Posts for: November, 2015
Corns and calluses are thick, hardened areas of skin that develop in response to your body's natural defense to repeated pressure or friction. While neither condition presents a long-term or serious health risk, they can be painful, irritating and unattractive.
Identifying a Corn or Callus
Corns and calluses are similar in nature, but differ in size and location. Corns are smaller than calluses and usually have a hard, thickened center surrounded by red, inflamed skin. They typically develop on the tops and sides of your toes and can be painful when touched. Calluses generally develop on your heels and balls of your feet. They vary in size and shape, although almost always larger than corns.
For most people who develop calluses or corns, eliminating the source of pressure is usually enough to make the thickened skin disappear. We recommend the following for treating corns and calluses:
- Wear comfortable shoes and socks. When footwear fits properly, there is less opportunity for friction and rubbing to occur.
- Soak your feet in warm, soapy water to help remove corns and calluses. Rub the thickened skin with a pumice stone to remove toughened layers more easily.
- Keeping your feet moisturized with foot cream or lotion will help improve the quality of your skin and rid your feet from calluses or corns.
When to Seek Care
When corns and calluses don't respond to conservative care, contact our office for a careful evaluation. We can investigate the possible causes of your corn or callus, safely remove the thick, hardened area of skin, and recommend appropriate footwear and treatment, including padding and inserts. Never attempt to cut away a corn or callus on your own, especially if you have diabetes or poor circulation. Instead, seek advice for careful removal and proper care.
Is there any health risk to allowing a toenail fungus to exist untreated over the long term?
I have avoided using oral drugs for chronic toenail fungus because I don't want to risk liver damage. Which raises the question: Is there any health risk to allowing a toenail fungus to exist untreated over the long term? Thanks!
Fungal infections of the nail can be difficult to treat. As a previous Ask Well column noted, plenty of remedies exist, but none are certain. And the one considered most effective, the drug Lamisil, is associated with rare cases of liver damage.
So it is no surprise that some people would consider covering up their feet and turning a blind eye to the problem. Most healthy young adults who ignore it will probably not notice any immediate issues. But over time, as the fungus progresses from the tip of the nail toward the cuticle, it can make the nail thick, discolored and brittle, and pain and inflammation become more likely.
In about one out of two dozen cases, the fungus migrates to other parts of the body, like the hands, back and legs, said Dr. Boni E. Elewski, a professor of dermatology at the University of Alabama at Birmingham who specializes in nail disorders. Older people or those taking medications that weaken the immune system, like chemotherapy drugs and corticosteroids, are particularly susceptible.
“If you don’t treat it, you have an organism living in your nail that could spread,” she said. “In most people, it probably won’t go beyond the foot. But there are some people who are at risk of getting it in the fingernails and other places.”
The other problem with ignoring nail fungus is that the fungus creates cracks and openings in the skin where bacteria can sneak in and cause infections. For people who have nerve damage and poor circulation -- someone with diabetic neuropathy, for example -- this can have serious consequences.
“Podiatrists frequently cite this as a cause of diabetic amputations,” Dr. Elewski said. “The fungus paves the way for bacteria, and it can definitely be a problem.”
If the side effects of Lamisil are your concern, Dr. Elewski said, then alternatives are on the horizon. Two promising new topical treatments -- Efinaconazole and Tavaborole -- are expected to be released next year. Nail lacquers can also be effective but require regular application. And it is better to begin treatment early.
“The longer you wait,” Dr. Elewski said, “the harder it is to treat.”
Bone spurs, also known as osteophytes, can occur anywhere in the skeletal system, and the feet are no exception. Bone spurs are simply overgrowths of bone, which most commonly form where two bones come together. Normally bone spurs in the feet are painless, but when exposed to pressure, they can cause the excess bone to rub against other nerve endings or soft tissues, resulting in pain.
Causes of Bone Spurs in the Feet
When your feet are repeatedly exposed to excessive pressure and stress, a bone spur can form as a result of the body's normal response to repair itself. The following activities and conditions are common causes:
- High-impact activities, such as running
- Excessive weight
- Poor-fitting footwear
- Tightening of the plantar fasciitis due to excessive stress
Because there are no obvious symptoms associated with bone spurs in the feet, diagnosing the disorder can be difficult. Some people experience unbearable pain in particular areas of their foot when exposed to pressure, which prompts them to seek medical care. Other people can go long periods of time without realizing they even have a bone spur. An x-ray can identify a bone spur in your foot, but if it isn't causing you pain, damaging other tissues or restricting your movement, treatment probably won't be necessary.
Identifying the cause of your bone spur, such as poor-fitting shoes or weight gain, is often times enough to reduce the pressure that is causing the pain.
Conservative treatments for bone spurs include:
- Change in footwear
- Weight loss
- Padding or insoles
- Deep tissue massage and stretching
If you're experiencing chronic foot pain, schedule an appointment at our office. We'll carefully examine your feet and evaluate your symptoms to better understand your condition. If you've developed a bone spur, we can work with you to create a treatment plan that best fits your needs and puts an end to your frustrating foot pain.
A bunion is an abnormal, bony prominence that develops on the joint at the base of your big toe. As the big toe joint becomes enlarged, it forces the toe to crowd against your other toes, and the pressure exerted on your big toe joint results in inflammation and pain. Early treatment is necessary to decrease the risk of developing joint deformities.
Bunions develop due to prolonged abnormal pressure or motion on your big toe joint, most often caused by inherited structural defects, poor-fitting shoes, foot injuries, or congenital deformities. Women are generally more prone to bunions because of the shoe types typically worn, such as high-heels and narrow-toed shoes.
Bunion pain can range from mild to severe, often making it difficult to wear shoes and perform normal activities. You should contact our office if you notice the following symptoms:
- An enlarged, visible bulge on your big toe joint
- Restricted movement of your big toe or foot that prevents you from performing normal activities
- Irritation, corns or calluses caused by the overlap of the first and second toes
- Frequent pain, swelling or redness around your big toe joint
Treatment For a Bunion
Treatment for a bunion will vary depending on its severity. Identifying the condition in its early stages is important to avoid surgery, with the main objective of early treatment being to relieve pressure and stop the progression of the deformity. Many times conservative treatments, such as padding, modified footwear or orthotic devices can be highly effective for preventing further growth and reducing the pressure and pain.
We recommend the following for reducing pressure and pain caused by bunions:
- Wear comfortable shoes that don't cramp or irritate your toes and avoid high-heeled shoes
- Apply ice to reduce inflammation and pain
- Our podiatrists can show you how to apply padding to your foot to place it in its normal position and reduce stress on the bunion
When early treatments fail or the persistent pain associated with your bunion is interfering with your daily activities, a surgical procedure may be recommended as a last resort to realign the toe joint and alleviate the pressure. We can advise you on the best treatment options available to relieve pressure on the bunion and slow the progression of the joint deformity.