Welcome to the Blog of Dr. Mark E. Sowell, DPM.

Please participate while you are here. Comment, ask questions and let me know how I am doing. My hope is that this blog will help relieve foot pain and avoid foot complications by providing some basic footcare information to its readers. I practice podiatry in Nacogdoches and Carthage Texas as well as over fifteen area nursing homes and assisted living facilities in East Texas.

Archive for Skin

Basic footcare guidelines:

  • Don’t ignore foot pain. It is not normal. If you experience any type of persistent pain in the foot or ankle, please contact our office.
  • Inspect your feet regularly. Pay attention to changes in color and temperature. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet may indicate Athlete’s Foot. Any growth on the foot is not considered normal.
  • Wash your feet regularly, especially between the toes, and be sure to dry them completely.
  • Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; this can lead to ingrown toenails. Persons with diabetes, poor circulation, or heart problems should not treat their own feet, because they are more prone to infection.
  • Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn out shoes as soon as possible.
  • Select and wear the right shoe for each sport or activity that you are engaged in (e.g., running shoes for running).
  • Alternate shoes—don’t wear the same pair of shoes every day.
  • Avoid walking barefooted. Your feet will be more prone to injury and infection. At the beach or when wearing sandals always use sunblock on your feet.
  • Be cautious when using home remedies for foot ailments. Self-treatment may turn a minor problem into a major one.
  • If you are a diabetic, please contact our office and schedule a check-up at least once a year
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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.  Skin lines or striations can be seen passing through callus tissue whereas they will pass 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 Lawrey’s seasoned salt 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.

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    Three weeks ago my sixteen year old son and I set out to hike the four C’s trail here in East Texas.  Basically it runs from the Neches river overlook to Ratcliff Lake Park near Crockett and spans about twenty miles.  I was reminded of two things on this trip with my son…I’m not sixteen anymore…and blisters hurt!

     Very few athletes that I know are unfamiliar with this term.  For that matter, most of us at some time in our lives have formed that wondrous, yet ill-appreciated lesion called a blister.  In general, blisters are raised and often fluid filled sacs of skin, which form in response to excessive heat and friction.  In the earlier stage of formation, blisters will be reddened areas of irritation or hot spots.  They will have definite burning sensations and will actually be warm to touch.  In those cases of continued activity, a clear watery fluid will seep into the area and the outer covering of skin will separate leaving a true blister.  New shoes, ill-fitted shoes, and just plain excessive walking can produce blisters in just abut anyone.

     However, although blisters may seem simple enough, they can spell trouble.  First of all, they can cause debility to such a point that a person cannot walk without pain.  Secondly, blisters have somehow notoriously invited improper treatment often resulting in infection and further problems.  Bathroom surgery without a license and with non-sterile instruments is indeed an open invitation to complications.  The most effective approach in dealing with blisters lies in the concept of self-prevention.  Checking one’s shoe fit, monitoring the activity level, and various types of shoe modification can be utilized to prevent these nasty hot spots from developing.

     According to this author, the outer layer of the blister should be left in tact.  It is a natural body defense shield against infection and greatly reduces the discomfort of the underlying raw tissue.  In an office setting and with sterile instruments, the fluid is painlessly drained and an adequate lubricating type of medication applied to protect the blister.  In about 24-48 hours the blister pain is gone and a layer of revitalized skin begins to form.  It should be emphasized that blisters should not be ignored or treated carelessly.  Although their occurrence and appearance seem quite simple, their potential hazards can indeed be complicated.  Happy hiking!

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    Feb
    25

    Athlete's Foot

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    Probably 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.  Patient 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!

    Categories : Fungus, Podiatry, Skin
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