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christos kasparis
christos kasparis, Board Certified Dermatologist
Category: Dermatology
Satisfied Customers: 99
Experience:  MBChB, MRCP, FRCP (Lon)
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Looking for a second opinion. ive noticed that my big toe on

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Hi, looking for a second opinion. ive noticed that my big toe on the right side of my left foot has been inflammed and red from Saturday evening. Its tender and painful to the touch. Since Sunday I've been using hydrocortisone 1% cream on it (2 applications only) and on monday morning it appears to be more red and has pus secreting from my toe in two areas .Please see pics. What is this called and what would you advise me to use/do and potential causes. Thank you.
First pic day 2
Second pic day 3
Third pic the natural nail
Fourth pic (day 4, today)

Hello my name is***** a UK-trained Consultant Dermatologist with vast experience.I am reviewing your question and I will reply in a moment.

Please let me know if you still require an opinion on this

Customer: replied 4 days ago.
Thank you, ***** ***** require an opinion on this
Not a problem just typing my answer

I can see on the photos what you describe, there is redness and swelling on the skin adjacent to your nail. This is called acute paronychia. There is also pus coming out as you mentioned suggestive of a bacterial infection. We have lots of bacteria just sitting on the skin but at times they can penetrate underneath and cause an infection. It looks pretty localised. My advice would be:

1. Stop the hydrocortisone cream. Although this is a mild steroid , it should not be used in cases of infection at least initially.

2. You can buy 2% Fucidin cream over the counter and apply it to the affected area twice daily for 7 days.

3. I would also advise using a good antiseptic wash called hibiscrub , once a day for 10-14 days , this will cleanse any bacteria from the skin. If it dries the skin then you can apply a moisturizing cream. Again over the counter or order it online.

4. If the redness started to significantly spread and there is more pus production, you would need a course of antibiotics by mouth from your GP.

In general acute paronychia settles down within 7-10 days with the right treatment. Let me know if any questions. Some info below

https://dermnetnz.org/topics/paronychia/

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Customer: replied 4 days ago.
Thank you.

My pleasure, thanks for the feedback

Customer: replied 4 days ago.
Sorry, one more question. As I won't be able to get hold of the items today, could i use savlon in the meantime.

Yes please do it will help a little , at least contain it

Customer: replied 4 days ago.
Thanks, ***** ***** best