When Paronychia Needs More: Understanding Surgical Interventions
Published: Oct 13, 2023

Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on October 13th, 2023.
While most cases of paronychia can be treated with conservative methods, sometimes surgery becomes necessary. Let's explore when and why surgical procedures might be needed for paronychia.
Contents
Draining the Abscess: A Common First Step
The most common surgical procedure for paronychia is abscess drainage. This is typically done when pus has collected under the skin. Your doctor will use a sterile needle or scalpel to make a small incision, allowing the pus to drain. This procedure is usually quick, done under local anesthesia, and provides immediate relief from pain and pressure.
Partial Nail Removal: When the Nail is the Problem
In some cases, especially with ingrown toenails, part of the nail may need to be removed. This procedure, called partial nail avulsion, involves removing the portion of the nail that's digging into the skin. It's often combined with a technique to prevent that part of the nail from growing back, reducing the risk of recurrence.

Advanced Techniques for Chronic Cases
For chronic paronychia that doesn't respond to other treatments, more extensive surgeries might be considered. One such procedure is the 'en bloc excision,' which involves removing a crescent-shaped piece of the nail fold. Another option is the 'square flap technique,' which removes only the thickened, fibrotic tissue while preserving healthy skin.
Frequently Asked Questions
Local anesthesia makes the procedure itself painless.
Most people can resume normal activities within a few days.
Minimal scarring is possible, but usually not noticeable.
It's possible, but proper aftercare reduces this risk.
Key Takeaways
While surgery isn't always necessary for paronychia, it can provide rapid relief and long-term resolution in stubborn cases.
Wondering if surgical intervention might be right for your paronychia? Consult with Doctronic to explore your options and get expert advice.