The last time I got my nails done, the manicurist wanted to trim my cuticles or least push them back. I said no! Though she meant to make my nails look nicer, fiddling with cuticles sets the stage for paronychia, an infection of the skin around the nails.

I discussed the importance of cuticles with Neal B. Schultz, MD, an assistant clinical professor of dermatology at Mount Sinai School of Medicine. He said that while most people think of a cuticle as just dead skin, its function is to seal the nail to the skin. When you cut a cuticle, you effectively cut your skin (even though, as when a callus is removed, it does not bleed)… and when you push back a cuticle, you separate the skin from the nail. Either way, you leave an opening for various types of germs to enter. Potential result: Painful, red, swollen areas of skin around the nails that leave fingers looking far from lovely.

When caused by bacteria, a paronychial infection is acute and its symptoms, which usually include pus, arise within one to three days. This type of infection can be treated with an oral antibiotic suitable for staph or strep… and it will get better faster, Dr. Schultz noted, if your dermatologist or primary care doctor also drains any pus.

When caused by yeast (typically the same Candida yeast that causes vaginal infections), a paronychial infection is chronic and “smolders” for weeks to months, Dr. Schultz said, though it will not form pus. Common error: If you mistake yeast for a bacterial infection and try to treat it yourself with over-the-counter antibacterial ointment, you only feed the yeast by trapping moisture in the nail bed. What is needed instead is a topical prescription anti-yeast medication, such as nystatin. Though a yeast infection takes months to cure, you should see improvement within a few weeks. As an alternative, you can try nonprescription clotrimazole (Lotrimin)—but this may work more slowly than nystatin.

Day-to-day care of healthy cuticles: If a bit of skin is sticking up from a cuticle, there is no harm in trimming that, Dr. Schultz said. Or if one section of cuticle has grown over a larger than normal portion of nail, it is safe to trim that excess—but only if you leave at least 1/16 of an inch of cuticle next to the skin and take care not to destroy the seal between the skin and the nail.

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