Archive for the ‘Athletes Foot’ Category

Blisters, Ingrown Toenails and Athletes Foot

July 28th, 2014 by Dr.Chang

INGROWN1Blisters are a result of the abrasion between your skin and sock or shoe. Because they can arise suddenly, it is important to take preventative measures to ensure your foot’s comfort. Preventing blisters begins with well fitting shoes, not too snug yet not too lose. Your socks should be snug fitting and made out of synthetic wicking material and with seams that cause minimal abrasion. Even after taking such precautions, many runners and athletes get blisters. If you find that you are prone to blisters, try regularly applying moisturizer to your feet, as dry skin is prone to friction, leading to blisters. Additionally, you may want to try rubbing your feet with Vaseline before a run if dryness is a problem for you, using foot powders to decrease moisture if your feet sweat too much, or wearing two pairs of socks so that they rub together instead of rubbing against your skin. You podiatrist may also prescribe prescription antiperspirants for more effective drying.

The rule of thumb is to leave small blisters intact so that the outer layer will protect the skin underneath. If you do get a blister on or off the trail, and it is large enough to see fluid inside, the best thing to do is to drain it and avoid it popping during activity. First, wash the affected area with soap and water. Sterilize a needle by rinsing it and soaking it in rubbing alcohol. Do not put the needle in a flame for sterilization as this method can lead to getting infectious carbon bits in your skin. Next, make a hole in the blister and squeeze out the fluid. Avoid removing the skin over a blister, because it provides padding and protection for the new skin growing underneath.  Finally, use hydrogen peroxide to prevent infection and wrap the area with antibiotic ointment and a bandage. You may want to use products like Second Skin or Band-Aid Blister Blocks, or soak your foot in Epsom salts to draw out fluid when you take off the bandages. If you find your blister is emitting yellow or green discharge, swell or reddens, you will want to see your doctor, as it is most likely infected. Additionally, if your blister is under or at the base of the toenail, see your podiatrist for treatment. Home removal of the toenail can cause infections and other complications, but your podiatrist will know how to drill a hole in the nail with an electric file.

ingrownIngrown toenails are one of the most commonly treated ailments. These are nails that are incorrectly shaped, so that they curve and grow into the skin, usually at the sides of the nail. This irritates the skin, causing pain, redness, swelling and warmth in the toe. Your toe may incur an infection if the nail breaks the skin, allowing bacteria to enter and cause an infection (indicated by a foul odor and a discharge of discolored fluids).  Ingrown toenails can be caused by a number of factors. While they are often hereditary, they can be the result of traumatic injuries, improper trimming, poorly fitting footwear, and nail conditions (such as fungal problems).

INGROWN3Home treatment of ingrown toenails should be limited to consistently cutting and filing the nail straight across and soaking the nail in Epsom’s salt. Never cut notches in the nail, do not repeatedly trim the nail borders, and do not place materials (such as cotton) beneath the nail, as all of these methods increase the likelihood of bacterial infection. Over-the-counter topical medications only relieve pain but do not cure the symptoms. “Home surgery” on your ingrown nails is not recommended, since repeated cutting of the nail can cause the condition to worsen over time. If your nail does not improve, visit your podiatrist for a simple procedure. Dr. Chang and Dr. Murray can easily perform a minor surgical procedure. They will take off the small offending border that is causing pain and permanently remove it so that it does not grow back into your skin. Note that they do not remove the entire nail, so this simple procedure can alleviate your pain with minimal recovery time.

Athlete’s foot, officially known as tinea pedis, is a fungal infection between the toes and on the soles of the feet. With this infection the skin on your foot may feel itchy or painful, will have scales redness and blisters. Podiatrists will recommend the applications of a fungicide such as Desenex, Tinactin, Lotrimin or Lamisil. Using these products a few times a day for two weeks to a month will help remedy the irritation and other symptoms. If symptoms reoccur, be sure to rotate the fungicide you use so that the fungus does not build up a tolerance to one brand. You may want to try additional remedies for the itching, such as soaking your feet in a baking soda and water solution, removing the dead skin with a pumice stone, or rubbing fine sandpaper along the bottoms of the feet (and disposing of the sandpaper after use!).

 

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Blisters are a result of the abrasion between your skin and sock or shoe. Because they can arise suddenly, it is important to take preventative measures to ensure your foot’s comfort. Preventing blisters begins with well fitting shoes, not too snug yet not too lose. Your socks should be snug fitting and made out of synthetic wicking material and with seams that cause minimal abrasion. Even after taking such precautions, many runners and athletes get blisters. If you find that you are prone to blisters, try regularly applying moisturizer to your feet, as dry skin is prone to friction, leading to blisters. Additionally, you may want to try rubbing your feet with Vaseline before a run if dryness is a problem for you, using foot powders to decrease moisture if your feet sweat too much, or wearing two pairs of socks so that they rub together instead of rubbing against your skin. You podiatrist may also prescribe prescription antiperspirants for more effective drying.

The rule of thumb is to leave small blisters intact so that the outer layer will protect the skin underneath. If you do get a blister on or off the trail, and it is large enough to see fluid inside, the best thing to do is to drain it and avoid it popping during activity. First, wash the affected area with soap and water. Sterilize a needle by rinsing it and soaking it in rubbing alcohol. Do not put the needle in a flame for sterilization as this method can lead to getting infectious carbon bits in your skin. Next, make a hole in the blister and squeeze out the fluid. Avoid removing the skin over a blister, because it provides padding and protection for the new skin growing underneath.  Finally, use hydrogen peroxide to prevent infection and wrap the area with antibiotic ointment and a bandage. You may want to use products like Second Skin or Band-Aid Blister Blocks, or soak your foot in Epsom salts to draw out fluid when you take off the bandages. If you find your blister is emitting yellow or green discharge, swell or reddens, you will want to see your doctor, as it is most likely infected. Additionally, if your blister is under or at the base of the toenail, see your podiatrist for treatment. Home removal of the toenail can cause infections and other complications, but your podiatrist will know how to drill a hole in the nail with an electric file.

Ingrown toenails are one of the most commonly treated ailments. These are nails that are incorrectly shaped, so that they curve and grow into the skin, usually at the sides of the nail. This irritates the skin, causing pain, redness, swelling and warmth in the toe. Your toe may incur an infection if the nail breaks the skin, allowing bacteria to enter and cause an infection (indicated by a foul odor and a discharge of discolored fluids).  Ingrown toenails can be caused by a number of factors. While they are often hereditary, they can be the result of traumatic injuries, improper trimming, poorly fitting footwear, and nail conditions (such as fungal problems).

Home treatment of ingrown toenails should be limited to consistently cutting and filing the nail straight across and soaking the nail in Epsom’s salt. Never cut notches in the nail, do not repeatedly trim the nail borders, and do not place materials (such as cotton) beneath the nail, as all of these methods increase the likelihood of bacterial infection. Over-the-counter topical medications only relieve pain but do not cure the symptoms. “Home surgery” on your ingrown nails is not recommended, since repeated cutting of the nail can cause the condition to worsen over time. If your nail does not improve, visit your podiatrist for a simple procedure. Dr. Chang and Dr. Murray can easily perform a minor surgical procedure. They will take off the small offending border that is causing pain and permanently remove it so that it does not grow back into your skin. Note that they do not remove the entire nail, so this simple procedure can alleviate your pain with minimal recovery time.

Athlete’s foot, officially known as tinea pedis, is a fungal infection between the toes and on the soles of the feet. With this infection the skin on your foot may feel itchy or painful, will have scales redness and blisters. Podiatrists will recommend the applications of a fungicide such as Desenex, Tinactin, Lotrimin or Lamisil. Using these products a few times a day for two weeks to a month will help remedy the irritation and other symptoms. If symptoms reoccur, be sure to rotate the fungicide you use so that the fungus does not build up a tolerance to one brand. You may want to try additional remedies for the itching, such as soaking your feet in a baking soda and water solution, removing the dead skin with a pumice stone, or rubbing fine sandpaper along the bottoms of the feet (and disposing of the sandpaper after use!).

When Can I Run Again After a Stress Fracture ?

October 11th, 2010 by Dr.Chang

I have seen an unusually large amount of running related stress fractures recently in the office.  I thought I would blog on a common concern of my athlete patients.

A runner with a Stress Fracture, often times have a burning desire to return to running.  Some think a stress fracture really in not a “real” fracture, so return to activity should take less time.  Right?  I say maybe ……A fracture of any type is a challenge as is significantly alters ones lifestyle.  Particularly runners.  They may end up forgoing a race, a goal they have set for achievement, or just miss the “runner’s high” they get from getting out on the road.  In find that  runners often get in a hurry to get back into the activity and can cause additional injury from not waiting until the appropriate time to return.

While it is true stress fractures are not “true” and complete fractures … the condition does require similar protocols for fracture healing.  However, in my experience, the traditional fracture healing times may by truncated.

Generally speaking an osseous injury requires 6-8 weeks of protection and relative inactivity to heal adequately.  This is a “rule of thumb” benchmark which has been made over time by medical professionals based on experience, x-ray evidence and patient feedback in the healing process.  It is individual dependent, fluid, but very close to accurate in my experience.

What are the biggest factors that influence my determination of healing?  !) X-Ray evidence.  2) Resolution of pain.
So, how do I transition back to running?

What is the most accurate indication of healing? Bone healing, as with fractures, is usually confirmed on x-ray.  If the x-ray shows sufficient callus formation around the fracture and “filling” fracture by reduction of fracture line lucency, the area is healed.  This means the bone is sufficiently stable for return to activity and re-injury risks are reduced.  It is best to wait until this has occurred to return to any running type of exercise….  If your goal is to get back to running pain free, hastening your return to running is not advised.

–         Pain is improved can I run? Depending on the type and degree of the fracture, pain can improve and sometimes resolve by 2-3 weeks.  I often see most fractures being pain free at week 4.  Absence of pain is a good sign, but not a guarantee that healing is complete.   If you were to run too soon, I could create a situation requiring a return to cast or boot and possibly even surgery.

How do I get back to running? The best way to get back to running is to do it progressively and gradually. .  Expect recovery to normal to be 3 times that (at least) to what your recovery time was observed at.  This means a recovery time of 6-8 weeks is a 18-24 gradual return to activity. .  Start slow, preferably on a surface that will protect you from re-injury.  As you transition back running, try up to 1 mile only for the first 3-5 days, and then start adding mileage to your normal running routine.  Pain is always a good guide to prevent re-injury.  Too much too soon, and your body will tell you.  Don’t ignore these signs.
Anything worth doing, is worth doing right.  This is especially true in an orthopedic injury.  There will always be another race.  There will be another time to set fitness goals.  Take time to respect your body and appreciate the remarkable ability you have to affect healing to an injury.  Your body thanks you!

See our website fracture informtion pages here and here , for more information.

Athletes and Foot Fungus

June 8th, 2010 by Dr.Chang

In treating an athlete population, we find there is a high occurrence of fungus issues. Here are the two most common fungus issues our athlete patients deal with and some solutions to fix the problems.

Athlete’s Foot

The Athlete’s foot typically affects the skin on the feet between the toes, but can move anywhere and even affect the toenails. When the infection spreads to the toenails, they become thick and distorted.

Fungi are organisms such as mold and mildew and grow best in conditions that are moist. Bacteria may thrive also as a secondary infection, which worsens the symptoms of the disorder and makes it more difficult to cure

It is common to catch athlete’s foot from other people who have it by walking on floors that are moist or wet (e.g. at swimming pools and in shared bathroom/locker room facilities). Athlete’s foot is also much more common in people who tend to have moist feet, a condition called hyperhidrosis. Athlete’s foot can also be spread by sharing other people’s shoes or personal care items such as towels and wash cloths.

Athlete’s foot and fungus may also spread to other parts of the body, notably the groin and underarms, by those who scratch their feet and then touch themselves elsewhere.

Symptoms Include:
– Reddened, cracked, and peeling skin
– Some bleeding
– Itching
– Burning
– Stinging sensation
– Development of small blisters (Blisters often lead to cracking of the skin. When blisters break, small raw
areas of tissue are exposed, causing pain and swelling. Itching and burning may increase as the infection spreads. In severe cases the skin may thicken, like a callus and begin to scale.

Treatment:
There are a variety of over-the-counter products that can be used to treat tinea pedis fungus, such as:
– Lotrimin, Lamasil AT, Clotrimazole (creams & lotions)
– Bromi-Lotion or Bromi-Talc Powder (drying agents)

After a period of time, if products used for athlete’s foot and fungus fail, physician strength or prescription topical and/or oral antifungal drugs, can be prescribed by your Podiatrist.

Prevention
-Wear sandals or shoes when walking on moist wet floors
-Don’t share shoes or personal care items such as towels
-Wear socks made of absorbent materials such as cotton or wool
-Change socks frequently if you perspire heavily
-Choose footwear that allows for the circulation of air
-Keep the floors in shared facilities clean and dry
-Keep your feet clean and dry by dusting Bromi-Talc Foot Powder in shoes and hose and feet
-Clean athletic shoes frequently with a good athletic shoe cleaning product

Fungal Nails
Fungal infection of toenails, called Onychomycosis, is a common foot health problem that many people do not recognize. Fungi easily attack the nail, thriving off keratin, the nail’s protein substance, and exfoliated nail bed tissue. This is especially common among athletes where the repetitive stress of activity distorts the toenail construct and allows organisms, which already exist on the skin, to invade under the nail plate.

Onychomycosis is an infection underneath the nail that can also penetrate the nail. If it is ignored, it could impair one’s ability to work or even walk because it is frequently accompanied by thickening of the nails, which then cannot be easily trimmed, and may cause pain while wearing shoes. This disease can frequently be accompanied by a secondary bacterial and/or yeast infection in/or about the nail plate.

Symptoms:
– Change in color (yellow or brown)
– Nail gets thicker
– Bad odor
– Debris collects beneath the nail
– White marks on the nail
– This infection is capable of spreading to other nails, the skin or even the fingernails.

There are a variety of products that can be used on the toe nails that fungus. We have had good results with topical:
– Formula 3
– Fungasil
– Gordochrom Fungicide-Germicide

Prevention
Clean, dry feet resist disease. Wash the feet with soap and water, and dry thoroughly. Shower shoes should be worn in public areas. Shoes, socks and hosiery should be changed daily. Use a quality foot powder, talcum not cornstarch. Buy shoes that fit well and are made of materials that breathe.

Seeing your Podiatrist :
– A Podiatrist (DPM) can detect a fungal infection early. A suitable treatment plan may include prescribing topical or oral medication (such as Lamisil), and debridement (removal of diseased nail matter and debris) of an infected nail. Debridement is one of the among most common foot care procedures performed by DPMs. Debridement allows for reduction of fungal load and more effective penetration of topical medications when used. In some cases surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured and prevents the return of a deformed nail.

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