Total Care Podiatry

 It seems people are more aware of the damage that occurs due to sunburns thanks to dermatologists and skin cancer screenings. ‘SPF’, ‘UVA’ & ‘UVB’ are becoming regular terms for those who enjoy outdoor activities. Whether you are going to the ocean, lake, river, or swimming pool, do not forget to put sunscreen on your feet. A sunburn on your feet can cause swelling, blisters, pain and limit your ability to walk in closed shoes. You may be able to stroll along the beach in flip-flops or sandals, but come Monday morning you most likely will be back in closed shoes and that is when you will be wishing you had put sunscreen on your feet. So, enjoy the rest of summer and if you have any concerns about your feet, come by the practice on Malop street and we will be happy to help you.

Here is a story from one of our valued clients:

“The first day on the beach I got a wicked sunburn on the tops of my feet. I didn’t have sunblock on, but I swear I was completely in the shade under my tent on the beach. I still don’t know how it happened. That totally sucked because it really hurt to wear flip-flops to and from the beach. It was the worst coming back from the beach because the sand on my feet would get ground into my sunburn by my flops.”

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.  

What is it?

Onychomycosis is a fungal infection of the nail. Fungi grow in all warm, moist places. The fungus usually commences growth at the end of the nail plate and continues to spread under the nail. Sometimes chalky, white plaques form on the nail surface and as the infection progresses yellowish, brownish discolouration may be seen. Cell damage by the fungus to the foot of the nail can cause the nail to thicken and change shape. Often callus (dead skin) is broken down and builds up beneath the nail plate. Of all fungal infections that occur on the body, nail infections are most difficult to prevent and treat.

How is it treated?

Fungal infections of the nail are treated in two ways:

1. Conservatively
2. Surgically

Conservative treatment involves a visit to the podiatrist for cutting and thinning of the nails; use of an anti-fungal topical medicament can be used if indicated by the symptoms. Consult your podiatrist for appropriate recommendations. Prevention of reinfection is very important. If this is not carried out, treatment will fail. If skin has been infected then advice on management of tinea pedis will be needed. Your podiatrist will advise you on this. In most cases conservative treatment successfully alleviates discomfort. However, some cases will require specific oral medication and surgery. Surgery is only considered when conservative treatment fails and oral medications are contraindicated due to potentially nasty side effects. Should the need arise these two options can be discussed with your podiatrist.

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.

What are they?

Plantar warts are lesions which occur on the soles of the feet. They can occur as singular or multiple lesions. Unlike corns which tend to look quite similar, warts have no skin lines running through them, are painful to squeeze and often have small black dots in their centre which represent the blood vessels within the wart tissue.

What causes them?

Warts are caused by a virus. There are many different types of wart viruses, some more resistant than others. The wart virus can be picked up in public showers, swimming centres and walking barefoot over infected areas. Warts tend to be very contagious so family members with warts should take care to prevent spread of the infection.

How are they treated

1. Boost the immune system just as you do to fight cold and flu viruses (i.e. Good diet and Vitamin/Mineral supplements may be advised)
2. Chemical cautery (breakdown of the tissues with strong chemicals) to the warty lesions. Single warts usually require 6 to 8 treatments. Multiple warts may be more resistant and take longer to clear.
3. Surgical removal – curretage.

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.

Nail surgery is a common procedure performed by most podiatrists to effectively treat an ingrown toenail, a nail that has pierced ( or is pressing against) the adjacent skin of the toe causing pain and inflammation and sometimes infection.
Surgery may be required when an ingrown toenail repeatedly gets infected, is continually painful, the patient is unable to wear shoes or the condition inhibits work, sporting or other activities.
Before surgery is recommended, your podiatrist will explore other, more conservative treatment options.

Nail surgery performed by Podiatrists

A ‘Partial Nail Avulsion’ (known as a PNA or nail root and matrix resection) is a minor nail procedure which aims to permanently treat ingrown toenails. The procedure is usually performed in the podiatrists’ rooms, takes around one hour and the patient is able to walk immediately afterwards.

What does a partial nail avulsion involve?

Your podiatrist will conduct a complete assessment, taking a medical history, a list of any medications that have been prescribed for you, as well as considering any other clinical factors that will determine whether or not this surgery is suited to you. An assessment will generally also include an examination of blood supply to the foot.

The procedure itself is performed under local anaesthetic via injection into the toe to numb the area. The anaesthetic will wear off in about two hours. Once numb, a tight elastic ring called a tourniquet is applied to the toe to control bleeding and the area is prepped to minimise the risk of infection.

The offending portion of the nail is then gently lifted and trimmed away, generally without the toe being cut or stitched. Both sides or the entire nail may be removed this way. A chemical may also be used at this point to assist in preventing nail regrowth.

The procedure itself is performed under local anaesthetic via injection into the toe to numb the area. The anaesthetic will wear off in about two hours. Once numb, a tight elastic ring called a tourniquet is applied to the toe to control bleeding and the area is prepped to minimise the risk of infection.

The offending portion of the nail is then gently lifted and trimmed away, generally without the toe being cut or stitched. Both sides or the entire nail may be removed this way. A chemical may also be used at this point to assist in preventing nail regrowth.

Once the procedure is completed, the tourniquet is removed and a sterlie dressing is applied. The patient is able to walk immediately afterwards, however assistance getting home is strongly recommended.

What happens after the procedure?

Re-dressing at home and a few consultations with your podiatrist may be required over the following two to three weeks following the procedure. For the first few days after the procedure, pain relief, the use of open toed shoes and activity modification may be necessary, however interference with day to day activities is generally minimal.

What are the potential complications?

As with any surgical procedure there is some risk of complication, however this procedure is known to be very safe and effective.
The most common side-effects are post-operative infection in the short term and the possibility of regrowth of the nail over time. The risks of infection can be minimised through good post-operative care and your podiatrist will advise and assist with your situation.

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.

What is an ingrown toenail?

An ingrown toenail is where the edge, or corner, of the toenail grows into the adjacent skin (the skin next to the edge of the nail) and pieces the skin, causing the toe to become red, swollen and tender (inflamed).

Ingrown toenails are common, with the big toe most likely to be affected on one, or sometimes, on both sides. The toenail curves and cuts into the skin, causing the toe to become tender and painful, particularly when you walk on it. If left untreated, the toe can become infected.

What causes them?

Ingrown toenails can be caused by a number of things:

• The most common causes of ingrown toenails are badly cut toenails and toenails that are picked, leaving jagged and sharp edges.
• Tight fitting shoes – wearing shoes that are too narrow, or too short,, can crowd your toes and cause your toenails to curve into your skin.
• Excessive sweating or poor foot hygeine – if the skin on your toes and feet is warm and moist, you are more likely to develop an ingrown toenail as the soft skin is easily peirced by the nail edge.
• Injury – such as stubbing the toe, or dropping something on it, can cause an ingrowing toenail to develop.
• Genetic factors – your risk of developing an ingrown nail can be increased by genetic factors, such as the way that you stand, the way that you walk, or having a naturally curved, or fan-shaped toenail.

How can it be treated?

It is best to treat an ingrown toenail as soon as you notice the symptoms. If caught early enough, your podiatrist may recommend the self-care advice listed below to prevent it from getting worse.

Soak your foot in warm water 3-4 times a day.
Use a cotton bud to gently push the skin away from your toenail.

Wear comfortable shoes with enough space around your toes.

Take painkillers, such as paracetamol, or ibuprofen, to relieve any pain. Children who are under 16 years of age should not take aspirin.
If your symptoms persist, your podiatrist will be able to remove the small part of the nail that is digging into your skin. As your toenail grows back, a piece of cotton wool or foam can be placed under your nail in order to prevent it from growing back into your skin. The cotton wool should be changed daily.

If your nail is infected, you may be prescribed a course of antibiotics.

Nail surgery

If your toenail does not improve your podiatrist may recommend that you have part, or all, of or your toenail surgically removed.

The most common surgical procedure for treating ingrown toenails involves only removing part of the toenail. This is called partial toenail avulsion. The edges of your toenail are cut away to make the toenail narrower.

Once the anaesthetic wears off, your toe may be very tender. You may need to take a painkiller, such as paracetamol or ibruprofen, and wear soft or open-toed sandals for about a week or so.

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.