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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.

March 09, 2017
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Can I Wear Nail Polish With Fungus On My Nails?

You have fungus on your toe nails and all you want to do is cover it up! Nothing better than nail polish to do that, but you know enough about fungus to know that fungus thrives in moist dark places. Nail polish gives that fungus a wonderful place to grow and thrive! Oakhurst Podiatrist, Dr. Allison Cheney has some options for you.

To start it is so very important to look beyond the nail itself and look at your foot surroundings. Where do you walk? What do you wear?

We do not know exactly how you got your fungus, but we want to keep it from happening again. Keeping your surrounding as "fungus-free" as possible will help!

Let’s go over some key pointers to keeping fungus at bay:

1. Spray your shoes with an anti-fungal spray. It helps keep the fungus away!

2. Throw away your old grungy gardening shoes if they are not rubber or those old favorite canvas shoes you’ve had forever.

3. If you have sweaty feet, change your socks once during the day to keep the moisture down. The less moisture you have, the less than ideal environment a fungus has to grow.

4. Use an anti fungal powder on your feet if you tend to sweat a lot.

5. Spray "Scrubbing Bubbles" or "Lysol Tub and Tile" type stuff weekly on your shower tiles.

6. Wash your bath mats weekly. We don’t know what critters are thriving in them.

7. Shampoo your carpet if you haven’t done that in a while. We don’t know what critters are thriving in them either.

8. Give your shoes a breather! Try not to wear the same pair twice in a row.

9. Get sterile pedicures and stay away from the soaking tubs that have whirlpool effect. They can never get the tubing cleaned properly.

10. Bring your own polish and flip flops to the nail salon.

After all this, are you still thinking of the nail polish! It can matter what type of polish you use. Nail polish with Tea tree oil is becoming very popular for a reason. It has been found that tea tree oil is a natural fungal suppressant. What does this mean? It means you can have fungus and wear nail polish too! At our Jersey Shore Podiatry office, we stock nail polish with tea tree oil to offer our patients just what you have been looking for. Podiatrist, Dr. Allison Cheney is so impressed with this product that she recommends you pick up a bottle today to keep your toes looking stylish and "fungus-free"! 

March 01, 2017
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When To Go To Urgent Care for Foot and Ankle Problems

Understanding the differences between a visit to a specialist, urgent care and the emergency room is key to positive health outcomes. Life-threatening emergencies require a visit to the emergency department, and chronic foot and ankle problems may require a podiatrist appointment; but for everything in between, there is urgent care. Whether you have a twisted ankle or a minor sprain, knowing your options for medical care can help ease the stress of a sudden injury.

During seasonal activities and sports, minor injuries such as lacerations/cuts, sprains and fractures tend to occur at unexpected times. At Immediate Care, we are committed to assisting all patients when they are unable to reach their primary care doctor or their specialist. In cases of more serious foot and ankle injuries, following-up with a podiatry specialist may be recommended to promote a full recovery.

It is important to remember that urgent care is not a substitute for emergency care. An emergency condition is one that is time-sensitive and can permanently impair or endanger the life of the patient. Patients with these conditions should dial 911 immediately.

Urgent care provides a convenient option for patients with a non life-threatening injuries that requires prompt care. At Immediate Care, we offer x-rays, laboratory services, stitches and a variety of walk-in occupational health services. ​ ​Frequent causes for urgent care visit, include the following conditions:

● Ear Infections                                                            
● Bladder Infections
● Influenza
● Cough/Cold
● Stomach Flu
● Respiratory Illness
● Asthma
● Allergies
● Fever
● Minor Burns
● Minor Rashes and Skin Infections
● Sports Injuries
● Trips and Falls
● Cuts/Minor Lacerations
● Sprains
● Animal/Insect Bites
● Fractures
● Minor Dislocations
● Back Pain

Our Immediate Care facilities are located throughout New Jersey in Hazlet, Toms River, East Windsor, Red Bank, Lacey and Edison. To learn more about urgent care, please visit or call 1-855-Walk-Ins. We are open seven days a week, and our staff will be
happy to answer any questions you may have.

- Dr Mary Ann Yehl, Medical Director of Immediate Care Medical Walk-In of Red Bank

February 13, 2017
Category: Dry, Cracked Feet

What causes the bottom of my feet to be dry and cracked?

This winter you may notice the bottom of your foot is dry and cracked.  Before you pull out your sandals for your spring break trip get your feet summer ready.  This common problem occurs for two reasons. #1.  Your skin becomes naturally dry in the winter months.  #2.  Your environment makes your skin dry and cracked.  Typically, we see the second common in the summertime when you may wear more open shoes or sandals.  The dust and dirt on the ground causes your feet, and heels especially, to dry and crack.  The first is a problem now when our feet are cold and dry from the heat in our homes and work places.  Both are well treated with an excellent moisturizing cream.  Ask Monmouth County Podiatrist Dr. Allison Cheney to recommend one for you.

Another, often overlooked reason for dry and cracked feet, is because of a fungal infection, such as athlete's foot.  This is commonly misdiagnosed, since there often is no itching or burning symptoms and the foot does appear very dry.  In these cases, treatment is often effective using a strong moisturizing cream in conjunction with a prescription anti-fungal medication.  Female podiatrist Dr. Cheney says results are typically seen in the first 2 weeks of treatment.   

If your dry, cracked heels and feet are not properly treated, the cracks can worsen and bleed.  This is painful for everyone and can be limb threating if you have diabetes.  The cracks can become infected and difficult to heal.  Treating cracks in your heel early, before they become problematic, will ensure that your feet stay healthy and remove the risk of infection.

If have already tried moisturizing cream with poor results, visit AllCare Foot & Ankle we specialize in adult and children foot and ankle care.  We can recommend the best treatment for your painful cracked heels and assess if you need an antifungal medicine as well.  If necessary, Dr. Cheney can do an in office skin biopsy that will provide her with a better understanding of what is occurring at the skin level. 

February 06, 2017
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What is the painful bump on the back of my heel? 

Monmouth County podiatrist sees many people develop a bump on the back of the heel.  Often the bump on the back of the heel is due to the pressure from the back of a shoe, it can become inflamed and painful.  Podiatrists often give the diagnosis Haglund's deformity, but it is more commonly known as a pump bump.  Typically, women are affected by a pump bump more than men are because of the shoes that they wear however female podiatrist in Oakhurst, Dr. Allison Cheney has seen an increase in men over the years. 

The cause of the “bump” is either a bone spur that forms on the back of the heel or accumulation of fluid around the Achilles tendon or both.   This bump forms for one of two reasons.  The first is due to excessive pulling of the Achilles tendon on the heel bone.  This occurs due to a tight or shortened Achilles tendon.  The other reason is because of the rocking motion of the heel bone during walking. This causes shear forces on the back of the heel and a buildup of a bone spur in response to the pressure.

If you catch a bone spur forming before it becomes painful, it is usually effectively treated with a custom orthotic device.  The custom molded orthotic helps to stabilize the foot function and limits the pressure and pulling on the heel bone.  Don't wait for heel pain to be extreme before you start.  Call your Monmouth County podiatrist Dr. Allison Cheney before a problem starts.

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