Ingrown Toenails

Ingrown toenails are an extremely common foot problem that occurs when corners or edges of the toenail grow into the soft tissues of the toe. The nail first pierces the skin and then continues to grow inward if the problem is not corrected. The medical term for this condition is onychocryptosis, and it primarily affects the big toe although it can develop in the other toes as well, though it very rarely occurs in the fingers.

This condition is often quite painful and the affected area will often become tender, swollen and red, the skin surrounding the nail may become hard, and a clear or yellow suppuration may also occur.  If the nail becomes infected the wound may become warm to the touch, and it may bleed and produce foul smelling pus. If signs of infection are present or if the patient also suffers from diabetes or peripheral vascular disease then medical attention should be sought as soon as symptoms present themselves, as complications and infection are much more likely to occur.

Ingrown toenails can be caused by a variety of factors, and the most common causes are nail trauma caused by athletic activities, wearing tight or constrictive shoes, injury to the feet or toes, having unusually long toes (which causes uneven ‘hot spots’ to occur), poor foot hygiene, congenital toenail malformation, diabetes, nail fungus infection, nail surgery (past or present), excessively sweaty feet, arthritis, and poorly trimmed or cut toenails. Improper cutting of the toenails causes problems on two fronts: the nails may be cut excessively short and they may leave behind jagged edges, both of which increase the risk of developing ingrown nails.

Most cases of ingrown toenails can be treated at home and will heal without medical intervention. The best way to treat an ingrown nail is to soak the affected foot in warm water and Epsom salts until the skin softens, then use the edge of a towel to gently push back the overgrown skin that is covering the nail. An antibacterial cream can then be applied to keep the skin hydrated and free from bacteria. If the ingrown nail requires more care a piece of cotton or dental tape can be used to very gently lift the ingrown nail out of the skin. Otherwise, this condition can be treated with regular foot soaks and gently pushing back the skin from the nail.

If symptoms do not improve with these treatments then it’s best to seek medical advice before infection occurs, as antibiotics may be prescribed to treat severe cases. Ingrown toenails can be prevented by wearing non-constrictive shoes with a wide toe, by keeping nails evenly and smoothly trimmed but not excessively short, by avoiding injury to the foot and nails, and by keeping the nails clean. Because ingrown toenails have a high rate of reoccurrence great care should be taken with the feet after the nail has healed, and any subsequent injuries or discomfort occurring in the nail or nail bed should be addressed right away.

If a patient is prone to the development of ingrown toenails special attention must be paid to foot care, especially to grooming habits and the type of footwear used. 

Suzy Pickhall, who has been a foot care expert over the past thirty years has written a viable guide on how to combat View Heel Pain Advice here, and a guide on How to treat plantar fasciitis click here.

Fungus Nails

Fungus nails are usually caused by the growth of fungi called dermatophytes (such as Candida) though they may also be the result of yeast or mold development as well. These microscopic organisms enter the skin through miniscule cuts or abrasions between the nail and the nail bed, and they require continuously warm and moist environments in order to survive and spread. This is why fungus more often occurs in the toenails than the fingernails; enclosed, damp shoes that maintain heat are a perfect environment for this type of infection to occur, not to mention that there is often more blood flow to the fingers than toes.

When fungus develops in the nails they often become thick and brittle and begin to crumble. They may also appear ragged and discolored and may separate from the nail-bed itself. Pain or discomfort is often felt in the fingertips and a mildly foul odor may be present as well. It is also possible for a sufferer to have a reaction to the fungus; this often occurs in the form of red, itchy patches of skin or ulcerations called dermatophtids and this reaction may develop on other parts of the body, not just the hands or feet.

While the physical symptoms of fungus nails are fairly evident doctors will often take a nail scraping in order to perform a fungal culture or potassium hydroxide (KOH) smear. It’s important to confirm that the nail infection is in fact fungus and not another skin condition such as psoriasis, lichen planus, dermatitis, eczema, or a nail bed tumour.

Fungal infections of the nail occur more frequently in men and in the elderly. Other factors that increase the risk of developing fungus nails include poor blood circulation, having diabetes, psoriasis, athlete’s foot, or an immune disorder, having a damaged or injured nail or nail-bed, humid work environments, walking barefoot in public places such as pools, gyms, and shower stalls, and wearing socks and shoes that do not allow for proper ventilation.

Nail fungus can be difficult to treat and may require the use of topical creams and oral medications, and it can up to four months before the infected nail has grown out and been replaced with a healthier, new nail. Topical creams often help with discomfort but will not likely cure the infection. In severe cases the entire nail may be removed to allow for healthier re-growth.

The risk of developing fungus nails can be reduced by keeping the nails short and clean; socks and shoes should be clean and dry at all times and antifungal sprays and powders will add an extra layer of protection as well. Sandals or shoes should also be worn in all public areas, especially pools and gym locker rooms. To protect the hands rubber gloves should be worn when exposed to water and moisture, picking or biting the nails should be avoided and manicure and pedicure tools should be properly sterilized before being used.

It’s also important to note that if an infection is already present it’s important to wash hands thoroughly after treating the infected areas as fungus nails can spread from one nail to another. 

Suzy Pickhall, who has got been a foot care expert for more many years has written a functional guide on how to combat Foot Pain in Ball of Foot , and Insoles and Shoe Inserts.

Burning Feet

Burning feet syndrome has been acknowledged as its own pathology for almost two hundred years but despite this pedigree it remains an elusive condition that has had little attention paid to it by the medical community and unfortunately, many physicians dismiss the symptoms as unimportant.

Symptoms

Burning feet occurs most frequently in people over 50 years of age, though it can develop in much younger people as well. The most frequent physical indications of this condition are as follows:

Burning sensation in the feet
Sensation that feet are excruciatingly hot
Numb or achy feet
‘Pins and needles’ sensation in the feet

These unpleasant symptoms usually occur in the soles of the feet but the discomfort may be experienced in the ankles and/or legs as well. Symptoms are often most acute at night and subside during the day.

Causes

The causes of burning feet syndrome (BFS) can be vague and hard to pinpoint, making diagnosis very difficult. There are several potential reasons why symptoms may develop:

Nutritional Deficiency: While the exact vitamin remains unidentified most patients with burning feet syndrome have riboflavin deficiency, and there may be insufficient levels of thiamine or nicotinic acid in the system as well.

Metabolic/Endocrinal Issues: Diabetes is the most common reason why burning feet occurs and many diabetics do in fact experience this side effect. This category also includes small fiber or autonomic neuropathies.

Hereditary Causes: Autosomal dominant inheritance (you get the gene from only one parent) may create an inclination to burning feet syndrome.

Mechanical Deviations: This included peripheral nerve compression (such as tarsal tunnel syndrome), hypothyroidism, and trapped nerves due to sciatica or spinal deviations.

Psychosomatic Developments:  The symptoms associated with burning feet syndrome (burning, heat, pins and needles) are the most common sensations reported in psychosomatic disorders.

While there are other, rarified causes for the development of BFS, the above list providers the most likely reasons why you may be suffering from these symptoms.

Diagnosis

In many cases burning feet syndrome can be linked to underlying issues such as diabetes or nutritional deficiencies but because symptoms of BFS may not be viewed as urgent by healthcare givers if there are no secondary symptoms extensive testing may not be pursued.

Treatment

When treating burning feet syndrome it’s necessary to first find the cause of the condition, as diabetic foot pain will be treated differently than a condition caused by sciatica or nutritional deficiencies. If you’re experiencing symptoms then it’s important to seek medical treatment. There are however, steps you can take to reduce the discomfort of burning feet such as wearing shoes with sufficient cushioning and arch support, wearing cotton socks, soaking feet in cold water (no ice), and keeping feet at a cooler temperature.

Conclusion

Burning feet occurs frequently in the elderly and in diabetics although it does not affect these demographics exclusively. If you are suffering from this condition it’s important to seek treatment as there may be a tangible health issue causing these symptoms to manifest. If no discernible underlying condition such as diabetes or nutritional deficiencies are found then try the suggestions above; while they won’t cure your burning feet they may reduce your level of discomfort.

Peter Stephenson, who has been a foot care expert for more many years has written a functional guide on how to combat View Heel Pain Advice , also view his other site plantarfasciitisadvice.com.