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By contactus@allcarefootandankle.com
July 17, 2019
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What are Warts?

Warts are one of several soft tissue conditions of the foot that can be quite painful. They are caused by a virus and can appear anywhere on the skin. Those that appear on the sole of the foot are called plantar warts. Children, especially teenagers, tend to be more susceptible to warts than adults. Some people seem to be immune to warts.

Causes

The virus that causes warts generally invades the skin through small or invisible cuts and abrasions. The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities.

If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of several warts; these are often called mosaic warts. Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. The wart may also bleed, creating another route for spreading. Occasionally, warts can spontaneously disappear after a short time, and, just as frequently, they can recur in the same location.

Symptoms/Identification

Most warts are harmless, even though they may be painful. They are often mistaken for corns or calluses, which are layers of dead skin that build up to protect an area which is being continuously irritated. The wart, however, is a viral infection.

Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Plantar warts are often gray or brown (but the color may vary), with a center that appears as one or more pinpoints of black. It is important to note that warts can be very resistant to treatment and have a tendency to reoccur.

When plantar warts develop on the weight-bearing areas of the foot (the ball of the foot, or the heel, for example), they can be the source of sharp, burning pain. Pain occurs when weight is brought to bear directly on the wart, although pressure on the side of a wart can create equally intense pain.

Home Care

Self-treatment is generally not advisable. Over-the-counter preparations contain acids or chemicals that destroy skin cells, and it takes an expert to destroy abnormal skin cells (warts) without also destroying surrounding healthy tissue. Self-treatment with such medications especially should be avoided by people with diabetes and those with cardiovascular or circulatory disorders. Never use these medications in the presence of an active infection.

When to Visit a Podiatrist

Dr. Allison Cheney a Podiatrist in Oakhurst, NJ recommends a consult with a podiatrist when any suspicious growth or eruption is detected on the skin of the foot in order to ensure a correct diagnosis. It is possible for a variety of more serious lesions to appear on the foot, including malignant lesions such as carcinomas and melanomas. Although rare, these conditions can sometimes be misidentified as a wart. 

Diagnosis and Treatment

It is possible that your podiatric physician will prescribe and supervise your use of a wart-removal preparation. More likely, however, removal of warts by a simple surgical procedure, performed under local anesthetic, may be indicated.

Lasers have become a common and effective treatment. A procedure known as CO2 laser cautery is performed under local anesthesia in either your podiatrist's office surgical setting or an outpatient surgery facility. The laser reduces post-treatment scarring and is a safe form for eliminating wart lesions.

Prevention

  • Avoid walking barefoot
  • Change shoes and socks daily
  • Keep feet clean and dry
  • Check children's feet periodically
  • Avoid direct contact with warts from other persons or from other parts of the body
  • Do not ignore growths on, or changes in, your skin
  • Visit your podiatric physician as part of your annual health checkup
By bchiaramonti@officite.com
October 18, 2018
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My baby just started walking what shoes are Best!

There are so many options for new walker shoes how do you choose?  As a podiatrist who treats pediatric patients I find this to be a common question parents ask.  One shoe I can recommend with confidence is the Momo Baby Girls Mary Jane Leather Shoes.  I started mine with the Flower Power White and they were a hit.  As a podiatrist I know how complicated the human foot can become so “starting out on the right foot” is critical.  The trend I have found with Momo Baby has been quality as well as function with style.  Now that my baby is on the move and walking unassisted I need her in a shoe that will not only protect her feet from debris/bacteria but also provide her the support she needs.  The flexible rubber sole is solid, it is a very sturdy bottom but easily moves with the little feet.  I felt safe knowing the rubber and deep tread pattern will reduce slippage/falls.  As she began to walk I never found her to look clumsy in these shoes as I have seen so many other kids look in some stiff shoes.  I loved the idea of a removable, anti-bacterial, breathable insole.  Not only does this keep feet comfy and dry but in the event as a physician I need to recommend a shoe to a child that requires an orthotic the ability to remove the insert is key.

Similar to the crib shoes I tried by Momo, my only negative I found was the adjustable strap.  It was very durable Velcro however it had a drawback and that was my child liked removing it.  By the time my little one was 13mo she found the sound of the Velcro to be her entertainment while driving along in the backseat.  I think a possible loop closure in addition to the Velcro could prevent the little ones from totally removing the shoes.  When reviewing all the other shoes available if this is only downside to the shoe I can live with it.  Keep making amazing shoes Momo baby.

 

Dr. Allison Cheney

Pediatric Podiatrist in Monmouth County, NJ

By contactus@allcarefootandankle.com
October 04, 2018
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An Excellent Choice for a Soft Sole Crib Shoe

My baby had been barefoot for the first few months aside from socks on occasion to go out.  Looking back, I probably should have started her getting use to something on her feet earlier on.  When I received these crib shoes she still was not even crawling.   At first glimpse when I opened the box I fell in love with the color.  They were fun and exciting and not the typical white that I was use to seeing in all my baby pictures from 40+ years ago.  Color was only the start of what I loved, when I put my hands on them I realized they were quality.  100% leather is hard to find these days in adult shoes as well as children.  The benefit of premium leather is its ability to breath keeping the baby cool and dry.   Nobody wants to see cute baby feet and then have them smell.  Immediately I was excited with these shoes and after use I grew to appreciate them even more.  The suede bottoms not only protect her feet from slippage when she moved, but also from debris and bacteria.  The only drawback I found was the elastic ankle.  My daughter has a thick foot and I found it to be a bit tough for me to get her foot in and out however I understand the reason.  Maybe in a new generation there could be an option to open up and snap close with the elastic?  Overall the shoes were amazing and despite moving out of the crib shoes quickly I would recommend this shoe for all new moms.  The best part to me in reviewing the shoes was that as a Podiatrist my Medical Association the APMA has given Momo Baby entire line of footwear the prestigious Seal of Acceptance.  I can now say with my own confidence after using that these shoes they are not only beneficial but give significant value to my child’s overall foot health.

Dr. Allison Cheney

Foot and Ankle Specialist in Monmouth County, New Jersey

By contactus@allcarefootandankle.com
March 23, 2017
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Acupuncture has been used for thousands of years to treat many diseases, chronic conditions and acute symptoms. It can be particularly beneficial for pain, as it can treat both locally and systemically. Both acute and chronic conditions have been shown to respond well to acupuncture treatments, and can even help where conventional medicine was ineffective, according to an article published in 1996 in "Acupuncture in Medicine." Be sure to discuss your condition thoroughly with your physician and acupuncturist before beginning acupuncture treatments.

Pain in Traditional Chinese Medicine

According to the Traditional Chinese Medicine Information Page, pain is considered a stagnation of qi, or energy, in traditional Chinese medicine. Qi runs in channels throughout the body. When an energy channel, or meridian, is blocked, pain can be experienced. Bruising occurs when one such meridian is blocked near the surface of the skin, while arthritis stems from qi stagnation in the joints. Acupuncture helps to break up the blockages and directly promote the smooth flow of qi.

Causes of Foot Pain

The phrase "foot pain" is not enough information for any type of practitioner to begin treatment. The foot has 38 bones, a myriad of tendons and ligaments, and is responsible for a great deal of our ability to stand, walk and run. Because of all these moving parts, many types of injuries can occur, and pain symptoms can vary greatly. The website Acupuncture Today lists improper foot posture, such as pronation, as one of the main triggers of foot pain. Improper footwear, edema, neuromas, overuse, exercise, and foot problems such as bunions and hammertoes can also cause pain in the feet. Each of these causes can be accompanied by pain in a specific area or certain type of pain. Plantar fascitis can have pain stemming from the heel and radiating toward the toes, while a bunion can cause pain and swelling in a more local area.

Several studies have found acupuncture to be an effective method for relieving different types of foot pain. In 1996, a study was published in "Acupuncture in Medicine" stating that acupuncture treatments on chronic foot pain were effective where western medical treatments were not. The journal "Medical Acupuncture" conducted a study using electroacupuncture on plantar fascitis. Electroacupuncture consists of passing an electric current through needles inserted into the patient's skin. According to this study, 82 percent of patients claimed a 50 percent or more improvement in pain reduction. They also found a correlation between the duration of disease and the number of treatments required, implying that the more chronic a condition, the more treatments will be needed.

Acupuncture Points on the Foot

 

Heel pain or heat in the soles of the feet, according to "A Manual of Acupuncture," can be treated by needling spleen 4, which is located on the inside of the foot, in the depression at the base of the first metatarsal bone. Spleen 5, located near the medial malleous, or inner ankle bone, can be particularly helpful in cases of ankle pain. For chronic numbness or pain, an acupuncturist may choose a point on the sole of the foot, kidney 1. There are points in between the toes on the top side of the foot, as well as along the outside edge of the foot. Your acupuncturist will decide which points are right for you, based on your specific condition.

Acupuncture and Western Medicine

 

According to the Traditional Chinese Medicine Information Page, acupuncture helps treat pain in a variety of ways. From a western medical perspective, acupuncture treatments help to release endorphins and enkephalins, substances needed for pain mediation. It also stimulates certain neurotransmitters, which are also important in pain perception, as well as adrenocoricotropic hormone, or ACTH. ACTH a hormone that triggers the release of cortisol from the adrenal glands. Cortisol is important in the body's inflammatory response, and it is also involved in the release of norepinephrine and epinephrine. Epinephrine is adrenaline, a potent hormone that can help decrease pain perception.

Article/Blog provided by:

Donna Zou, Licensed Acupuncturist of Traditional Acupuncture at the Jersey Shore.

For More Information on Acupuncture, please visit www.tradacu.com

 

 

By contactus@allcarefootandankle.com
March 13, 2017
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Toenail Fungus Cause Treatment and Prevention

Nail Fungus (Onychomycosis)

Thickened, brittle, discolored and often painful nails are often caused by a fungal infection of the nail.  This condition can occur for a variety of reasons and can be treated in a variety of ways.   

Causes of Nail Fungus:

- Sweaty feet – moisture creates an environment where fungus can thrive.

- Trauma – loss or loosening of nail can allow fungus to infiltrate under the nail and with time infection can slowly overtake the whole nail or infect others.

- Compromised immune system – patient with diseases like Diabetes, HIV, or those who have compromised blood flow.  Whenever the body is unable to mount an active immediate defense to an infection, the infecting organism can gain advantage.

- Overuse of nail polish – frequent nail polish use can prevent light from reaching the skin under our nails.  Fungus thrives in the dark.

Treatment Options:

Topical – topical solutions applied like nail polish may be prescribed/dispensed.

Apply once daily directly to affected nail(s) surface, the skin that adjoins the nail as well as underneath free edge of the nail.

Remove medication once weekly with nail polish remover.

Best when used on mild fungal infections.

Success rate – up to 40%

Oral – The most common medication for nail fungus is called Lamisil (terbinafine).

Before therapy is initiated a sample of nail is often sent to pathologist to confirm diagnosis of fungus.

Once diagnosis has been confirmed, the patient must complete a blood test to confirm their liver is healthy as these medications are removed from the body via the liver.

Treatment consists of one daily dose of medication for 90 days.

Success rate – 70%

Laser – There are FDA approved lasers specifically designed for toenail fungus.

Toenail removal - reserved for severely infected nails, painful nails, patients with compromised immune systems, or those that have failed other treatment options.

Removal is an in office procedure performed after numbing toe with an injection.

Option 1 – nail is allowed to regrow during which time topical medication is applied to reduce risk of re-infection.

If the nail is allowed to regrow back, it takes about 8-12 months to regrow.

Success rate – approximately 90%

Option 2 – permanent removal can be performed via application of chemical after nail removal in office. A dry skin then remains once healed.

Success Rate – Approximately 95%

Adjunctive Therapy:

For your convenience our Oakhurst Podiatry office carries many of these recommended adjunctive therapies to remove fungus from your environment and prevent recurrence.

Mycomist Spray – antifungal and antibacterial spray used to sterilize shoes intermittently to prevent fungal growth.

Sterishoe – UV lamp specifically designed to eradicate 99% of pathogens that live in our shoes and cause infection and foot odor.

Topical antifungals solution/cream – these medications are designed for treatment as well as prevention of recurrence of infection as new healthy nail grows.

Biotin Pills – biotin is a vitamin that increases the health of the nail, nail growth rate, and helps some loose nail reattach to underlying skin as nail grows.

Nail Polish – nail polish formulated with naturally occurring antifungals, like tea tree oil, and removal of harmful chemicals found in regular nail polish that can lead to dryness and cracking of nails.

Nail file or buffing devices – overly thick nails can reduce effectiveness of antifungal medications. Reducing nail thickness allows for better penetration of medications.

Shoes and socks – if sweating is an issue, breathable shoes and socks may be recommended.  Socks that have wool or synthetic fibers help allow moisture to evaporate off feet more quickly.

Long Term Simple Prevention You Can Do

- Avoid walking barefoot in public places.

- Use Mycomist spray or Sterishoe several times a week to reduce fungus in frequently worn shoes.

- Use a daily shower cleaner after bathing to prevent fungal growth in tub/shower.

- Replace the bath mat outside of the shower weekly.

- Change socks in the middle of the day if you sweat frequently.