention. You should consider visiting a healthcare provider, specifically a dermatologist or a podiatrist, who specializes in nail and skin conditions. They can perform a thorough examination, possibly including imaging studies if necessary, to determine the exact cause of your pain.


What to Expect During Your Visit
During your appointment, the doctor will likely ask about your symptoms, including when the pain started, any associated symptoms (like swelling or discoloration), and any history of trauma. They may perform a physical examination of your finger and nail, and if an infection is suspected, they might take a sample for laboratory analysis.


Treatment Options
Treatment will depend on the underlying cause of your pain. If it is due to an infection, antibiotics or antifungal medications may be prescribed. For ingrown nails, the doctor may need to perform a minor procedure to relieve the pressure and pain. In cases of trauma or hematoma, they may need to drain the blood if it is causing significant discomfort.


Conclusion
Pain under the nail can be caused by various conditions, and since your symptoms have persisted for over a month, it is crucial to seek medical advice. Early intervention can prevent complications and lead to a more effective treatment plan. Remember, it is always better to err on the side of caution when it comes to persistent pain.