Our Pueblo, Pueblo West, CO Podiatrists Can Help You With Toenail & Skin Problems
LASER THERAPY FOR TOENAIL FUNGUS
Have you ever met someone who kind of irritates you at first? Then later, as you get to know him, he sort of grows on you? It’s actually a pretty pleasant sensation when you realize that someone you previously disliked is now a good friend. It’s a shame that not all things that grow on you are equally nice.
Take lowly fungi, for example. They’re usually not too bad. In fact, fungi do a lot of work for us. Yeast helps ferment things and gives bread dough a nice lift, and mushrooms can be delicious in a salad or on a burger. But toenail fungus? Not such a good thing. In fact, it can be downright gross.
Toenail fungus is most often a mold-like fungus, and is usually caused by the same microorganism that causes athlete’s foot (an itching, burning infection of the skin). In fact, an attack of athlete’s foot may lead to an infection in the toenails.
Because fungi tend to thrive in moist, dark environments, you’re more likely to find them lurking where things are nice and damp, and where plenty of people are walking around, sharing their fungal infections with everyone. Swimming pools, locker rooms, and showers definitely fit the bill. You’re also more likely to develop a fungal infection if you tend to have sweaty feet (which keep your socks and footwear damp, thus providing an ideal environment for fungal growth). Wearing closed-in footwear (like men’s dress shoes or blocks of concrete), or having small injuries in your skin or nails may also make you more susceptible.
Fungal infections in your toenail may start off as a white or yellow spot at the tip of your nail. As the infection progresses, it will likely spread into the nail bed, causing your nail to become thickened or even distorted, discolored (usually yellow or brown), and sometimes kind of stinky. The edge of your nail may become crumbly or brittle, and the nail itself may lose its luster or shine, and you may also notice that debris begins accumulating under your nail, which may give it a dark color. Over time, your nail might also begin to loosen from the nail bed. (Plus, if you listen very closely, you may hear the faint, maniacal laughter of the fungus as it invades your body. It usually sounds something like: “Mwhahahahaha.”)
Fungal nails aren’t the only type of foot problem that can cause the above symptoms. That’s why it’s important to get an accurate diagnosis from your friendly neighborhood podiatrist. Of course, it’s always best when you go to see your doctor as soon as possible after experiencing symptoms. Unfortunately, fungal nail infections can go on for years without treatment. You might simply not notice it, or you might ignore the infection because it isn’t causing any immediate pain. Unfortunately, fungal nail infections tend to be more difficult to treat the longer they’re around, so visit your podiatrist sooner rather than later.
In order to make a firm diagnosis, your podiatrist will likely inspect your toenail and may take a scraping of the nail (which will be cultured or examined under a microscope) in order to find out whether or not you really have fungi growing on you.
They include topical medications, oral medications, which can have some serious side effects; and the newest modality which is laser therapy.
Laser therapy treatments have shown to improve unsightly toenails issues.
At Pueblo Ankle and Foot Care. we use laser therapy for fungal toenails which is the easy and convenient treatment that helps turn your discolored and disfigured nails into clearer, healthier looking nails.
- Painless treatment for onychomycosis
- No pain, no downtime, and no risk
- No more embarrassment about unsightly feet
If you're tired of looking at those unsightly toenails, please contact our practice, Pueblo Ankle and Foot Care, to determine if you are a candidate for laser therapy.
Toenails are generally pretty innocuous. They’re rarely threatening (except, of course, when toenail clippings fly across the room like tiny bits of organic shrapnel at slightly less than the speed of sound). Usually, toenails grow straight out, keeping a nice noninterference policy with the rest of the toe. There are times, however, when nails begin to turn on you. One or both of the sides or corners of the nail begin to curve downward into the toe, causing the skin around the nail to become irritated and painful. At times, the nail may even penetrate the skin, letting in bacteria that decide that the toe is a fabulous place to live (and these are guests you definitely don’t want to have around).
There are many possible causes or contributing factors for ingrown toenails. If you have a family history of malevolent nails, or if you have nails that already seem to curve down on the sides, you may be susceptible. Pressure on your toes from too-tight shoes or socks may also lead to ingrown toenails, as can trauma (like stubbing your toe on the corner of your bed in the middle of the night, dropping a brick on your foot, or kicking a soccer ball (or bowling ball, for that matter) a bit too hard). Certain nail conditions, such as fungal infections in your nail bed may also contribute.
Improper trimming of your toenails may also be a significant factor. Cutting nails too short (you should be able to get your fingernail under the sides and end of your newly trimmed toenail) or trimming down the sides of the nail (you should trim straight across) can lead to problems. Peeling or tearing the corners of the nail can also be harmful.
Oh. And keep in mind that, while ingrown toenails most commonly occur on the big toe, any toenail may be affected.
Your first clue that your nail has gone from friendly to malicious is inflammation around your toenail. This will manifest itself as pain, warmth, redness, and swelling. You may also develop a callus along the side of your nail in response to an increase in pressure from your ingrown toenail and the associated swelling. Or, it’s possible that you’ll just have a toenail that appears to go pretty deeply down into your skin. If an infection develops, things usually get a little more nasty. You may notice drainage accompanied by a bad smell, and there may be a collection of pus. (Yes. It’s pretty gross.)
If you suspect you have an ingrown toenail, it’s probably best to go see your podiatrist about it, especially if infection is present. Definitely see your foot doctor if you have diabetes, nerve damage, or poor circulation in your foot. Your podiatrist should be able to make the diagnosis by performing a physical exam of your toe. (X-rays and such are pretty much unnecessary in diagnosing an ingrown toenail.)
If you do not have an infection in your toe, you may be able to get away with just doing some home treatments (unless you’re diabetic or have nerve or circulation problems in your foot). You can soak your foot in warm water or salt water three or four times a day, and gently massage the sides of your nail to help reduce inflammation. Then, apply antiseptic and a bandage over your toe. You may want to wear shoes, like sandals, that put no pressure on your toe while it heals. Don’t try to perform the endearingly named “bathroom surgery” by attempting to cut out the ingrown portion of your nail yourself. Also, (although you may have heard different from your best friend’s mother-in-law’s cousin’s wife) doing things like cutting a V- shape in the end of your toenail is pretty much useless. (Some believe that it allows the edges of an ingrown nail to grow together, but nail growth depends on the nail root, not the end of the nail. The V-method simply doesn’t work.)
If your nail fails to improve, or if you have an infection in your toe or other medical problems, your podiatrist can help bring your ingrown toenail back from the dark side. He or she will likely inject a local anesthetic into the area and remove the side of the nail that’s causing the problem. Your podiatrist may also opt to destroy the portion of your nail root
that’s contributing to the ingrown nail (especially if this is a recurring problem for you). This may be done by using acid to destroy the root, or by using a laser. (Who knew treatments for ingrown toenails could be so close to science fiction?) Your podiatrist will also likely prescribe an antibiotic to clear up the infection in your toe. (Be sure to take all of the prescribed medication, by the way, even if your symptoms appear to have cleared up.)
You’ll probably want to stay off your foot and keep it elevated for a few hours, but you should be able to resume many normal activities the next day (although you’ll want to avoid vigorous movements like running for about two weeks). Occasionally, the entire nail may fall off after surgery; a new nail will grow over the next few months, although it will probably be a bit more narrow if your podiatrist has destroyed a portion of the nail root.
With the ingrown portion and accompanying infection taken care of, your toenail should reassume that harmless nature we love so well. Just treat it as well as you can, or it may show its destructive side once again.
If you have an ingrown toenail, don't be afraid to book an appointment. Your treatment will be gentle and virtually painless, and we'll get you back to your normal activities right away.
PLANTAR WART (VERRUCA PLANTARIS)
One of the most widely accepted (yet still false) myths is that witches have more warts than non-witches. This is simply not the case. There are plenty of otherwise stereotypical broomstick-flying female magic-workers that have very nice skin indeed.
The truth is that you don’t need to be a witch to get warts. And you certainly don’t get warts from flying around on a broomstick (although you may be apt to get splinters in rather tender parts of your anatomy). Warts are actually caused by the human papilloma virus (or HPV for short). This virus can create warts anywhere on the body (and no, witches aren’t more inclined to get them on their nose or chin), although the area of focus for this article is, naturally, the feet. Warts that form on the bottom of the feet (the plantar surface) are called plantar warts. Which is sort of a no- brainer, really.
Warts are contagious, although not extremely so. Skin that has sloughed off of a wart, or blood from a wart will contain the virus, so coming in contact with such bodily detritus may spread the virus to you. Common areas of infection (since the virus tends to like warm, moist environments) are public showers, lockers, and swimming pools. Sharing shoes or socks with another person who has warts can also lead to an outbreak (and is, admit it, a little gross). You can also spread warts from one part of your body to another by touching or scratching at a wart, then touching another body part. The virus then usually enters the skin through small cuts. (And just so you know, muttering “Double, double toil and trouble,” probably won’t cause warts. Unless you do it while standing in a public shower.)
People with sweaty feet tend to create ideal environments for the HPV, and thus may be more susceptible to developing warts. Children, adolescents and the elderly are also more likely to get warts than other groups of people. And some people are actually immune to the virus. They don’t get warts at all, the lucky folks.
Plantar warts are often mistaken for calluses (and vise versa) because they can look similar. Warts are sometimes covered or surrounded by thickened skin, which may make you think you’ve got a callus or corn rather than a wart. However, unlike calluses, warts tend to be painful if you squeeze them from the sides, while calluses tend to be painful when you press on them directly. Warts also often contain little black dots (which, contrary to popular belief, are not wart seeds but clotted blood in small blood vessels). Also unlike calluses, if shaved down, warts tend to exhibit pinpoint bleeding.
Warts are usually fairly well defined, and may look like small grainy or fleshy bumps on the underside of your foot, or might be hard and flat. They may vary somewhat in color, but are usually brown or gray. Because there’s so much pressure on the bottom of your feet, plantar warts may grow up into the skin rather than create a prominent bump on top of it. However, they won’t grow outside of the skin layers and into your bones. The virus is definitely just an epidermis dweller.
Over time, your wart may grow larger and spread, creating mosaic warts (basically a cluster of warts). The more warts you have, the harder they may be to treat. And, the more pain you may experience while standing, walking or running.
While rare, it’s possible that a growth on your foot may be cancerous. So, even if you think your bump is a benign wart, it’s probably best to get it checked out by your podiatrist. He or she can suggest various treatment methods if it is a wart, and if it’s a malignant growth, you can get treatment started quickly.
Your foot doctor will probably get a history of your warts, asking how long you’ve had them, what you’ve done so far to treat them, whether your warts are causing you any pain, and if you’ve noticed any changes in your warts recently. (Your podiatrist shouldn’t ask how long you’ve been practicing the dark arts, or if you have a good potion for turning a neighbor into a frog. If he or she does, you can probably give ’em a good dope slap.)
In addition to your warty medical history, your podiatrist will also perform a physical examination of your wart, and may shave it down slightly to check for pinpoint bleeding. If the growth is suspicious, he or she will probably take a biopsy of the growth and have it analyzed.
It’s entirely possible for warts to clear up on their own, although this may not happen very rapidly (or at all, in some cases). So, you may opt to have your wart removed rather than wait it out. Over-the-counter options are available, although they are often not as effective as treatment by a podiatrist. It can be difficult for these treatments to penetrate the thick skin on the plantar surface of the foot, and it’s kind of hard to avoid destroying healthy tissue along with the wart. If you have diabetes or other problems with your circulation, nerves or immune system, you should not try to treat warts yourself.
Some over-the-counter or other in-home treatment options include:
- Duct tape – Yes, you may be able to use this ever-useful tool to create fashion accessories, patch things up around the house, and get rid of your warts. Users of this method typically cover their warts in duct tape for six days, then soak the warts in water to soften the skin. After that, they gently rub at the warts with a pumice stone or emery board to remove, or at least reduce the size of the wart. A single treatment probably won’t get rid of your wart, but repeating this process over a couple of months may produce results. It’s a pretty painless option, and given the printed duct tape designs that are now available, this may be the most fashionable method.
- Salicyclic acid – This method peels off layers of the wart a little bit at a time. You usually apply it twice a day, usually for several weeks, and rub away the wart in between treatments using an emery board or pumice stone. When using this method it’s important that you apply the acid only to the wart, and not to the healthy tissue near the wart.
- Freezing – Cryotherapy methods are available both over-the-counter and in a doctor’s office. The stuff you can buy in a drug store generally doesn’t get things as cold, although it may be somewhat effective.
If these over-the-counter treatments don’t adequately reduce your wart problem, or if you have diabetes or other issues, your podiatrist can offer further treatments. Unfortunately, many of these methods can be painful, so be sure to discuss all your options with your doctor before deciding on a treatment, particularly for children. Treatments from your podiatrist may include:
- Freezing – While you can get over-the-counter cryotherapy treatments, your podiatrist has access to liquid nitrogen, that ultra-cold stuff that can freeze a flower so fast that it shatters if you tap it. But don’t worry-your foot doctor won’t shatter your foot or even your wart. Basically, it just kills the tissue in and around the wart. A blister forms and eventually sloughs off, taking the wart with it. The liquid nitrogen freeze is more likely to be effective than over-the-counter freezing options, simply because it’s so darn cold. This method can be painful, so take care before treating children with cryotherapy.
- Cantharidin – Another way to kill the tissue in the wart is by applying a substance produced by the blister beetle. You may get an uncomfortable blister from this method, but the application of cantharidin itself isn’t likely to be painful.
- Surgery – Your wart can be excised using sharp instruments or lasers, although this method could result in scarring, is likely to be painful, and may involve a long recovery.
- Immune system boosts – Your body loves to destroy malevolent viruses, although sometimes it needs a little extra help. There are injections and topical creams available that can stimulate your immune system and help it fight off the virus causing your warts.
- Anti-viral injections – While antibiotics are not good for warts (since warts are caused by a virus and not by bacteria), your doctor may suggest an anti-viral medication called bleomycin to kill your HPV infection. However, these injections can be quite painful and are not recommended for those who are pregnant or breastfeeding.
Warts do tend to come back rather frequently, so you may find yourself starting your treatment all over again, or trying different treatments over time. Which may make you consider taking up a wand and donning a black pointy hat. Just be aware that, alas, magic is probably not going to be any more effective than any other treatment. Plantar warts can spread easily. If you think you have one or more plantar warts, come in immediately to have them removed before they multiply
FOOT OR ANKLE SKIN CANCER
THINK IT'S SKIN CANCER?
Have you noticed a growth or a discoloration on your foot or ankle? Has this growth changed shape or color recently?
In either case you should come in for an evaluation to let us determine if these conditions warrant treatment. Foot or ankle Melanoma (cancer (malignant tumor)) are often missed or diagnosed too late. We see these conditions every day in our practice and we are equipped to diagnose and treat these conditions quickly and effectively.
Don't put yourself at risk by ignoring these signs. Schedule a consultation so that our podiatry team at Pueblo Ankle and Foot Care can safeguard you against the cancers and complications that could develop.
ATHLETE'S FOOT (TINEA PEDIS)
Athlete’s foot is one of those conditions that’s more gross and nasty than debilitating, although it may seem like a serious annoyance. Like a monster in a bad science fiction film, the fungus that causes athlete’s foot (the tinea fungus) lives off of human flesh, quite literally. It tends to thrive in damp, dark places, like the inside of your shoe (particularly when your feet are sweaty). And, despite the name, it doesn’t affect just athletes (although they may be particularly susceptible because of sweaty feet and shared locker rooms and showers).
Athlete’s foot is likely to be spread by contact with contaminated damp surfaces, such as those found in locker rooms, showers and swimming pools. Therefore, wearing shoes in such areas, or washing and drying feet immediately after contact, will help prevent infection. The fungus also likes it best when your feet are nice and sweaty, so drying off your feet and changing your socks and shoes frequently will help it feel decidedly not at home, keeping it from hanging around.
The fungus that causes athlete’s foot usually causes a burning or itching sensation in the affected area (which is often, although not always in the feet). The skin is likely to become dry and scaly, and as the conditions worsened, may become reddened and develop painful blisters. The fungus will often show up on the sole of the foot (although it may occur in other areas as well), and will sometimes spread to the areas between the toes and even into the toenails, making the nails brittle and yellow. Adding insult to injury, bacteria may take advantage of your foot’s weakened state and cause an infection.
To determine if you have athlete’s foot, your podiatrist will often inspect the foot visually, checking for the symptoms listed above. He or she may also scrape the skin to see if the fungus grows from a culture, or may check the sample under a microscope. (However, cultures might take up to three weeks to grow, so there isn’t always a quick 100% sure diagnosis.)
Getting rid of this clingy fungus usually involves a couple of different methods: discouraging it from growing by making conditions less pleasant for it, and using medication to kill it. Your podiatrist will likely suggest that you take measures such as making sure to dry your feet thoroughly after they become wet and changing your socks or shoes frequently to prevent a damp environment from forming around your feet. He or she may also prescribe medication (or suggest effective over-the-counter meds) to combat and kill the fungus itself. Such medications often take the form of creams, powders or sprays, although an oral anti-fungal medication may be the most effective at getting rid of a deep-seated fungal infection. If a bacterial infection is also present, your podiatrist will likely also prescribe some form of anti-bacterial medication.
Because this fungus can be pretty persistent, sticking with your podiatrist’s suggested treatment method may be crucial in getting rid of the infection. Don’t stop halfway through the treatment, even if the area looks like it’s cleared. Stick with it, and you may be able to say a permanent (or at least lengthy) goodbye to your unwelcome fungal visitors.
Pueblo Ankle and Foot Care offer various treatments for Athlete's foot. If you think you have athlete's feet, schedule an appointment with our foot specialist and let us help you find relief.