TOENAIL & SKIN CONDITIONS

Athlete’s Foot

Athlete’s foot is a very unpleasant skin disease caused by a fungus. The infection often appears between the toes but can occur in other areas of the foot. Other areas of the body may also be affected if you scratch the area and then touch other spots.

The fungus that causes athlete’s foot loves warm, dark and moist environments, like the inside of your shoes. Athlete’s foot is contagious and you can pick it up in public areas like swimming pools, locker rooms, spas and showers.

Symptoms of athlete’s foot can include any of these:

  • Itching and burning between the toes
  • Peeling, scaling or dry skin
  • Swelling and inflammation
  • Blisters

Treating Athlete’s Foot

If your symptoms persist even with good foot hygiene and wearing clean socks and dry shoes, consult a podiatrist.

Once we confirm that you have athlete’s foot, oral or topical antifungal medication will be prescribed. Antibiotics can help if the infection is bacterial rather than fungal.

Frequent foot bathing, drying thoroughly and applying foot powder to shoes and socks can help with recovery. Because athlete’s foot is so contagious, discourage transmission of the fungus by disinfecting home showers and tubs after each use.

Preventing Athlete’s Foot

Good foot hygiene can help prevent athlete’s foot:

  • Wash your feet every day with soap and water and dry carefully, especially between the toes.
  • Wear flip-flops or shower shoes in public areas.
  • Use powder in shoes and socks regularly to reduce moisture.
  • Change socks and shoes regularly.
  • Choose synthetic blend socks that wick moisture away and change often.

Blisters

A blister is a pocket of fluid protected by the overlying layer of skin. Blisters on the feet are usually caused by friction and can make wearing shoes and most activities painful. Blisters can also be caused by an insect bite, a skin burn, infection, sunburn, an allergic reaction or trauma.

Often, blisters on the feet result from wearing shoes that fit poorly. If the footwear is too tight or too loose, your feet can rub against the shoes causing friction. In this case, fluid will build up beneath the skin. Excessive moisture such as perspiration can also cause blisters, especially for runners in warm weather.

Symptoms

If you are experiencing skin irritation when wearing shoes, look for raised bumps of skin where the foot is in contact with the shoes. These will be fairly soft because they are filled with liquid.

Treating Blisters

The best treatment for a blister is to leave it intact to let new skin grow underneath. Even if it bursts, leave the covering skin in place as it will help protect the area from infection. Just cover the blister with an adhesive bandage and avoid shoes that rub against the area.

If your blister does not heal within a few days or if you observe any signs of infection, visit your podiatrist for expert care. The doctor will use a sterile needle to drain the blister and then apply antibiotic ointment. If the area is infected, oral antibiotics may also be prescribed.

Preventing Blisters

If friction against your shoes has caused a blister, invest in shoes that are the right size and that fit well. Adding an insole to the shoe can reduce friction with extra padding.

Athletes should focus on keeping the feet dry with foot powder or with moisture-wicking socks.

Calluses and Corns

Calluses and corns are skin problems often found on the feet. A callus is a thick, hardened skin on the bottom of the foot that protects the skin from too much friction. They are often found on the ball of the foot, the heel and under the big toe.

A corn forms when two toes rub together, causing thicker skin with inflamed tissue underneath. Corns between the toes have soft cores, while those on the top of a toe are hard corns.

Both of these skin growths are caused by excess pressure and friction and can result from overuse, from an abnormal gait, and by wearing shoes that are either too tight or too loose

Calluses and corns are skin problems often found on the feet. A callus is a thick, hardened skin on the bottom of the foot that protects the skin from too much friction. They are often found on the ball of the foot, the heel and under the big toe.

A corn forms when two toes rub together, causing thicker skin with inflamed tissue underneath. Corns between the toes have soft cores, while those on the top of a toe are hard corns.

Both of these skin growths are caused by excess pressure and friction and can result from overuse, from an abnormal gait, and by wearing shoes that are either too tight or too loose

Symptoms

A callus will show hardened, thickened skin and may appear as a bump. The skin can be dry, flaky or scaly. Walking on a callus can be painful as they grow large.

Whether a hard or soft corn, you will notice hardened, raised bumps that can be painful when pressed.

Treating

Home treatment can be effective for corns and calluses that are not painful:

  • Soak feet in warm, soapy water and then rub the thickened areas with a pumice stone or foot file.
  • Apply a moisturizing lotion or cream every night and cover with a loose sock.
  • Add over-the-counter moleskin or pads – not with salicylic acid – directly to the callus or corn to ease pressure.

Professional podiatric treatment can help ease the symptoms and eliminate the skin growth. We will shave the surface of a callus to relieve pressure. An exfoliant such as a cream with urea can remove dead skin. An oral antibiotic can clear up any sign of infection.

If we determine that your callus or corn is caused by your gait or foot structure, custom-fitted orthotics can greatly ease the friction and pressure

Prevention

Custom-fitted orthotics and metatarsal pads can help eliminate the abnormal pressure or friction that caused the metatarsalgia.

Athletes or anyone who runs or works out must wear the proper footwear for their chosen activities. New shoes must have adequate cushioning and, for those who run or repeatedly jump on hard surfaces, choose rubber heels and soles for better shock absorption.

Fungal Toenails

A toenail fungus will get under the surface of the nail where it takes hold and may even spread to other toenails. Left untreated, the infection may make it difficult to walk and work. The thicker toenails are hard to trim and make it painful to wear shoes.

Fungal nail is contagious and you are vulnerable in public areas like swimming pools, showers, spas and locker rooms. People with diabetes or who suffer from circulatory problems or immune deficiency are prone to toenail fungus.

Symptoms

Toenail fungus causes many unpleasant symptoms including:

  • Change in toenail appearance, texture and color
  • Nail thickening
  • Unpleasant odor
  • Debris noticeable under the nail plate
  • White marks on the nail plate

Treatment

Home treatments including over-the-counter antifungal creams may ease the symptoms of toenail fungus, but full healing can only be obtained through a podiatrist’s care.

After taking a culture from the nail to determine the cause of the problem, we will treat it with topical and/or oral medication. Debridement, or removal of the diseased nail matter and its degree, is an effective treatment. Surgery may even be required to remove the nail permanently and prevent the regrowth of a deformed nail.

Prevention

Toenail fungus can be prevented with these commonsense tips:

  • Wash your feet with warm soapy water every day, and dry thoroughly.
  • Always protect your feet in public areas with shower shoes or flip-flops
  • Wear clean socks every day and change more often if they become sweaty
  • Trim nails straight across and short enough so that they don’t extend beyond the toe tip
  • Choose socks made of synthetic fiber to wick moisture away from the skin
  • Don’t use polish on those nails that may have an infection

Ingrown Toenail

Ingrown toenails are nails where the corners or sides grow into the nearby soft tissue. The big toe is the most common location, but any toenail may become ingrown.

An ingrown toenail may be caused by improper trimming of the nail where the corners are curved. Heredity may play a part as can pressure on the toes from crowding or tight shoes.

Symptoms

  • Pain
  • Swelling
  • Redness
  • Drainage
  • Odor

Treatment

If you suspect an ingrown toenail, soak the foot in soapy water or a warm saltwater bath, then smooth on antiseptic lotion and bandage. If there is no improvement in a day or so, visit your podiatrist. Over-the-counter medications are ineffective, and don’t try to remove any part of the nail yourself.

For those with diabetes, peripheral vascular disease or another circulatory disorder, do not attempt to self-treat an ingrown nail. Get help from a podiatrist as soon as possible.

See your foot doctor if there is any sign of infection around the toenail such as drainage or excessive redness. To eliminate an ingrown toenail, the doctor will remove the ingrown portion and treat the infection with oral or topical medication. For chronic problems, the corner of the nail along with its root will be removed.

Prevention

  • Wear comfortable shoes with a wide toe box.
  • Avoid wearing high heels.
  • Trim toenails straight across with toenail clippers and don’t round or dig into the corners.
  • Don’t tear or rip the nail edges.

Skin Cancer

Your feet and ankles are vulnerable to skin cancer – even the soles of your feet. Certain types of skin cancer are unrelated to sun exposure. 

There are 3 types of cancers found in the foot and ankle:

  • Squamous Cell Carcinoma. These are the most common form in the feet and don’t spread in early stages. The growths can be itchy and may resemble a plantar wart, eczema, and ulcer or a fungal infection.
  • Malignant Melanoma. Melanoma is one of the deadliest skin cancers and survival depends on early detection. A melanoma grows down into the skin and then can spread in the body through the lymphatic system and blood vessels. Melanomas can take many forms and may appear as a mole, ingrown toenail, bruise, plantar wart, ulcer or blood blister
  • Basal Cell Carcinoma. Because this cancer is usually caused by sun exposure, it is found on the feet less often. One of the least aggressive cancers, basal cell rarely spreads beyond the skin. They look like non-cancerous skin tumors or benign ulcers.

To spot a melanoma, follow the ABCDs:

  • Asymmetry where the two halves of a lesion don’t match
  • Borders that are ragged or uneven
  • Unusual colors like pink, red, black or blue, or more than one color
  • A diameter wider than a pencil eraser

Treatment

A skin biopsy can confirm any suspicion of skin cancer.

If the biopsy is positive for skin cancer, your foot doctor will recommend the best course of treatment for your unique scenario.

Prevention

Limiting sun exposure for the feet and ankles can help prevent skin cancer. When you are outdoors, apply sunscreen of at least SPF 30 regularly, and don’t forget the soles of your feet when you are lying on the beach.

Examine your feet regularly for anything unusual. Check the bottoms and between the toes too. If you notice anything suspicious, schedule a visit with your podiatrist right away.

Warts

Warts can appear anywhere on the body. When they are on the bottom of your foot, they are called plantar warts because they occur on the sole of your foot.

Because the bottom of the foot has a lot of pressure, the warts grow inward into the tissue of your foot. Sometimes they are covered by a callus that you can see on the surface of the skin.

Plantar warts are caused by the human papillomavirus which enters the body through a break in the skin. This virus is very contagious and can be picked up in public areas such as swimming pools, showers and locker rooms. Teenagers and children are prone to getting this virus as are those with weakened immune systems.

Symptoms

  • A rough, grainy growth on the bottom of the foot
  • A callus that may have covered the wart
  • Black pinpoints on the surface of the wart
  • Pain or tenderness when walking or standing

It’s essential to seek out a podiatrist’s help immediately if you notice an ulcer.

Treatment

Over-the-counter wart treatments are not effective in eradicating the wart. Our professional treatments include:

  • Prescription salicylic acid treatments to peel away the wart.
  • Using liquid nitrogen to freeze the wart. This is also called cryotherapy. The area will be numbed to reduce pain. The dead tissue will come off in a few weeks.
  • Laser treatment to destroy the wart by closing off the blood vessels.
  • Surgical removal of the wart.

Prevention

  • Always cover feet with shower shoes or flip-flops in public areas.
  • Keep your feet clean and dry.
  • Change socks and shoes daily.
  • Don’t touch any warts that you have as they can spread.
Chestnut Hill Office Call: 617-232-1752 Newton Office Call: 617-630-8280
New England Podiatry