Clinical Cases

Acute Paronychia

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Homeopath Lily Samardzic-Rafik presents a brief case of Acute Paronychia.

Paronychia is an often tender infection or inflammation around the base of the nail fold. It can start suddenly (acute paronychia) or gradually (chronic paronychia).

Acute paronychia develops over a few hours when a nail fold becomes painful, red and swollen, due to some form of injury (ie. biting nails, cutting cuticles. ) Yellow pus may appear under the cuticle. It is usually due to “Staph” bacteria germs. Mild cases can be treated with soaks and antibiotic cream, but most cases are treated with oral antibiotics. Sometimes an abscess (a pocket of trapped pus) forms and has to be incised.

Here you will find an acute case of Paronychia, treated with homeopathy alone, resolving in a few days.

After cutting back at the cuticle, the area seemed to become infected the next day. the patient waited a couple days but it seemed to be getting worse. The area was very painful and hot, pulsating and ameliorated by cold. The appearance was shiny, red, inflamed and puffy as in the photo.


RX: BELLADONNA 1M, 2 pills dry under tongue

Next day there was not much change. Thearea was still painful but there was no pulsating sensation. It was very sensitive to touch. In Paronychia, there is pus that is trapped and needs an outlet. There is no suppuration here. Either we want to suppurate or we want the body to abort suppuration and absorb the pus. I chose the second option, to absorb the pus. Thus the choice for Hepar 1M. If we wanted to suppurate we would choose a lower potency , perhaps 5c – 9 c.


Keynotes: suppuration, sensitive to touch, abscesses

HEPAR SULFUR 1M , 1 pill in 125 ml water. Take 1 tsp, 4-6 times daily.

The area started to ameliorate slowly and 4 days later the swelling had completely resided. The finger had no pain and was back to normal except that the skin started to peel where the abscess was.


At this point not much else needed to be done (perhaps some calendula cream to help the skin to heal quicker) and we can let the body do its work.

The patient could go back to her constitutional treatment, which was Lachesis ( complementary to Hepar) .

About the author

Lily Samardzic-Rafik

Lily Samardzic-Rafik, DiHom (Pract), MSc Hom Med, has been in private practice since 2009 in Casablanca , Morocco. She is a classically trained homeopath who graduated from the British Institute of Homeopathy Ireland and has a Masters in Science in Homeopathic Medicine. Visit Lily at her website:

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