Toenail Fungus Treatment – What are my options?

What is toenail fungus and fingernail fungus?

Fungal infections of the nails (onychomycosis) can be a persistent and sometimes embarrassing problem and occasionally can become painful. These infections develop when fungi, known as dermatophytes, burrow under nails causing them to become crusty, thick, discolored, and distorted.

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heel spurs

Hammertoe Treatment & Recovery Time

If you have a difficult time finding comfortable shoes, your toes always feel like they’re crammed into your footwear, and you’re experiencing consistent foot pain, you might need to find a treatment for hammertoe. There are basic treatments that you can consider, but ultimately long-term treatment may involve minimally invasive surgery. If you think surgery will be the category you’ll fall into, your next question will probably have to do with the hammertoe surgery recovery time.

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Bunion Treatments in Lambertville

Best Treatments for Bunions

One of the big advantages of living in urban communities like Hamilton and Lambertville in New Jersey is the ability to have many options for just about everything. We are fortunate to have an abundance of options for eating, working out, and having fun.

We offer many options for bunion treatment here at Foot & Ankle Centers. No matter which ones we use, the goal is always the same – to provide the relief you need! Read more


Foot Creams for Dry Skin – Podiatrist Recommended

Dry Skin on Feet – Best Moisturizers, Cures, and Prevention

Foot moisturizers for dry skin can be one of the best treatments for treating and preventing dry heels and feet. The skin on the feet is thicker than skin elsewhere and requires specialized creams that can penetrate this thicker skin.

Moisturizing with an appropriate cream or lotion designed for thick skin on the bottoms of the feet can help dissolve callused skin and keep cracked heels or heels fissures from developing.  There are several products that we regularly recommend to our patients that can cure or prevent dry skin. We discuss those products below. First, please read this important disclosure about the products recommended in this article.

Specialized Moisturizers for the Thick Skin of the Feet

To work best on the feet creams and lotions must include an acid or similar ingredient that can help the moisturizer penetrate the skin.

Urea Cream 40%: The best choice for dry skin on feet

The most effective cream we have found for our patients contains 40% urea.

Directions – Standard: We recommend using Urea cream at bedtime following a bath, shower or soaking. The feet should be blotted dry with a towel and then the cream applied immediately. Rub gently until it is fully absorbed. Use every night for 2 – 3 weeks for the best results.

 Directions – Severe / Fissures: If you have severely dry skin or fissures, then follow the instructions above but also cover your foot in an airtight soak overnight for the first week using the Urea cream. This “occlusive” covering will super-hydrate the skin. We recommend the use of a Silipos gel therapy sock to lock moisture in without restricting circulation.

Remove Thick Skin and Callus Weekly for Best Results

For the Urea cream to best penetrate the skin to assist with healing you will need to remove as much of the thick and callused skin as you can. There are several methods to do this.

One of the easiest ways is to use an electric callus remover. We have tried several and highly recommend the Pedinova Electric Pedicure Kit. This well-built rotary grinder comes with bits that are specifically designed to grind away callus (it comes with bits for thick toenails too).

We recommend grinding the calluses with the Pedinova right after bathing when your feet are still a little damp. If it starts to feel warm, then stop for a few seconds and then start again. If it starts to get warm very quickly then you have gone far enough.

A less expensive option, although much more work, is a manual foot file. Our favorite is the Microplane PedicureRasp which can often be found for less than $10.

Creams and Lotions for Preventing Return of Dry Skin

Once your skin is in better shape you will not likely need a cream as strong as Urea 40% to maintain your now smooth skin,

You will, however, want to continue to apply a penetrating moisturizer at least daily and after every bath or shower to prevent the problem from returning.

An excellent choice is simply to use a less concentrated Urea cream. We often recommend a 20% Urea cream used after every bath or shower.  The Gormel 20% Urea cream is a respected brand that is well priced.

If you have very mild dryness or just an occasional flare-up, Urea is probably stronger than you need. In this situation, we recommend Ammonium Lactate lotion. Amlactin is the best-known brand but we recommend the generic Ammonium Lactate 12% lotion as it is the same formulation at significantly less cost.

What if the Dry Skin Continues?

There are many other conditions that can lead to dry skin so if you don’t see improvement within a couple of weeks see your podiatrist, your primary care doctor or your dermatologist.

Other conditions that lead to dry skin on the feet include:

  • Dermatitis:  Dermatitis simply means “inflammation of the skin” and it can have many causes. It also can take on many appearances. Sometimes the skin is red and swollen but sometimes it just appears dry and scaly.  Dermatitis will not likely respond to moisturizers and is often treated with steroid cream.
  • Athletes’ Foot: Athlete’s foot (or “tinea pedis”) is a fungal infection of the skin. Although it often itches it sometimes appears as only dry skin. Athlete’s foot is usually treated successfully with topical anti-fungal medications.
  • Systemic Conditions: There are some systemic conditions that can cause an appearance of dry skin on the feet. There are many but good examples are psoriasis and eczema.
  • Weather:  Dry skin is more common in winter when humidity levels and temperature decrease. Many people find they only need to use the moisturizers in the winter.
  • Harsh soaps and shampoos. Many soaps and shampoos remove moisture from your skin as they are designed to remove oil.

When used on a regular basis a foot cream should help the skin become rehydrated and healthy once again – as long as you simply have dry skin. If you don’t see improvement it is a sign that something else might be causing the problem.

If you have skin that does not respond to the moisturizing plan described above, contact us for an appointment.

healthy feet

Understanding & Avoiding Ingrown Toenails

That painful ache you’re feeling in your big toe around the nail is just getting worse. It started out as just slightly annoying, but now it hurts to wear your shoes and walk. You may have realized that the pain is coming from one of your toes, more specifically the toenail. Perhaps you’ve noticed some redness or swelling around the toe, and maybe you even have some drainage from around your nail. These signs indicate that you might have an ingrown toenail. Ingrown toenails can range from simple irritation to a serious issue that poses additional health risks.

What is an ingrown toenail?

Ingrown toenails occur when the edge of the nail begins to grow into the soft skin of the toe. Initially, it may simply be painful and irritating, but when left untreated, ingrown toenails can become infected. Once a bacterial infection sets in, the area around the nail may swell, redden, and become filled with pus, which may or may not drain on its own. Because bacterial infections set in so easily around an ingrown toenail, it is important to have them examined and treated by a podiatrist as soon as possible. Without proper treatment, the bacteria can move beyond the toe and the area around the nail and enter the bloodstream.

Ingrown toenails may cause serious complications

Because of their high likelihood of infection, ingrown toenails may actually pose serious complications for some patients. Those who have joint replacements, pacemakers, or diabetes are at especially high risk for complications and further illness as a result of bacteria moving beyond the nail and into the bloodstream. This can cause infections to set in around artificial joints or implants, and for diabetics, it may cause complications with controlling blood sugar and staying healthy.

Causes of ingrown toenails

Improper trimming: Ingrown toenails may occur for a number of reasons, but perhaps the most common is simply trimming the toenails too short or trimming and rounding the corners.

Socks and shoes that are too small: Another common cause is wearing socks or shoes that are too tight around the toes, particularly those that are too short and thus cause the ends of the toes to press against the front of the shoes or socks.

Picking at or tearing toenails: Picking at the nails and tearing off the edges may also add to the risk of developing an ingrown toenail. Tearing off the edge of the nail causes the edge of the nail to come off unevenly, and risks tearing deeper into the nail towards the nail bed.

Injuries: Injuries to the toe or the toenail may also cause ingrown nails. The most common types of ingrown nail-causing injuries include stubbing the toe, dropping an object on it, or repetitive actions such as kicking during soccer or those that cause the feet to either swell or slide forward and put pressure on the toes, such as running or hiking.

Other causes of ingrown toenails: Other causes of ingrown toenails include heredity and fungal infections. For some unfortunate people, ingrown toenails appear to have no obvious cause.

Ingrown toenails, diabetes, & circulation disorders

In those with diabetes or circulation disorders, ingrown toenails may quickly progress from minor irritations to serious conditions with complications such as gangrene or bacterial infections.

Treating ingrown toenails when home care fails

If you have followed proper toenail hygiene and wear well-fitting socks and shoes but still suffer from ingrown toenails, you may benefit from a visit with your podiatrist. It is especially important to seek a podiatrist’s care for your ingrown toenails if you have diabetes or any type of cardiovascular disorder. Your podiatrist will evaluate the problematic toe to determine the severity of the problem, whether or not there are signs of infection, and the best course of action.

If your toenail is ingrown, treatment by a podiatrist typically involves numbing the toe with a local anesthetic followed by removing the edge of the nail. Depending on the severity of your ingrown nail and whether or not it is infected, additional measures may be taken to destroy the root of the nail to encourage new, healthy nail growth, or medications or other treatments may be administered. Most healthy patients don’t require any pain medication, even after the anesthetic has worn off, although antibiotics may be prescribed if there are signs of infection.

What happens after an ingrown toenail is treated?

Most patients have very few restrictions on their activity or footwear after the treatment of ingrown toenails. Most are able to bathe and shower normally and are also able to wear normal shoes right away after treatment. Those who take part in sports or other exercise activities are also usually able to go back to their activities without restrictions the next day. However, it is important to follow proper toenail care and ensure that your socks and shoes fit properly to help prevent future ingrown toenails, particularly since recurrence is fairly common.

Preventing ingrown toenails

There are some factors that simply can’t be avoided, such as hereditary tendencies towards ingrown toenails. If your parents suffered from them, you may as well. However, several other factors, when addressed properly, may help prevent ingrown toenails.

Wear properly fitting socks and shoes. Properly fitting socks and shoes are imperative in preventing ingrown toenails. Shoes and socks that are too short or too tight around the toes put excess pressure on the toes and may result in ingrown nails. Avoid shoes that are too loose as well, as the feet may shift forward and cause the toes to press against the front of the shoes, particularly when walking or running.

Take care in trimming your toenails. When trimming your toenails, cut straight across and avoid rounding the nail. Ideally, you should leave enough of an edge that you can slide a fingernail between the nail and the toe. Take care to avoid trimming your toenails to not overdo it. Repeatedly trimming the nails with great frequency may do more harm than good. In addition, avoid cutting a notch in the nail. At one point, it was thought that doing so might relieve the pressure, but in reality, it causes the nail to grow in a downward position — increasing the likelihood of developing ingrown nails.

Seek help from a podiatrist. Even if you are wearing properly-fitting socks and shoes and practice proper nail care, you may not be immune to ingrown toenails. It is important to seek help for a podiatrist at the first sign of an ingrown toenail rather than simply trying to treat it on your own. Those who attempt to treat their own ingrown toenails without podiatric help are far more likely to suffer from infections and to have recurrences of their ingrown nails.

If you have been suffering from painful toes and toenails, call one of 4 convenient locations today to schedule an appointment with one of our podiatrists. We look forward to helping you keep your feet healthy and happy for years to come.

custom orthotics

Do Custom Made Orthotics Really Work?

Orthotics are inserts for shoes designed to relieve foot and ankle pain by normalizing mechanics, decreasing weight-bearing stress, and providing cushioning for the feet. There are many types of orthotics made of many different materials. Some orthotics are custom made, some are built from pre-made components, and some are available over-the-counter (mass made).

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ankle sports injury

4 Misconceptions About Foot & Ankle Injuries

Your feet are complex structures, so oftentimes there’s more to an injury than meets the eye. This can be problematic, because some trainers and parents try to treat all injuries the same, with rest and ice, but that might not be effective. Today, we clear up four common misconceptions about foot and ankle injuries.

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seniors ankle problems

Ankle Fractures Can Be Death Sentences For Seniors

New research presented in the Journal of Foot and Ankle Surgery suggests that ankle fractures can essentially be a death sentence for elderly individuals.

For the study, researchers decided to see if “low energy” open ankle fractures had an impact on a senior citizens’ life expectancy. “Low energy” open ankle fractures were classified as compound fractures of the ankle resulting from every day, low-impact activities, like tripping on a step, falling off a curb or stepping wrong and bringing your weight down on an awkwardly positioned ankle. This is a clear distinction from high-impact ankle fractures, which are more common during car accidents or athletic activity.

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