Archive for Infection
Ingrown Toenails
Posted by: | CommentsAn ingrown toenail is a result of a nail growing into the skin that surrounds it. The big toe is the most common location but it may occur in any digit. At Sowell Podiatry, ingrown toes nails are very common. Too often these ingrown toenails are not cared for quickly enough and infection has typically set in when they arrive in our office. Ingrown toenails may cause pain at the tip of the toe or all the way down to the base of the toe and are usually more painful when walking and when wearing shoes.
A red, swollen, painful nail margin is very common with infection of the ingrown toenail and often times there will also be bleeding and pus. Parents should be aware that children are often times slow to discuss this problem and if they get any hint that there might be a problem such as altered gait, sock stains or a grimace they should inspect the child’s toes immediately. We perform many toenail procedures and take many steps to make this as comfortable and pain-free as possible.
Ingrown toenails have many potential causes. Some of the most common are:
- Improperly fitting shoes.
- Trauma to the toe.
- Thickened toenails due to fungus or repeated trauma.
- Improper trimming of toenails.
Treatment of an ingrown toenail typically involves addressing any bacterial infection in the skin first. Surface infection may often respond to proper foot soaks or antibiotic creams and oral antibiotics may also be used depending on the severity of the infection. A removal of the offending toenail is generally required and is often performed under local anesthesia. At this point, the toenail edge may be removed and allowed to re-grow or it may be removed permanently, this is called a matrixectomy. Please call Sowell Podiatry if you are suffering with an ingrown toenail and we will help you return to an active pain free lifestyle as quickly as possible.
Toenail Fungus – Onychomycosis
Posted by: | CommentsOne of the most common foot conditions Dr. Sowell sees everyday is painful onychomycosis. That is to say that fungal nails have become very common in our society today and it is estimated that over 35 million people have fungal toenails in the United States alone. Fungal toenails are characterized as being thick, yellow, crumbly and abnormal in growth. They often times become very painful and can be embarrassing for patients. At Sowell Podiatry we take this condition very seriously and address it with a protocol that should provide a higher success rate.
1) We clean and sterilize all instruments properly using autoclave and chemical baths for each instrument that touches a patient.
2) We biopsy toenails before treating the toenail to verify that the condition is in fact caused by a fungus. There are some conditions such as micro-trauma and psoriasis to name a few that mimic onychomycosis.
3) We provide in depth debridement services for fungally infected toenails to reduce their risk of spread.
4) We measure and record fungal infection to determine if the condition is getting better.
5) We offer multiple treatment options to help the patient find a treatment course that fits their goals.
At Sowell Podiatry it is our goal to reduce the spread of fungal toenails in our community and we do that one toe at a time. If your toenails look abnormal, yellow or painful please give us a call.
Athlete’s Foot
Posted by: | CommentsProbably one of the most missed diagnosis of the foot I see is Chronic Dermatophytosis, aka Athlete’s Foot. We all seem to recognize the acute form many get in high school where the feet itch excessively and the skin between the toes is wet and has turned white, aka maceration, but we often mistake the chronic type of dermatophytosis as dry skin. Patients say, “Doc I keep putting moisturizing cream on my skin but they still look dry”. Well that’s because their problem is a fungus, not dry skin.
You do not have to be a member of a sports team to get athlete’s foot. In fact, believe it or not, you don’t even have to play a sport. The condition itself usually results from an overgrowth of a particular fungus organism. In most cases, the areas between the toes and the arch of the foot are most often involved. Athlete’s foot may appear in different stages, each with its own presentation. For instance, the acute stage may have blisters or have intense itching. In addition, there may be maceration between the toes and occasional drainage. The chronic condition is characterized more by a dry and scaly appearance and rarely itches. My favorite description of chronic dermatophytosis (yes I have a favorite!) is “a moccasin distribution of dry ruptured vesicles”. There is some confusion as to how this skin condition can be transmitted but at the present time, the consensus of opinion is that there is a contagious capacity. In short, you might be able to catch it from the next guy or gal, so watch your barefoot walking! Also, it can come from fungal toenails if you have those.
Occasionally, an athlete’s foot condition will become infected and require more extensive therapy. In actuality, the threat of subsequent infection is probably a prime reason for treating more aggressively the earlier stage of the condition. After all, one might ask, what is really so bad about a little itching between the toes. Well, by itself, probably not a whole lot. But in those cases where that little itching develops into a more involved complication, then we might be facing a more serious problem.
At the first sign of an athlete’s foot condition, I would recommend a short trial period of a medicinal preparation available at the pharmacy in spray or cream varieties. Following several days use, if the condition persists, I would recommend a visit to the foot specialist. One thing is for sure, do not give up your athletic status in the hopes of relinquishing your athlete’s foot!
Abscess in the Foot
Posted by: | CommentsAs a podiatrist, I see many unusual things. Diabetics who have stepped on a sewing needle and not realized it, puncture wounds from thorns that went through a hunting boot and holes completely through a foot due to a misguided pressure washer! All of these injuries require the removal of a foreign body but they also have the potential to lead to an abscess. In fact, any break in the skin can lead to an abscess.
An Abscess is a collection of pus under the skin. Abscesses are considered localized infections that can cause pain and illness. An abscess can initiate the growth of aggressive infections to other parts of the body. When an abscess develops on the foot, the area involved may become red, hot, swollen, and tender. This infection can spread and ultimately affect other tissues in the foot and leg. When abscesses become large and go untreated, the infection can spread to the bone and lead to a bone infection (osteomyelitis). Once the bone becomes infected, more extensive surgery may be necessary to resolve the infection.
Abscesses can be caused by many factors. Patients that have depressed immune systems are much more at risk for developing an abscess. Diabetes is an example of a disease where one’s immune system is compromised. Often times, a small break in the skin or a blister can start the formation of an abscess. Poor hygiene can also contribute to abscess development and must be addressed during the course of any treatment. Abscesses can form on the feet and can be extremely painful. Abscesses tend to grow in warm moist places, and therefore, the foot is a frequent site for this condition. Trauma is another cause of abscess formation. When direct injury occurs to the foot or any part of the body resulting in a break in the skin, a pathway for infection is created.
Abscesses can be treated conservatively or surgically depending on the extent of the abscess formation. Initially, the treatment should consist of rest and staying off of the affected limb or body part. Warm soaks and moist heat can help alleviate the pain associated with abscess formation. Antibiotics are usually given to the patient to fight off the infection. However, depending upon the extent of the abscess and the organism involved, oral antibiotics may not be enough to fight off the infection. Drainage of the abscess may be warranted if the infection does not resolve. If the abscess is surgically treated IV or oral antibiotics may be administered. After the abscess heals or during the healing process itself, the wound should be kept clean and close monitoring of the condition should be performed.
As you can see, an abscess can be a very serious condition and should be evaluated and treated by a physician. Podiatrists are trained to handle injuries and infections of the foot and are an excellent choice when dealing with an abscess, or potential abscess.
