NAIL AND SKIN PROBLEMS
Thickened nails can cause pain by increasing the pressure underneath the nail too much, or by ingrowing. They can be caused by trauma, circulation problems or a nail infection. Don't despair, they can be managed.
Fungal Nail Infections
Fungal nail infections (onychomycosis) are extremely common, recent statistics suggesting 50% of people over 65 suffered with it, and if those people had diabetes it jumped to 65%. It can be contracted through contaminated instruments, or by sharing showers, nail polish or foot baths with someone who has the infection. It can also be contracted through a minor trauma to the nail (if you kick it) and the natural flora on your skin can migrate into the nail.
It can be treated with topical medications or oral tablets. There are many products on the market and it's not so much about finding the best one, it's about finding the right one to treat the specific infection you have. To work this out it needs to be systematically trialled. Pathology testing can be used to see if you have the bug that will respond to oral medication. Laser treatment is a relatively new form of treatment. We welcome more research to show its effectiveness.
Ingrown toenails are very sore and need to be attended to sooner rather than later. They are caused by nails that are too wide, too thick, cut incorrectly, trauma or pressure. The nails needs to be cut back properly and the pressure relieved to reduce your pain. Sometimes, antibiotics and medication may be required if the area is very infected. A long term management plan will be outlined to manage what's exactly wrong with your toe.
Surgery is always used as a last resort for ingrowing toenails. But, this technique for removing ingrowing nails permanently (95% of the time), and is very effective. A recent study showed this form of nail removal had the lowest rates of re-growth and post-operative pain compared with other surgical techniques. This process is used to remove a portion of a nail that is causing pain.
Firstly, we need to ascertain whether you are medically suitable to undergo this procedure, and if so is done with local aesthetic and takes a few minutes to complete. The rates of post-operative pain are minimal and the procedure very effective. Interested? Watch a video of the procedure and see how quick and simple it is. The area takes about 3 weeks to be completely healed.
Corns and Callouses
Corns and callouses are dead skin that builds up with pressure from joint changes (such as arthritis) and pressure from footwear. Callouses tend to be across large areas like the heel and sole of the foot, and corns are generally at bony prominences like the top or sides of toes. Firstly, the hard skin that's causing the pain needs to be removed. Corns and callouses can be really painful to stand on but virtually painless to treat - there are no nerves in dead skin so no pain to remove them. They're sore when you stand on them because they're hard and causes inflammation and pain in the underlying tissues. So it means that you will feel considerably better as soon as you leave the practice. Secondly, the cause of the corn or callous need to be addressed to minimise the re-occurrence.
Warts are not necessarily painful and are often mistaken for corns. But rather than being caused by pressure, they are a virus similar to the cold sore virus. Warts are common in children and adolescents and become less common as we age. Unlike a corn, they are very tricky to surgically remove so this is not advised as a first line treatment. The potential scarring as a result of surgically removing a wart can cause long term pressure point and pain. So the first aim of treatment is to make the immune system realise that the virus is in that area and to attack it. Like when you have the flu there is no treatment for it, the Doctor will send you home with bed rest to let your body fight it. So the "bed rest" for wart is trying to try and create a local reaction at the site of the lesion to stimulate your immune system. To do this we can apply topical acids, freezing them or even use whacky things like garlic and banana skins! They can be with you for some time or go relatively quickly. It will all depend on how quickly your immune system attacks the lesion.
Psoriasis, Dermatitis and Skin Irritations
Whether you have an allergy or issue with a skin irritation, having this on your foot can be painful to walk on. We can advise on what is best to do as a first line treatment to reduce the pain or suggest local Dermatologists (skin specialists).