Archive for Skin
Smelly Feet
Posted by: | CommentsThroughout life there might be times when we are bothered by how our feet smell. If I had a nickel every time the mother of a teenage boy was embarrassed by his smelly feet I could travel more…just kidding. Some suffer with excessive sweating (hyperhydrosis) and bacterial skin infection that can lead to malodor. In my practice I like to start with a simple solution and if it does not work then we can try something more aggressive. In the case of “smelly feet” I recommend tea soaks. Simply boil some water (enough for a foot bath), steep a few tea bags and let the water cool to a point you could put your elbow in it without discomfort. Then soak your feet for about fifteen minutes and do this daily for two weeks. The tannic acid in tea should lower the pH enough to kill surface bacteria and should help shrink sweat glands a bit. A few puffs of Lysol in the shoe never hurt either. If this does not do the trick the call and make an appointment at Sowell Podiatry and we will get to the bottom of the problem!
Corns and Calluses
Posted by: | CommentsOur bodies have a wonderful ability to protect us from injury. For example, reflexes help us avoid many bumps and bruises. Another protective ability we don’t often think about is the skin’s ability to avoid ulceration. When the foot is getting a large amount of pressure focused in a relatively small area the skin adds layers to protect itself. These extra layers of keratin make the skin less vulnerable to puncture and reduces its ability to break. These added layers are known as callus.
If callus is allowed to collect unchecked it can become very painful, can change how you walk and can lead to open wounds on your feet. This increases your risk of infection.
Callus goes by many names depending upon its location on the foot:
-“Corns” are usually on top of the small joints of the toes.
-“Soft corns” are usually between the toes at pressure points.
-Calluses on the bottom of the feet are usually just called “calluses” but podiatrists typically call them tylomas.
-“seed corns” are painful focused calluses found on pressure spots typically on the bottom of the foot.
Calluses of all types can lead to severe pain and should be addressed with treatment as well as prevention. Typically, trimming the callus will reduce your discomfort but determining why the callus is there will help us prevent its recurrence. Shoes and how we walk in them are often the culprits and modifications of them can lead to the calluses going away due to the reduction in pressure. Shoe adjustments, pads, inserts and orthotics are just a few conservative approaches that can prevent callus formation.
If conservative measures are unsuccessful, surgery might be recommended to help you walk without painful corns and calluses in the future. Contact Dr. Sowell and see if he can make each step less painful.
Warts
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Today, we know that you don’t have be a liar, touch a toad, or drink a witch’s evil potion to get a wart. In all probability, you can’t even grow one by touching another person’s wart. Apparently, these lesions are non-contagious but can spread within the involved area of the same individual. In actuality, warts are encapsulated or walled off growths of viral tissue. Plantar warts on the feet are frequently painful with squeezing type pressure. In the vast majority of cases, the growth of a wart is preceded by some sort of skin puncture or would defect that in all probability, allows an entry site for contamination. Whether we all have inactive or potential wart viruses circulating in our bodies or gain the virus through the wound is as of yet unclear.
An interesting and often confusing distinction must be made between certain calluses and plantar warts. The surface of the wart often looks bumpy, or papillomatous, like cauliflower while skin lines or striations can be seen passing around a wart. In addition, plantar warts, upon close examination, will often demonstrate small black dots which when trimmed will bleed. These are tiny blood vessels, which become caught in the growth itself and are absent in regular callus tissue. A final line of distinction in identifying a wart is in its response to pressure. Squeezing a wart will usually produce extreme pain as opposed to similar pain from direct pressure on calluses.
Warts that appear on the hands and fingers are usually more responsive to therapy than are those on the feet. The professional methods of treatment available for plantar warts include just about everything from chemical applications and surgery to banana peels and hypnosis. Some warts respond quickly and some do not, and that my friends, is just plain honesty. I tend to start conservatively and if not successful become more aggressive in the fight. Even though we all know those old wives tales to be ridiculous, perhaps until your appointment with your foot specialist, you should stay away from toads, telling lies, and drinking weird tasting brews.
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!
Is it a wart? A Guide from a Podiatrist in Nacogdoches Texas
Posted by: | CommentsI’ll never forget a golf outing about ten years ago when I had just returned to Nacogdoches to practice podiatry. I was grouped with three older guys and we were playing in a scramble. After a few holes together, they realized that I was a foot doctor for a living and off came the shoes! Lol. Not a big deal. I am happy to help as many people as I can with their foot concerns ( that’s why I’m blogging today) but now that I am blogging I think I will try to discuss the common questions I get while out and about. I won’t mention your names!
After church Sunday, one of our moms pulled me aside and wanted me to determine if a lesion on her son’s foot was a wart. This is a common question and, yes, a professional should be consulted if the lesion is not easily resolved. But I thought I would describe the common descriptors of a plantar (bottom of the foot) verruca (wart). I learned it this way…
“A plantar verruca is characterized by papillomatous tissue with skin line deviation, capillary budding and pain upon lateral compression” I’ll explain. Papillomatous tissue looks like the surface of cauliflower, Skin lines (fingerprint lines) curve around the lesion, Capillary buds look like brown spots within the wart, and it hurts when you squeeze it because a wart gathers up nerve fibers as it develops.
I hope this helps. This is not intended to limit questions along the way…lol. Just intended to help those I don’t bump into. Please let me know how I can help and I’m glad the young man in church was a good sport when I told him we have a fairly easy way to get rid of it. For him, I hope it works so that we don’t have to remove it surgically! He made it clear that he was relieved…lol.
