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nails and skin
Only the most common problems will be discussed here.
Athlete's Foot (Tinea Pedis)
It presents in many different ways. It can be dry and flaky (usually
in small circles on the bottoms or sides of the feet) or it can be moist
with blisters that are itchy. It can exist in combination with bacterial
infections, which can create an angry redness and discomfort. It can
be between the toes, at the ends of the toes or on the bottoms or sides
of the feet. It can be itchy, but not always. It can affect the nails
as well as the skin. It can be acute and sporadic or chronic and never-ending.
Some people have sweaty feet and are more prone to it. It is not caused
by lack of cleanliness (in most cases). It can be picked up at swimming
pools, in gyms, from any wet floor, from a partner or house mate. It
is common and usually easy to treat. It is usually worth the time and
effort to see a podiatrist and get a proper diagnosis and prescription
for the most effective medications.
Fungal Toenails
Very common and often distressing. Difficult to treat. New oral medications
(pills) are 75% effective (according to their literature) and don't
guarantee that the problem can't recur. The new medications are relatively
safe as opposed to the older oral anti-fungals which caused liver distress,
there can still be side effects. Fungal toenails can be treated with
topical solutions (creams do NOT work) but this method is less effective.
Though it sounds barbaric, removal of the toenail (under local anesthetic)
(by a professional) will improve the chances that a topical solution
will work.
Ingrown Toenails
These are more common in women because of the footwear that tends to
squeeze the toes. The shape of the nail can be modified over time by
wearing too-tight shoes. This can create a chronic ingrown toenail.
If a toenail continually grows into the nail border and creates discomfort
or infection, most likely a nail procedure will be required to eliminate
the problem. This involves a local anesthetic, removal of the nail border,
destruction of the nail matrix (growth centre for the nail), one to
two weeks of diligent soaking and taking care of the healing tissues.
It is a highly successful procedure by experienced practitioners. If
you have an infected ingrown toenail, see a podiatrist. The nail border
that is digging into the skin and creating the infection can be removed.
Once this is done, there is usually no need for antibiotics. Anyone
who has diabetes or poor blood flow should see a podiatrist or medical
doctor immediately if this problem arises.
Difficult Toenails
Toenails can be thick, fungal, painful, crumbly and downright impossible
to cut oneself. Podiatrists manage these difficult toenails using proper
instruments. Again, anyone with diabetes or poor blood flow should never
ever cut their own toenails.
Corns
Often confused with warts, corns are a discrete area of thick skin that
usually cause pain. They are located on toes, between toes, on the bottom
of the foot and overlying bunions. They can be trimmed but they will
usually come back. To eliminate them completely, an assessment must
be done to determine why they exist. Often they are shoe related and
sometimes they are caused by bony prominences. Sometimes, surgical excision
of the bony part is the best option. Always try conservative options
first. Corn pads with acid destroy the top layer of skin. Often the
corn goes much deeper than the acid can reach. The best way to treat
them is to see a podiatrist - have them assessed for the underlying
cause, have them trimmed and padded and take a good hard look at what
shoes you have that may be causing them.
Callouses
Usually on the bottom of the feet - forefoot area or heels most commonly,
they indicate an increase in weightbearing pressure. They are sometimes
associated with dry skin. People who wear sandals alot will have more
callousing. High arched feet and severe flatfeet tend to develop callouses.
It's a good idea to have the problem assessed by a podiatrist and then
to carry on home treatment on an ongoing basis. Sometimes padding, insoles
and orthotics can eliminate this problem.
Blisters
They show up on the backs of heels most often, sometimes on the bottom
of the foot or toes, between toes or over any bony prominence. Blisters
can literally form in minutes. If a shoe rubs against the skin repeatedly
a blister will usually form. It is the body's way of saying, hey, stop
that! If you are developing blisters in new shoes - ascertain that the
shoes aren't too small first. If the heel is rubbing, simply place a
round one inch square piece of moleskin over the irritated area. If
a blister has already developed, cut a hole out of the centre of the
moleskin and place it where the blister is. Then cover the whole dressing
with a bandaid. This should keep shoe pressure off the blister. You
can also buy blister pads which can work as long as they effectively
keep pressure off the blistering area. If blisters develop fluid inside,
the best option is to soak in warm salt water. If the blister doesn't
resolve or if you have diabetes or poor blood flow see a professional.
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