About 7.1 million Americans are treated by podiatrists for ingrown toenails each year. This common problem often stems from toenail trauma—stubbing the toe or dropping something on it, for example. And, shoes with tight toe boxes certainly don’t help. When treated properly, ingrown toenails often resolve without incident. Sometimes you can treat ingrown toenails at home, but recurring cases could mean that there’s a need for ingrown toenail surgery.
Toenail abnormalities are fairly common, but they can still be alarming to patients. The good news is that most of these issues can be treated fairly easily. Whether your nails are yellow, crumbling, or pushing into the surrounding skin, there are many simple home remedies for toenail problems that can help relieve your symptoms. Of course, a podiatrist can ease some of your concerns and offer next-level care if these measures fail to remedy your toenail problems. If the look of your nails really concerns you, a product called Keryflex can be applied in the office as a temporary cosmetic enhancement while the nail heals.
Even though fewer than 2% of pediatric visits involve concerns with nails, parents often experience anxiety when they notice discoloration, abnormal growth patterns, rough texture, or loss of the nail plate in their children’s toenails. They may fear fungal infections, bacteria, virus, or a more widespread disease. Diagnosis by non-experts is very difficult, so researchers recommend that you see a podiatrist for any children’s toenail problems. Still, it’s good to be informed about the conditions your child is most likely to experience, so here are the top ten toenails disorders commonly found in children.
Often, parents bring their children to our office with a condition that looks like toenail fungus. But some patients have visited their primary care physicians and taken a course of oral antifungal medication before arriving at our NYC podiatry office—only to find that the reason the antifungal didn’t work was that they did not suffer from fungus at all! Here’s how to tell if your child really has toenail fungus and what other conditions may be occurring.
Hispanics and Latinos make up 27.5% of New York City’s population. This group suffers from foot pain and health issues like any other, yet they tend to be more reluctant to seek professional help. The first step toward wellness is asking your primary doctor to check your feet and give you a referral to a foot and ankle specialist who can offer state-of-the-art care. Dr. Mariola Rivera, DPM is a friend to Hispanics and Latinos in the New York City area who are looking for a Spanish-speaking, board-certified podiatrist to add to their healthcare team.
Though the weather is barely breaking 60 degrees, we are getting close to at least imagining those warm, sunny days where it seems most prudent to wear sandals. Ingrown toenails are one foot-related issue that can really dampen your springtime fun. Not only do they look unsightly in sandals, but they are also downright painful! When the corners of the nails bite into the skin, redness, inflammation and purulence ensue. No one wants to kick off spring with an infection like that! Worse yet, ingrown toenails can quickly spiral into a limb-threatening condition for those with vascular disease, neuropathy or diabetes. The board-certified podiatrists from The Center for Podiatric Care and Sports Medicine in NYC discuss how to treat and prevent this common foot affliction.
Any avid runner knows that the sport is not always so glamorous. There are some days where we’re drowning in tears when one of our black toenails finally prepares to fall off. The average person may call this a “black and blue toenail” or “runner’s toe,” whereas a geek (or your non-geeky podiatrist!) might call it a “subungual hematoma” — which is a fancy way of saying “bruised toenail.” No matter what you call the condition, it ain’t pretty! The good news is: we know how to fix it!
Ingrown toenails are an impossible situation to tackle on your own. You will need to see a licensed and trained podiatrist to help you get your feet to a healthy state again. “Ingrown nails are not only painful, but they can also cause an infection in the toe,” says Dr. Katherine M. Lai of The Center for Podiatric Care and Sports Medicine in New York City. “Often, we will treat nails that repeatedly become ingrown with an in-office procedure that can remove the ingrown nail permanently.”
Dr. Lai explains that there are several procedures a patient might have, depending on the severity of the condition and the way the nail is growing. “Some of the ingrown nail procedures are: P&A (phenol and alcohol) procedure, where the ingrown nail is removed back to the nail root and phenol is applied to the root to stop the ingrown nail from growing back in; or Winograd procedure, where the ingrown nail, adjacent swollen skin, and the nail root are surgically cut out. The skin and rest of the nail are then stitched together.”
These procedures, done in a clinical setting, are the best way to prevent ingrown toenails from occurring. In addition to ingrown toenail surgery, there are several other steps you can take to keep your toenails growing properly and protect your toes from infection…
Ingrown toenails are one of the many common issues treated at our NYC Center for Podiatric Care and Sports Medicine. We see people of all age groups come in with this type of injury. Often, the problem seems to occur for no real reason at all, but we find risk factors include: tight shoes, improper nail trimming, or foot injury. Sometimes the nail becomes infected and you’ll need to soak them in warm water with Epsom salts, apply antibiotic ointment, and stop in to see us for treatment. Generally, treatment is a quick outpatient procedure that allows you to return to work the same day.
This past November, manufacturers of the PinPointe FootLaser celebrated a big milestone as the 100,000th procedure was performed. While there are several competitors on the market now, PinPointe was the very first light-based device given FDA clearance to treat the appearance of onychomycosis nail fungus. This nail fungus solution was presented as a safer, more effective alternative to oral medications.
The cost of treatment ranges from $600 to $1,000 — which is deemed a “cosmetic procedure” that is not covered by insurance; so the decision to seek laser therapy is one to seriously consider. You’re probably wondering, “Does the PinPointe FootLaser work to cure toenail fungus for good?” We have the answer for you, here at the Center for Podiatric Care and Sports Medicine.
How Do Lasers Work To Eliminate Toenail Fungus?
“The laser creates a thermal effect,” says Steve Duddy, president and CEO of NuvoLase, Inc., the manufacturers of PinPointe FootLaser. “Temperatures are raised to levels high enough to impact the growth of the fungus without causing discomfort to the patient,” he tells Nails Magazine. During the 30 minute treatment, patients may sense a little bit of warmth, but that’s about it. The laser is able to penetrate the nail plate to essentially cook the fungi to death. Patients can keep their toenails, simply waiting for the fungus nail to grow out — as with most other treatments. A full recovery generally takes anywhere from four to six months, up to a year.
How Well Does the PinPointe FootLaser Work?
Clinical trials of the PinPointe FootLaser have been very encouraging. A multi-site retrospective study of 265 patients conducted by five private parties in the UK and United States reported “continuous improvement” for 71.8 percent of participants.
The success of one’s treatment depends upon the severity of the infection. “With mild-moderate cases, patients have an excellent chance of success,” explains Michael Bilinsky, D.P.M. of Beverly Hills, California. “With severe cases, clients have seen dramatic improvement, but when they expect to end up with a normal nail, they can be disappointed.”
Here at our NYC podiatrist’s office, we prefer to under-promise and over-deliver. We let patients know that success rates depend on a myriad of factors, including:
Adherence to a post-treatment plan.
Follow-up care is very important, as re-infection rates are high. “The life-cycle of fungus includes a dormant stage,” says Daniel Waldman, D.P.M. of North Carolina. He adds, “Many doctors schedule a follow-up visit not only to monitor the growth of the fungus, but also to make sure patients are performing home care.”
This home care may include a change in footwear, the use of topical treatments, disinfecting one’s shoes, and maintaining dry feet.
Are There Any Drawbacks To Laser Treatment For Fungal Nails?
Topical medications are generally considered to be ineffective for fungal nail treatment, as they cannot penetrate deep into the nail bed where infections lie. Oral medications are more effective, but side effects run the gamut from headaches to gastrointestinal upset — and require liver enzyme tests to be sure the internal organs are not overtaxed by the treatment. So, from that standpoint, the PinPointe laser (with its zero side effects) appears to be the obvious choice for treatment.
Keep in mind that there is no true way to “cure toenail fungus fast.” Laser treatment for fungal nails is not a cure, but it can temporarily improve the appearance of thickened, yellow toenails over time. We feel that laser foot fungus removal can be incredibly advantageous, but patients must be willing to comply with our recommendations for remaining fungus-free down the road.
“Just as in laser-whitening treatment of fading teeth, with laser nail treatment the fungus can come back over time,” according to Ben Pearl, DPM. He adds, “It is also important to disinfect the areas in which the fungal spores reside, so the nail does not get reinfected. There are now ultraviolet lights to do this, which are safer than many disinfectant chemical sprays.”
“I am so grateful for having had Dr. Geldwert perform bunion surgery on both of my feet. I have complete confidence in him and continue to see him for other sports related injuries. I was cautious about having surgery for the first time, but his knowledge, patience, and skill made me completely comfortable in trusting him. And I couldn’t be any happier with the results!! When anything else feels wrong with my feet, I love that I now know to go immediately to him. He is my top choice for anyone searching for the best foot fixer/surgeon/sports doctor in NYC! Thank you, Dr. Geldwert!!!”
– J. M., Manhattan, NY
Manhattan Office 111 East 88th Street New York, NY 10128 (212) 996-1900 See map here
Westchester Office 10 Mitchell Place Suite 105 White Plains, NY 10601 (914) 328-3400 See map here
Manhattan Orthopedic and Sports Medicine 57 West 57th Street New York, NY 10019 (212) 996-1900 See map here
Dr. Josef J. Geldwert DPM, Dr. Katherine Lai DPM, Dr. Ryan Minara, DPM, and Dr. Mariola Rivera DPM serving Westchester County, White Plains, Ardsley, Bronxville, Harrison NY, Larchmont, Mamaroneck, New Rochelle, Rye, Scarsdale, Rye Brook, Chappaqua, and the surrounding area.
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