So, your nails aren't the pearly-thin things they used to be?
Perhaps they don't clip off anymore as need garden pliers pressure. No joke, one of the most frequent questions I'm asked is: "Why do toenails get thick with age"? (And often get an infusion of the dreaded discolor) So how and why does this happen?
0 Comments
This weeks sack 'o' questions covers acid plasters, sneaky pinky toe corns and white nail marks.
Call it a bumper crop. Right now, corn plaster manufacturers are spraying Cristal like a kid with a garden hose. They're in a Dubai 7-star hotel, served by waiters dressed as lobsters. This is going by the sheer amount of questions I've received lately about corn acid. Sesamoiditis is a mysterious foot malady.
X-rays are ambiguous and some claim it doesn't even exist. You can't see your sesamoid bones. You'd be hard-pressed to feel them — literally. What is certain though: sesamoids sit snug under your big toe. When the area here's injured, it burns. (Problem is other conditions also cause this. But we'll get to that later) So, what exactly is sesamoiditis and how can you treat it? This was an excruciating little toe corn that was dug in. Deep.
The patient couldn't even wear trainers without it throbbing and last had it treated over a decade earlier. With pinky toe corn removal, you have to be sure to get ALL the fragments of hard skin. (If not, they still irritate) If they're years old, like this one, there's almost always some riiiiight at the bottom. The soothing cream I used at the end was Gehwol Mint. Now this query is a real common one:
"Have I got fungal toenails?" (I get all the glamorous questions) Then it's followed by — how can I get rid of it?! Now, sometimes even for me, it's hard to tell. I'd have to know your medical history, what you've tried etc. Also, the reality is that not all fungal toenails are home-curable. But there's always a few tell-tale signs. As well as one or two things you can do. I get asked a lot about odd-shaped toes. (Mostly of the pinky variety)
It's generally not something you need to get alarmed about. (That's unless it's causing you an insane amount of pain, of course!) I also get asked regularly about white marks on toenails. I get a lot of email questions; and I send a lot of informational replies.
(For free) So much so, it struck me: why don't I share the love? This one's about three subjects close to my heart. I of course mean, pinch callus, nail fungus and corn acid burns. 1/31/2024 0 Comments White Spot on Nail (Is it Fungal?)Ah, the dreaded white spot on your nail. You thought it would never come for you.
That fungal tap on the shoulder was for other people. Or so you thought. Yet, here you are, avoiding eye contact with your nail for too long. Yep, I get a lot of emails about white spots on nails. Now there's a few different causes; and a fungal nail infection is one of them. 1/25/2024 0 Comments Toenail Hematoma vs MelanomaSo, there's a dark mark beneath your toenail. It's gnarly.
You can't remember banging it. You googled — and now you're anguished. Is it a toenail hematoma or melanoma? Trust me, black stains under nails are a big patient worry. The vast majority of the time it's nothing serious. But now and again, sometimes, occasionally, it's something else... Rough and ready winter cracked heel taken down a peg or two.
I used a small 15 scalpel blade which worked surprisingly well. This heel fissure is painful and split. Ones getting deep like this need several skin removals over time. The callus itself is easy to chip off. I then applied foot cream halfway through to thoroughly moisturize (Gehwol Fusskraft Mint) 1/20/2024 0 Comments Foot Corn Acid Damage (Removed)This patient, like many many others, used acid to remove the corn on the inside of his big toe. (These were the drop variety not the plasters)
You can see the peeling skin as a result of the corn acid. Anyway, that white patch of skin is no more. It's burnt and will still hurt until it eventually drops off. The key with taking off these is to remove enough to provide pain relief; but not so much to cause a wound.. Corns between toes tend to creep up on you. By the time you KNOW you've got one; it's too late.
This one was situated on the joint and covered by a thin layer of clear callus. This patient had applied acid but not enough for it to really do the damage it does in some cases. Removing these interdigital corns is almost as much about feel as by sight. Sometimes a small nugget of hard skin is enough to still cause pain afterwards. So you want some good foot ick? Parasitic worms, ram's horn nails and gouty royal toes?
Well, you've come to the right place! After all, your feet are a veritable selection box of gnarly conditions. (Call it the Foot Ew-niverse) (This is a longer version of the previous video)
Effectively this was two foot corns; the oval-shaped one here and a smaller one underneath that! To get anywhere near the corn here, I had to gently par away the thick overlying callus. This patient only has this foot corn. It had formed up over years from a severe bunion throwing off her walk on that side. She'll need a nice comfy insole and plenty of good callus cream to keep it under control. Ok, so this was a decades-old foot corn. It was covered by a thick layer of hard skin.
(Longer video of said callus removal here) It was very painful as it was smack bang in the middle of her upper foot. This was caused by a pronounced bunion which meant most of the pressure from walking was put right through this central point. With these types of foot corn, they become more like a giant disc of hard skin as opposed to a corn. In other words, removing them needs lots of chipping away as opposed to "popping out". Sometimes, foot corns this old need a re-treatment in a few weeks to get on top of it (as well as offloading with an insole going forward). (Plus a good healthy dollop of Gehwol Callus Cream to stop it hardening up again) This deep heel foot corn comes back every few months. (Like this other one)
The patient has some mobility issues. So it's prone to the same place. I'm conscious of not just removing the top layer of this corn; that wouldn't relieve the pain for as long. There isn't a huge amount of overlaying skin callus with this corn. This leads to me believe it's more of a twisting motion that's causing it. As always, I recommend Gehwol Callus Cream to keep on top of this. It spaces out the time between treatments and often corns coming back full stop. So here we have classic early interdigital corns. (Foot corns between toes)
This lovely patient had tried home treatment with acid corn plasters. This is why we see that flaky, peeling layer of skin. On my advice, she stopped using them as they just pile up burnt dead skin. These flared up due to a new pair of shoes. The material they are made of was not very accommodating at all. (Annoyingly, I lost the first part of the removal as I forgot to press record!) For a much deeper foot corn removal, see this video! 12/27/2023 0 Comments Fingernail Damage (From Shellac)Now, I love nail fungus and athlete's foot spores. But *breathes in* ...a change is as good as a rest.
So today we head north. From your toenails to your fingernails. To be more precise: fingernail damage from shellac and how you can heal it. (We also cover beauty barons, toenail pies and fun fingers) 12/21/2023 0 Comments Essy Electric Foot Callus Remover Vs. Scholl Velvet Smooth | Battle of The Foot FilesI was gifted an Essy Electric Foot Callus Remover foot file from a patient.
Dubious at first due to its small size and glittery gold. I was pleasantly surprised at how powerful it was compared to the hefty Scholl Velvet Smooth. Don't get me wrong - both can deal with light callus pretty well. But deep heel skin is a different story. In this electric foot file review, I discuss the pros and cons of each. This was a small and shallow heel corn.
It didn't give this patient any pain but it would have at some point. You don't see these foot corns THAT often. They tend to be caused by lots of friction from tough shoe and boot rub. This heel corn was easily home-removable. The patient didn't know it was there. (To home remove, all they would need to do would be to slather it in this foot cream and wait for it to fall off a day later) I scraped off first to reduce the thickness of the surrounding skin. This makes it easier to "pop out" with the instrument. With foot corns that are super old (in this case, 20 years) or super deep, I like to REALLY get the dead hard skin out.
I also make a point of levelling out the hard skin ring of callus that surrounds them. This alone can cause a lot of pain. (I use Gehwol Fusskraft Mint to soften this and make it easier to scrape off) With foot corns this big and established, they often benefit from another treatment about a fortnight later to settle them down. This lovely patient had pain from this corn under her pinky-toe since a surgery a few years ago.
Hard skin had built up first (under a tailor's bunion), then a corn. Removing this corn was about getting rid of the valleys first; then really picking out the very bottom with a gouge blade. (This is actually the second part of this corn removal video). This was quite a small foot corn in terms of diameter — but pretty deep to the bottom. Ideally, I'd like to offload the area going forward to ensure the pressure that creates this foot corn stays off it. (If you think you have one of these, be sure to apply plenty of Gehwol Fusskraft Mint to stop it growing down) This was a long-standing (dreadful joke) foot corn right on the ball of this patients' little toe.
(Under a tailor's bunion) It wasn't particularly wide, but pretty deep and covered with a thick-ish layer of callus. The first step was to remove the overlying thick hard skin. (As always, I soften this first with Gehwol Fusskraft Mint.) With the foot corn exposed I then removed it as far as was comfortable and effective. It was shaped like a classic pyramid, with the narrowest part nearest foot nerves. Enjoy! This nice patient was 37 and had this foot corn since he was 15.
He'd had insoles, cream and lots of various appointments - to no avail. He did a good job at getting the overlying hard skin flat and level which reduced the pain a little. However, this meant that the ingrowing hard corn skin underneath was compact and solid! With these type of corn removals (ones that have been there years) I always try and remove hidden bits of corn that remain after the main plug is removed. This is because these tend to be what causes pain even after an appointment. (I used Gehwol Fusskraft Mint to soften the corn right at the start. I find this works away underneath and makes the years old corn skin easier to dig out) The last stage of this corn removal is here. This lovely patient has a small, dry corn right at the inside end of her second toe. This developed as she does a lot of hiking.
The scissoring effect of it rubbing against her big toe created the corn and a build-up of callus. She was lucky here. Interdigital corns tend to be lower, more moist and very painful! Likewise the pinch callus she had on her big toe. This tends to be caused by a twisting motion when your big toe joint starts to jam up with arthritis. It's very common (I get it!) (The foot cream I used was Gehwol Fusskraft Mint for those that have asked) |
|
Gareth Havard Podiatrist |
Affiliate disclosure: As an Amazon Associate, we may earn commissions from qualifying purchases from Amazon.com