Author: Hanan Kane

Say goodbye to discoloured fungal toenails!

It’s been a fantastic, hot summer here in New Zealand, with lots of time wearing sandals, at the beach and feeling that soft, green grass beneath of our feet. For many of our patients recently, it’s also been the time that they’ve noticed a few unusual changes in the appearance of their toenails – usually yellow and white patches – and have come in to find out what it is and what they can do about it! For many of these patients, the verdict is the same…

It’s a fungal nail infection

A fungal nail infection, medically referred to as onychomycosis, is the infiltration of the nail by a fungus. The changes you may see in your nail occur as the fungus spreads and feeds on the keratin in your nail. In fact, approximately 50% of abnormal toenail appearance changes are caused by a fungus, and around 10% of all adults suffer from fungal nail infections. What does that mean?

Fungal nail infections are easily spread

Yep, fungal infections are definitely contagious and are easily spread within households and public places. This is because fungus spreads through spores that move through the air, as well as direct contact. Fungus also thrives in warm and moist environments, and doesn’t require sunlight to grow. This makes places like showers, public pools, changing rooms, gyms and nail salons the ideal breeding ground for fungus. Once you’ve picked up an infection, the environment inside closed in shoes also provide ideal conditions for the infection to grow and persist. When you come in contact with the fungus and your immune system doesn’t clear the infection before it takes hold, the symptoms will begin. Certain conditions do make people more susceptible to infection. These include:
  • Poor circulation
  • Increased age
  • Male gender
  • A compromised immune system
  • Previous trauma/injury to the feet and nails
  • Family history of infection
  • Diabetes

What do fungal infections look like?

Nails can appear:
  • Brittle
  • Crumbling/flaky
  • Thickened
  • White/yellow/brown discolouration
  • Worm-eaten appearance
You may also develop whitish streaks or spots in the nail, and the nail may begin to come away from the nail bed. They may also cause an odour.

Make sure it really is a fungal nail infection and not something else

It’s important to note that there are other conditions that have a similar appearance to fungal nail infections, such as psoriasis of the nail and trauma. This is why before spending time and money treating the infection, you should get a confirmed diagnosis. We can do this in our clinic in just 5 minutes, easily and painlessly from a small sample of your nail. Once we have a confirmed diagnosis, we’ll talk through the best way to treat your infection based on your symptoms and presentation. We’ll also give you all of the information you need to stop the spread of infection to your friends and family, and minimise your risk of future re-infection as much as possible! For more information or to book an appointment, give our expert team a call on 09 523 2333

How To Get Rid of Plantar Warts

If you or your kids have ever had warts, you’ll know that they’re unpleasant, unsightly and can at times be uncomfortable, especially if they’re on the bottom of your feet. They can quickly spread from one member of the family to another and once you’ve contracted them, they may pop up (literally) at any point in your life. So what exactly are warts and what can you do about them? Otherwise known as Verrucae Plantar warts are medically known as verrucae and tend to present on the sole of the foot. Warts are actually a virus called the human papillomavirus (HPV). It spreads through a break in the skin, like a small cut or graze, either directly or through sharing the same surface like a shower or a floor. What are the symptoms? A plantar wart appears as a small round-ish growth with rough or frayed edges. It remains rough within the wart itself. You may also notice tiny black/brown dots within the wart which are actually small blood vessels which will bleed if the wart is cut. You may notice that the lines of your skin move around the wart as opposed to through it. There may also be hard skin in the form of callus covering a wart. We typically reduce this hard skin in the clinic to both confirm that the lesion is indeed a wart and also for treatment. Is it really a wart or is it a corn? Perhaps one of those most difficult elements of treating warts is their similarity in symptomology and appearance to the untrained eye. Even to the trained eye! We’ve seen plenty of patients come in to see us after they had previously been told they had a corn when it was a wart and so their treatment had been unsuccessful. Corns also present on the sole of the foot and are round in appearance. They are a build-up of hard skin and have a smoother appearance and edges than a wart. Corns tend to elicit pain on direct pressure whereas warts tend to elicit more pain on a sidewards squeeze. Unless you’ve picked at it and caused damage, corns don’t tend to bleed, either. How do you treat it? To treat warts, you first need to see your Podiatrist. We don’t recommend at-home treatment because you risk damaging the surrounding skin and putting yourself at risk for a bacterial infection. We often see patients who have tried a stick-on pad over the wart as a means of treatment. Typically these pads contain some form of acid designed to break down area of the wart, eating away at it. The danger here is that the size of acid on the pad is usually much bigger than the size of the wart itself. The acid then works on the healthy skin surrounding the wart and it becomes very painful, red, tender and unpleasant. At Perform Podiatry we have a wide range of treatment options available depending on what is best suited for you and your wart(s) to see them gone. If you or your family are wanting an effective solution for warts from the foot health experts in Remuera, give us a call on 09 523 2333

Ingrown toenails: The lessons and the patients

We’ve been seeing a lot of patients with ingrown toenails lately. From kids to adults alike – we’ve even quickly removed ingrown toenails from kids at 6 months old. That’s right – your nails don’t discriminate against age. We thought we’d highlight 3 recent cases because we find that a lot of people (definitely not all) tend to fall into these categories. Case One: “It’ll be all good, bro” As the title may suggest, this was a classic kiwi male. Hard worker, on his feet all day, works in both steel capped boots and gumboots. He first noticed his ingrown toenail developing a few months ago. Yes, that’s right – months ago. He felt a bit of pain but shrugged it away, thinking it’ll go away on its own. It didn’t. One side of the nail pierced the surrounding skin. The toe became swollen. In the following month, it developed a minor infection. Because of the swelling, the other nail edge started growing into the skin too. It bled. It was irritated when he wore shoes and at work. But being a trooper, he persevered. Until 2.5 months after he first noticed a little bit of pain, he came in to see us. Case Two: The fashionable businesswoman She came in to see us approximately two weeks after her pain began in her big toe. She tried cutting it and controlling it herself, but to no avail. The toe was red, swollen and has a small amount of yellow exudate as it had developed a minor infection. She wears pointy shoes to work and continued to do so for the last two weeks – but when she’d sit down at her desk she would take them off to get some relief for her toe. She also took lots of painkillers. The trigger for her to come in to see us was because the pain got so uncomfortable that even a sheet on her toe at night started causing her pain. Case Three: The young footy legend This 11-year-old superstar came in with his mum because his toe was red, swollen and very painful. So much so that he couldn’t kick the ball anymore without yelling out in pain. The pain had started 7-10 days ago he guessed. He also doesn’t cut his nails – he ‘picks’ them. The lessons If you can relate to any of these people, don’t worry. You are most definitely not alone. There are a few takeaway points here:
  • Self-management can be more difficult than you think once the nail has grown into the skin. Because the edge of the nail can be so deep down there, even if you cut most of the nail, very often a small nail spicule is left that keep irritating the skin and prevents it from healing. This very often happens when the nail is ‘picked’ off.
  • Don’t wait for ingrown toenails to get worse before coming in to see your Podiatrist. The longer the problem, the harder it becomes to get the offending nail edge out (though don’t worry, we’ve got all the right tools to do it).
  • If you wait too long, the swelling of the toe can cause the other edge to become ingrown too because of the increased pressure from the skin.
  • Performing daily activities will only get harder and you don’t have to put up with that.
  • See your Podiatrist. Now. If you have an ingrown toenail.
We’re happy to say that for all of these particular cases and the many others like them, we were able to safely remove the offending nail edge and get everyone pain-free and back on their feet. For some, we did this conservatively and without anaesthetic, and for others, we performed a minor ingrown toenail surgery where we also applied a chemical to permanently stop the side of the nail from growing back. If you’re suffering from ingrown toenails, come in and see our expert team at Perform Podiatry! Proudly providing expert care to Remuera and the surrounds. Give us a call on 09 523 2333

Struggling with ingrown toenails?

Ingrown toenails can be massively frustrating – and not to mention very painful! They stop you from wearing shoes, partaking in sports and activities you enjoy and every step is a constant uncomfortable reminder that they’re still there! So what does an ingrown toenail mean? An ingrown toenail means that the nail edge has grown and curved into the adjacent skin. In most cases, the nail curves down into the skin, but in some cases it could be that there is excess skin/tissue surrounding the nail that the nail has grown into. It’s painful, uncomfortable and very frustrating if the pain doesn’t resolve – which it may not if any of the nail edge is still left hiding down in the skin! What causes ingrown toenails? Many factors can encourage ingrown toenails but there is one biggie -an improper nail cutting technique. Toenails should ideally be cut in a straight, clean line with no fraying edges and no curves. Curving the edges of the nail can encourage the nail to grow curved down into the skin. Another is pulling at frayed nail edges and ‘picking’ your nails. This can leave a nail spicule at the edge of the nail which may then grow down into the skin. Because it can be residual nail spicules when they’re obstructed by the surrounding skin, you won’t evenrealise that it’s still in there. Tight footwear creates pressure on the sides of the toes that can push the nail into the surrounding skin. Sometimes the cause can be an uncontrollable genetic factor that dictates the way the nail is grown. Don’t worry – regardless of the cause there are definitely solutions to both alleviate ingrown toenails and to stop them from coming back once and for all! What are the symptoms? The biggest symptom is pain on touch, pressure and movement. The toe may often appear red and swollen. If you see a white/yellow exudate from the surrounding skin then it’s likely that you have picked up an infection. Because infections can occur anywhere that there is a skin break, it’s important to take extra care with ingrown toenails. What can I do for it? Can I stop it from coming back permanently? Those with diabetes, nerve damage or poor circulation should never attempt to treat their ingrown toenails at home. If you have good general health and suspect you have an ingrown toenail, soak the nail in warm salty water for 5 minutes then dry thoroughly. If pain persists, it will need to be examined by your Podiatrist that will determine the proper course of treatment. Here at Perform Podiatry, we treat and manage ingrown toenails every day! We’ll start by examining the toe and the intruding nail, checking for infection and will then safely and cleanly clear the offending nail edge. This can be done with or without anaesthetic and we also offer permanent solutions to permanently remove a small section of the nail to give you a clear, pain-free nail edge and stop the troublesome edge from growing back! Stop putting up with that pesky toenail and give us a call to chat more about ingrown toenails and how we can help you too! Experience our commitment to excellence in Podiatry for yourself and get back to wearing the shoes you love!