Fungal infection of the toenails

A common and cosmetically displeasing condition affecting the toenails. Also known as Dermatophytic Onychomycosis. The infecting organisms are usually from the family of dermatophytes but can also include yeasts and moulds.

What are the signs and symptoms?

Well, these are not always present in the early stages but may include….

• Discolouration starting at the free edge of the nail moving down the side towards the cuticle
• White, yellow, crumbly appearance of the nail
• The whole of the nail may be involved
• Thickening of the nail
• Separation of the nail from the nail bed
• Pain under the nail
• Inflammation around the nail

Signs and symptoms of nail discolouration or deformity may not always be clear and should never be ignored. If you are concerned it is best to consult a Podiatrist or Doctor for a proper diagnosis.

How did this happen?

The most common cause of toenail fungus is cross infection with Tinea Pedis better known as Athlete’s Foot! A common fungal infection of the skin. Other causes include:

• Keeping feet in a closed, warm, moist environment
• Ill fitting footwear or hosiery
• Wearing synthetic fibres or nylons in footwear and hosiery
• Occluding nails with nail polish for long periods of time
• Cross infection in communal areas

Fungal organisms are opportunistic, which means they often affect people whose immune defences are running low.

Treatments

The type of treatment advised very much depends on the organism, the area of nail affected and how severe the infection is. If there are mild to no symptoms and the cosmetic appearance is not causing concern, treatment may not be necessary.

For mild to moderate fungal infections or if you are unable to take systemic medication, the recommendation may be to start treatment with an anti-fungal nail lacquer as a home treatment. This works well in conjunction with regular reduction and filing of the affected nails by your Podiatrist throughout the treatment period.

If the infection is more severe, the recommended treatment may involve a combination of oral medication, anti-fungal nail lacquer application and nail reduction and filing by your Podiatrist. Fungal infections of the toenails can be a real challenge to treat but not impossible!  Working as a team with your Podiatrist will give you a better chance of cure.  

Prevention is better than cure!

Prevention is definitely better than cure when it comes to fungal infection of the nails.

The following tips will help you keep your nails fungus free:

• Look after your nails keep them short and filed. Use your own nail care equipment
• Treat any fungal infections of your feet as soon as possible to prevent cross infection to your nails
• Let your feet and nails breathe! Wear cotton hosiery and well fitting shoes. Dispose of old contaminated footwear
• Take nail polish off, avoid leaving on your nails for long periods
• Wear protective footwear in communal areas such as swimming pool sides and changing areas
• Keeping your immune system healthy!
• Visit your Podiatrist regularly for a foot health check

Sources:

British Association of Dermatologists – www.bad.org.uk

CKS – Nice. Fungal nail infection – cks.nice.org.uk

The post Fungal infections of the toenails appeared first on FeetPlus Horley and Rochester.

You may have heard of or experienced this debilitating heel condition. Plantar fasciitis is an inflammation of the Plantar fascia and is the commonest cause of heel pain.

The plantar fascia is a fibrous band of tissue that supports many structures in the foot. Inflammation results from acute micro-tears commonly occurring at its point of origin on the heel bone. With constant use of the feet during daily activities, the micro-tears have little chance of healing and so the condition becomes increasingly painful particularly first thing in the morning and after long periods of inactivity.

Common signs and symptoms to watch out for are:

• Bruise like pain or ache around the inner region of your heel.
• Pain on weight bearing, usually worse in the morning or after any period of inactivity.
• There may be redness and swelling of the affected area
• Limping due to pain. Aches and pains on the supporting limb and foot.

What has caused this? Well, It could be a number of things which we will discuss, but often patients recall a particular activity or moment since it all started. You may recall your heel landing heavily on the ground perhaps.

Causes of injury to the plantar fascia include:

• A Tightness of the plantar fascia
• Excessive Pronation
• A tight Achilles tendon
• Being overweight
• Wearing shoes that lack cushioning/ support/ stiffness
• Occupational overuse

These may produce excessive tension and stress on the plantar fascia leading to micro-tears.

Plantar fasciitis is self-limiting however, it is likely to be a real killjoy in the meantime! Perhaps you are a dancer, a runner, a teacher or a chef standing on your feet all day, if you are suffering from Plantar fasciitis you will want to manage this problem fast.

Treatments you can do at home:

• Rest your foot and reduce any pounding exercises.
• Stretches – In a sitting position, bring your toes towards you and hold for 30 secs and repeat 3 times before getting up to walk. These stretches can work wonders if you do them daily especially first thing in the morning!
• Roll your foot on a cold tennis ball, a drink can or a Pediroller
• If you are overweight start a healthy diet and try increasing your non-weight bearing exercise like swimming.
• Try a gel heel cup and change to cushioning footwear like trainers.

Recovery from Plantar fasciitis can be a lot faster after starting a course of conservative treatment, so come and see us! Your Podiatrist will have vast experience in the treatment of heel conditions. We can work with you not only to treat the Plantar fasciitis but also prevent it happening again!

Sources:

Plantar fasciitis, Medscape January 2019 Craig C. Young

CKS NICE.org.uk Scenario, Management of Plantar Fasciitis

Mayo Clinic website, Plantar fasciitis

The post A common heel problem appeared first on FeetPlus Horley and Rochester.