Nail care is a very important part of podiatric medicine and surgery. There are ten nails on the average human foot, each of which can cause problems. Common conditions seen include ingrown nails, thick nails, long nails, fungal nails. Ingrown nails can lacerate the skin and cause skin and bone infections. Thick nails can cause ulcerations or sores of the nail bed. Long nails can lacerate the skin of adjacent toes or can pull off and cause an open wound or blood blister of the nail bed. Fungal nails can develop into an athlete’s foot infection.
Many people have difficulty with their toenails and need assistance in caring for them. A foot and ankle surgeon can diagnose the cause of toenail problems and can recommend treatments. Podiatrists treat the above and other conditions by medical and surgical means.
Fungal Nail Infections. A fungus is an organism that lives in warm moist areas. Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older.
Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time, it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail.
Nail fungus is not something to take lightly. This common cause of foot pain can create significant discomfort and disrupt your mobility. Proper treatment for a fungal nail infection can include antifungal medications or foot surgery to remove part or all of the infected nail. Over-the-counter antifungal nail creams and external applications tend to be ineffective against an infection because topical creams cannot penetrate the nail.
Probably the easiest and most highly recommended option is avoiding or limiting nail fungus altogether by keeping the nails clean and well groomed. If it’s too late for prevention, make an appointment with our Seattle podiatry office to find a solution.
Our podiatrist, Dr. John Hoy, may prescribe an oral antifungal medication to clear up a pesky nail fungus. A prescription antifungal medicine is designed to help the body grow a healthy, infection-free nail that will eventually supplant the affected nail altogether. This approach is especially recommended for those who:
- Have a history of cellulitis
- Experience pain or discomfort from the nail infection
- Have diabetes or other risk factors for cellulitis
If there is no fungus the pill will not work. The way to tell if there is fungus is we take a nail sample to send to the lab. If it shows fungus a blood test to check the liver and blood count is needed before prescribing the medication.
One thing to keep in mind, however, is that nail fungus treatment has no set timetable for complete recovery, even with a prescription. The entire healing process will differ patient to patient. It’s important to practice proper nail care at all times, even if the nails still look irregular in shape and appearance. Even if you’ve received treatment already, just know that nail fungus may come back. Recurrent infections happen frequently, especially when the nail is constantly exposed to warm, moist environments.
Surgery is an option to treat nail fungus, especially if the infection is to a point of pain. If that’s the case, Dr. Hoy will suggest the nail be removed either in part (debridement) or in its entirety (avulsion), and a new nail will then gradually develop in its place.
Nail Care. In addition to treating fungal infections, surgical removal of a part of the nail or the whole nail by a podiatrist may be necessary for some conditions such as ingrown nails or infections due to thick or fungal toenails.
Debridement, or reduction, of nails in patients who cannot do so themselves because of physical or cognitive limitations is also important. In patients with conditions such as diabetes, peripheral vascular disease or peripheral neuropathy can cause problems if one injures themselves while trying to take care of one’s own nails. By having a podiatrist perform these medical and surgical services for at-risk populations, complications can be avoided.