Toe Disorders
Fungal Toenails
LASer treatment
Causes
Toenail fungus is very common and anyone is susceptible to acquiring the dermatophyte or yeast most commonly. Toenail fungus thrives in dark moist places such as the toe box of a shoe. Genetics can play a role in the development of an ingrown but most commonly if there is trauma to the nail plate such as cutting the nail to short, dropping something on your toe or kicking something and you break the seal where the skin attaches to the bottom of the nail plate, fungus has the opportunity to enter the nail bed and growth slowly begins. The nail plates eventually become discolored, thick and curved and may cause pain. Did you know that if you had your toenail removed it would take 9-12+ months to grow back and it would still grow back with fungus? Rarely is there a reason to remove the nail plate with our treatment protocols.
diagnosis
Toenail fungus is most commonly discolored brown or white and over time the nail plate begins to thicken and curve which can lead to pain in your shoes. Samples of the nail plate may be taken and sent for analysis to determine the specific organism causing the toenail fungus.
TREATMENT
At MOFAS we have been successfully resolving nail fungus with our treatment protocols with a 95+% success rate. Our laser nail therapy program will show continued improvement in the appearance of the nail plate every month. Laser nail therapy is a non-invasive, safe and painless way to promote the growth of a healthy nail plate thereby resolving the unsightly appearance. There is no danger in performing the treatment to the patient. There are no side effects. Treatment time is 10 minutes per foot and consists of 3 treatments 4 weeks apart and we also offer quarterly or semi-annually maintenance treatment plans to keep your nails looking healthy and fungus free.
Most commonly lamisil or sporonox is prescribed for the treatment of toenail fungus. Unfortunately these medications are very hard on the liver and require constant blood work to make sure it is not affecting the liver in a negative way. It is also advised that people do not drink alcohol when taking these medications. There are viable alternatives to treat your nail fungus effectively and safely with excellent results at MOFAS.
Hammer Toes
CAUSES
Hammer toes are due to a muscular imbalance between the muscles on the top and the bottom of the toes which cause deviation of the digits. The toes help to stabilize the foot during walking.
DIAGNOSIS
Diagnosis is made by obtaining X-rays to check the structure of the foot and toes and also moving the toes through their range of motion and checking for flexibility of the joints. A skin exam is also performed to check for overriding callous formation on the top or tips of the toe.
TREATMENT
Conservative treatment consists of padding and over the counter topical pain creams. If the toe has a flexible contracture than an in-office procedure through a stab incision can be made to straighten the toe with 1 suture for closure, and you are in a shoe the next day. If the contracture of the toe is rigid then a procedure to straighten the toe is required and needs 4-6 weeks to heal properly.
Ingrown Toenail
CAUSES
Ingrown toenails are due to the nail plate penetrating the edges of the skin and causing pain and can lead to an infection. Most commonly the cause of an ingrown toenail is tight shoes leading to excess pressure on the nail plate. Trauma from stubbing the toe, dropping something on the toe or incorrectly cutting the nails can lead to a deformed nail plate causing an ingrown. Genetics and thick fungal nails can also lead to curvature of the nail plate.
DIAGNOSIS
Most commonly there is pain to palpation about the offending border with surrounding redness and occasionally drainage seen on your sock.
TREATMENT
99% of ingrown toenail procedures are performed in office under a local anesthetic using lidocaine most commonly, unless you have an allergy then other anesthetics can be used. Once the toe is numb a small sliver of the nail plate will be removed and then using a q-tip a chemical is placed in the opening and the nail matrix is eliminated so the nail border will not return. Post-operative soaking instructions are dispensed and explained and you will be seen 1 week later for follow-up to clean the toe. You are wearing a shoe the same day. However the more pressure you keep of the toe for the 1st 2-3 days is optimal to control any discomfort during the healing process.
