Green Nail Syndrome

Green Nail Syndrome is an inflammation of the skin around the nail (paronychia) caused by an infection with Pseudomonas aeruginosa, a bacterium. It can develop in individuals whose hands or feet are frequently submerged in water, detergents or damp soil. The bacteria grow and multiply rapidly in moist environments such as sinks, swimming pools, and sponges.

As indicated by the name of this syndrome, the most common symptom of Green Nail Syndrome is the discolouration of the infected nail as it turns a dark green colour, due to the bacteria secreting the green pigments pyoverdine and pyocyanine. The patient can also suffer from tenderness surrounding the infected nail along with redness and swelling.

Normally, the seal between the nail and finger acts as a physical barrier to prevent this kind of infection, however hyper-hydration or damage to the epidermis can impair the barrier, allowing the colonisation of the bacteria.

Treatment for Green Nail Syndrome varies greatly depending on the severity of the infection and the length of time it has been present. The least invasive treatment includes soaking the nail in alcohol or vinagar and regularly trimming the nail back, in order to dry out the area and prevent further bacterial colonisation.

For moderate cases of Green Nail Syndrome topical antibiotics (silver sulfadiazine, gentamicin, ciprofloxacin, bacitracin and polymyxin B) or oral antibiotics (ciprofloxacin) are prescribed. In severe cases, surgical removal of the infected nail may be required.