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Skin Care and Diseases

MRSA finger infection & nail loss

08/23/2006

Question:

I was recently diagnosed with a CA-MRSA cellulitis of my fingertip. I am currently taking Bactrim DS 2X a day for 14 days, and it seems to be healing. 1/3 of the nail had detached, 1/3 was surgically removed (pre-cellulitis), and the last 1/3 is detaching. Still some redness & swelling, but lessening daily.

Once the infection is cleared, is there anything I can do to encourage normal nail regeneration? Would a film barrier type bandage (like Tegaderm) make any difference?

Answer:

Unfortunately there is no way to guarantee regrowth of your nail.  The infection you have is very severe and may partially or totally destroy the growing nail matrix so the nail may not return. Although typically fragments of the matrix survive, and you may have a distorted nail.  We can hope for the best. 

With your nail gone, the nail bed will produce a pseudo-nail which is thickening of the nailbed surface.  It will be partially protected and will come off as the new nail grows in.  I would wear a very loose-fitting protective bandage until that pseudo-nail forms.  Please do not occlude it as this tends to macerate the covered area.  I have no experience with Tegaderm in this kind of situation, although it does work well in ulcers on other parts of the body.  I would suggest that you check with your board certified dermatologist who can examine your finger and see how badly the growing surface was damaged and advise you on protective finger wrap.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati