March 2024

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

Diabetes can cause two problems that can potentially affect the feet: Diabetic neuropathy and Peripheral Vascular Disease. Diabetic neuropathy occurs when nerves in your legs and feet become damaged, which prevents you from feeling heat, cold, or pain. The problem with diabetic neuropathy is that a cut or sore on the foot may go unnoticed and the cut may eventually become infected. This condition is also a main cause of foot ulcers. Additionally, Peripheral vascular disease also affects blood flow in the body. Poor blood flow will cause sores and cuts to take longer to heal. Infections that don’t heal do to poor blood flow can potentially cause ulcers or gangrene.

There are certain foot problems that are more commonly found in people with diabetes such as Athlete’s foot, calluses, corns, blisters, bunions, foot ulcers, ingrown toenails, and plantar warts. These conditions can lead to infection and serious complications such as amputation. Fortunately, proper foot care can help prevent these foot problems before they progress into more serious complications.       

Each day you should wash your feet in warm water with a mild soap. When you finish washing your feet, dry them carefully especially between your toes. You should also perform daily foot inspections to ensure you don’t have any redness, blisters, or calluses. Furthermore, if you are diabetic, you should always wear closed-toed shoes or slippers to protect your feet. Practicing these tips will help ensure that your feet are kept healthy and away from infection.

If you have diabetes, contact your podiatrist if you have any of the following symptoms on your feet: changes in skin color, corns or calluses, open sores that are slow to heal, unusual and persistent odor, or changes in skin temperature. Your podiatrist will do a thorough examination of your feet to help treat these problematic conditions.

Heel spurs are the result of calcium deposits that cause bony protrusions on the underside of the heel. Heel spurs are usually painless, but they have the potential to cause heel pain. Heel spurs tend to be associated with plantar fasciitis, which is a condition that causes inflammation of the band of connective tissue that runs along the bottom of the foot. They most often occur to athletes whose sports involve a lot of running and jumping.

Some risk factors for developing heel spurs include running and jogging on hard surfaces, being obese, wearing poorly fitting shoes, or having walking gait abnormalities.

It is possible to have a heel spur without showing signs of any symptoms. However, if inflammation develops at the point of the spur’s formation, you may have pain while walking or running. In terms of diagnosis, sometimes all a doctor needs to know is that the patient is experiencing a sharp pain localized to the heel to diagnose a heel spur. Other times, an x-ray may be needed to confirm the presence of a heel spur.

Heel spurs can be prevented by wearing well-fitting shoes that have shock-absorbent soles. You should also be sure that you are choosing the right shoe for the activity you want to partake in; for example, do not wear walking shoes when you want to go on a run. Additionally, maintaining a healthy weight can be beneficial toward preventing heel spurs, as it will prevent an excess amount of pressure being placed on the ligaments.

There are a variety of treatment options for people with heel spurs. Some of these include stretching exercises, physical therapy, shoe inserts, or taping and strapping to rest stressed muscles and tendons. If you have heel pain that lasts longer than a month, don’t hesitate to seek help from a podiatrist. Your doctor can help you determine which treatment option is best for you.

A new treatment for fungal nails, or onychomycosis, which has grown in popularity in recent years, is laser treatment. Laser treatment involves the use of a laser that kills fungus in the toenail with heat. Laser therapy causes no side effects and does not affect nearby healthy tissue.

Toenail fungus afflicts almost 10 percent of the U.S. population and is more common among the elderly. The most common symptom of toenail fungus is the discoloration and thickening of the nail. The nail can also become brittle and a foul smell may be produced. In rare cases, pain might be present. While it is not a serious condition, it can lead to a perception of disgust amongst those it affects. There are several different fungi that cause fungal infections. These include dermatophyte, yeast, and mold. The most common of these is dermatophyte.

Diagnosis for fungal nails involves a podiatrist utilizing microscopy and fungal cultures. This will allow the doctor to determine whether it is a fungus or another condition, such as lichen planus, psoriasis, nail damage, and onychogryphosis.

Fungus in the nails can be hard to get rid of with over-the-counter drugs. This is due to the nail being hard and protective, with fungus able to slip between the nail bed and plate. Furthermore the slow growth of the nail increases the difficulty of fungus going away. Laser treatment seeks to get around this by directly penetrating through the nail and killing the fungus. The laser is used on each infected nail for a couple of minutes. Patients then typically return several weeks or months later for another laser treatment. During this time the podiatrist will routinely observe the foot and infection. It is also recommended to wear clean socks and shoes and allow the feet to dry and breathe to prevent toenail fungus.

Laser treatment is still a relatively new treatment and not all podiatrists have laser machines. Ask your podiatrist if they do laser treatment for toenail fungus and if it is right for you.