Saturday, September 19, 2009

Toenail Fungus: The Getting, Going and Staying Gone.

Onychomycosis is the medical term for nail fungus and yes, you are not the only one hiding your ugly toenails. Over 6 million Americans suffer from toenail fungus and the number continues to grow more every year. Every day, I am faced with questions regarding oral treatment for toenail fungus, and there seems to be a lot of misunderstandings and myths. Do you know the truth about oral fungal treatments?
Truth or Myth? Oral treatments such as Lamisil damage your liver.
This can be true and false. Oral fungal medication does put your liver at an increase risk of damage, but when used properly the risk is minimal. For this reason, activities like consuming alcohol are prohibited while taking the medication because it intensifies the risk of liver damage. To prevent any damage from occurring, doctors will take blood work to determine your liver function before and during the course of your treatment. If any signs of risk are present, the treatment is discontinued and there are often no consequences once the treatment is halted.

Truth or Myth? You can NEVER have toenail fungus and athletes foot at the same time.
Myth. Toenail fungus and athlete’s foot are caused by the same fungus, thus it is very common to see both at the same time. Often, one will experience athlete’s foot first and then the fungus migrates to the toenails. It is thus very important to treat athlete’s foot aggressively and to use preventative medicine to keep the fungi off of your feet. I often suggest patients to use over the counter antifungal cream a couple times a week on their feet if they are prone to getting fungal infections.

Truth or Myth? Sweaty feet can cause toenail fungus.
True! Fungus loves warm moist environments. You’re gym sneakers are a 5 star resort for the family fungi vacation. If you have sweaty feet, you are creating a haven in your shoes and socks for fungus to multiply. A podiatrist can offer several treatments for excessive foot sweating and will help decrease the nasty growth from spreading. It is also suggested to change your socks twice a day and to alternate shoes so as to not wear the same pair two days in a row and thus allowing them to dry and air out.

Truth or Myth? If I take oral medication for toenail fungus, I’ll never have to worry about fungus again!
Myth. The fungus that grows under our toenails also grows in our shoes, showers, floors, soil, and almost everywhere you walk. Thus, reoccurrence after the oral medication can be very common. It is important to take preventative measures to keep fungus out of your toenails! There are a number of products that kill fungus in your shoes and on your feet. Using these products weekly after your toenail fungus is gone can help decrease the risk of seeing those ugly toenails.

Truth or Myth? Oral treatment is the only way to get rid of Toenail fungus?
Myth? If the entire nail is infected, there are very few treatment options and oral medication has the most documented success. But recently, there have been some breakthrough treatments that have become very popular. There are several types of lasers that are on the market that are showing good signs to eliminate the fungus. In addition, there is a product called Keryflex that not only improves the aesthetics immediately but has been to cure it as well. This product is a topical that is applied by your podiatrist and requires 4-5 treatments every 6-8 weeks. Keryflex is a simple procedure that is painless and about a tenth of the cost of most laser treatments. See a video on how Keryflex is applied.

Tuesday, September 8, 2009

Treating my toenail fungus…what about all my shoes?

In a recent blog by Dr. Crane, we learned about the new exciting technology of laser treatment for toenail fungus. A lot of patients inquire on what they can do to save their shoes. Afterall, it’s pretty common we have “multiple, can’t be without, spent a lot of money and hardly worn” shoes in our closet.

The answer to treating your shoes is easier than you think. Shoe sterilizers are on the market and at Healthy Steps, we are pleased to offer the best shoe sterilizer on the market.

Introducing Sterishoe. Accepted by the American Podiatric Medical Association, it looks like a shoe stretcher and is available based on your shoe size. The device contains a germicidal ultraviolet light (UVC). This technology is well known to hospitals and water treatment systems. UVC is clinically proven to destroy microorganisms. The Sterishoe is the first ultraviolet shoe sanitizer that utilizes UVC inside a shoe.

How does it work? It’s simple. You insert the SteriShoe into your shoe. As slight compression is applied, the treatment begins as the UVC rays are activated. If compression is reduced, the light automatically turns off.
Since UVC can be harmful if you look at it too long or hold it close to your skin, Sterishoe provides two important safety measures to protect you. A compression sensor and an ambient light sensor. This way, if the shoe sanitizer is removed from the shoe, the compression sensor will automatically turn off the power to the lamp.

To treat open toe shoes or sandals, there are two shoe bags that are provided. If the ambiant light sensor detects too much light, the sanitizer will turn off automatically.

The sanitizer should be applied after wearing the shoes. This way, microorganisms are erradicated and you have healthy feet!

For more information regarding Sterishoe, contact contactus@faant.com or go to Healthy Steps for more information.

Friday, August 28, 2009

Ugly Toenails Linked With Depression! New Treatments Are Available!

Many people suffer from a common problem: ugly, thick toenails. Often this is caused by onychomycosis, a fungal infection in the nails. Most people actually feel this is simply a minor cosmetic problem and really do not classify this as a disease. Reality is that onychomycosis can actually be a devastating problem for many people. In fact, a recent study has linked onychomycosis with depression in otherwise healthy patients.

Onychomycosis, over a period of time, makes your nails yellow, thick and often extremely disfigured. This is embarrassing and many people hide their toes in closed in shoes due to the disfigurement. Many people will even wear sneakers to the beach to avoid showing their toenails. Surveys have shown a lack of intimacy, decreased feelings of self-worth and depression associated with onychomycosis. With almost 30% of the adult population suffering from toenail fungus, and this number increasing to almost 90% in the elderly, why do most people feel it is just cosmetic? Because it hasn’t happened to them yet!

There is hope for people who suffer from toenail fungus. Traditional topical and oral therapies have been less successful than patient expectations. Lots of unhappy people with sever frustration!

Topical therapies patients have tried encompass a wide variety of products and folklore including the use of Vick’s Vaporub, organic cornmeal soaks, and a variety of over-the-counter products. Even the only FDA approved prescription topical, ciclopirox, is shown to be only 8% effective in their own package insert! Imagine painting your toenail with a topical therapy for over a year, every day, and still having ugly toenails!

After failure of topical therapy, most people discuss oral anti-fungals with their doctors. Common oral therapies include terbinafine, fluconazole, and itraconazole. These are more effective than any topical, but come with possible side effects including many drug interactions and liver problems. They are touted as somewhere between 50 and 70% effective depending on dosage and duration of therapy. Many people after taking these medications still have ugly toenails! More frustration!

Hope has recently increased for patients who have struggled with chronic onychomycosis. New laser therapy for onychomycosis is the most exciting treatment now available. A pulsed UVA laser has been shown in preliminary studies to eradicate much of the fungus and often clearing is seen in 9 to 12 months. This therapy is not widely available, but has been shown to be around 80% effective in these early studies. The FDA is still reviewing the Patholase laser application for approval, but the treatment is available in limited areas as an “off-label” usage. The laser light is painless and only affects the infected tissue. Hope abounds!

Funky looking toenails can also occur from psoriasis, eczema and other nail pathologies. If you have thick, nasty looking toenails, a visit to your local podiatrist for a PAS (Periodic acid-Schiff) stain of a piece of your toenail will determine if you have a fungal infection. If you have a positive PAS stain, look into the new laser therapy before your toenails cause a lifestyle change! There is hope even if you have suffered from embarrassing toenails for years!

Wednesday, May 6, 2009

Deadly Pedicure?

With so many lawsuits connected to deaths, chronic infections and disfigurement from pedicures; you would think the public would be clamoring for reform. Just the opposite, most consumers completely blow off the risks and have the "it won't happen to me" attitude. Approximately $6 Billion dollars are spent on spa related nail care every year, making it a huge industry.

Unfortunately, along with that pretty pedicure you can take home: hepatitis, cutaneous herpes, warts, HIV, bacterial and fungal infections. These can be deadly, especially in the diabetic or immuno-compromised patient!

A 43-year-old San Jose, California woman's husband remembers the small cut on her toe that led to her death from a skin infection in 2004.

A 46-year-old Ft Worth, Texas mother left the pedicure salon with a small abrasion on her heel from a pumice stone in July 2005 and died of staph related illness in Feb 2006. Her family is still embroiled in a wrongful death lawsuit.

Texas, California, and Florida have taken a closer look at the cosmetology industry and have put stronger sanitation laws in place, but the consumer needs to be more aware of their risks and simple precautions!

You may never be 100% safe from infection when receiving a pedicure, but there are many simple precautions consumers can take to protect themselves.
1. What does the salon look like? If it's not clean and shiny like a doctor's office, don't stay! Cleanliness is next to godliness in the nail salon!
2. Check the photo on the license of the nail technician. Make sure they match.
3. Ask about sanitation procedures. Instruments should be autoclaved in a steam sterilizer just like surgical instruments. When in doubt, bring your own! There are lots of instrument sets available to purchase and clean yourself.
4. Is the spa chair pipe-less and cleaned after each pedicure? This is a new chair technology that is available to make you safer. Has the spa updated their old whirlpool chairs with this pipe-less technology?
5. Did the nail technician wash their hands after their last pedicure? Hand washing should be standard protocol and prevents spread of almost all pathogens including the common cold.
6. Is the nail technician wearing gloves? This is the only profession that handles sharp instruments putting the client and the technician at risk that OSHA does not require them to wear gloves. You wouldn't let a dental technician clean your teeth without gloves, would you?
7. Never let the technician use a sharp blade to trim a callus or cuticle. This puts you more at risk. If your calluses or heel fissures are that thick, please visit your podiatrist prior to the nail salon.

Nail salons are definitely improving their sanitation and trying to make you safer, but you must be a savvy consumer. The risk of infections from pedicures can be virtually eliminated if the operator used autoclaved or disposable instruments, used a pipe-less pedicure spa chair, wore gloves, employees washed their hands, and used proper sterilization techniques. Demand a safe pedicure or you and your family may be sorry!

Tuesday, April 14, 2009

Friday, April 10, 2009

Toenail Laser Therapy on the News!

Toenail Fungus Laser on Good Morning America!

see the video by clicking here

Discusses the new PinPonte Laser therapy available at Foot and Ankle Associates of North Texas after May 1, 2009!

Sunday, March 29, 2009

Killer Nail Polish?

We are always warning the public about safe pedicure practices, but have you thought about what's in your nail polish?

Reading labels is not just for the grocery store! Did you know that the chemicals in nail polish are potentially hazardous for your health? The immense variety of nail lacquers and polishes make it hard to choose the perfect product! Whether you want to strengthen brittle nails, lengthen short nails, or just add a little color to your fingers and toes – there is a vast arsenal of products in an infinite palate of hues to satisfy every fancy. However, do not be fooled by the seemingly innocent contents of that small, brightly colored bottle. Read the labels!

The dangers of nail polish are directly correlated with the chemicals used in their manufacture. Most nail polishes are chock full of a variety of harmful substances. The major toxic compounds that you need to watch out for are toluene and dibutyl phthalate.

Toluene is a clear fluid that is a component of many products: gasoline, paints, shoe polish, and even explosives! This compound allows t the nail polish to stay in its liquid form in the bottle and is responsible for the rapid drying of the nail polish when on your nails. Toluene is bad for your health because it affects your nervous system causing nausea, headaches, and depression. In addition, toluene induces kidney and liver damage as well as eye, nose and throat irritation. It has even been implicated in the development of cancer!

Dibutyl phthalate (DBP) is a chemical that is used as a binder to improve the endurance of nail polish when applied to your nails. This is the substance that allows plastic ware its flexible properties. Women of child-bearing age are being asked to avoid DBP because it has been linked to cancer in laboratory rats and the disruption of hormone levels in humans. In addition, this compound may play a role in childhood asthma, lasting fertility problems in newborn boys, and liver toxicity.

Besides toluene and DBP, compounds such as ethyl alcohol, formaldehyde, and glycol ethers are potential toxins found in nail polish as well! Why are these chemicals so bad?

Ethyl alcohol – irritant of mucous membranes and suppresses the activity of the central nervous system

Formaldehyde – neurotoxin that has produced cancer in certain laboratory rats

Glycol ethers – substance that has been associated with birth defects in animals, lower sperm counts in human males whose mothers were exposed to low levels, and higher than normal rates of miscarriage with increased exposure

Take the time to find a product that is DBP and toluene-free! There’s no point in taking an unnecessary risk just to keep those toes colorful!

Tuesday, March 24, 2009

TOENAIL FUNGUS LASER TREATMENT

TREAT YOUR TOENAIL FUNGUS SAFELY AND PAINLESSLY
with the new PinPointe FootLaser

Coming in May to
Foot & Ankle Associates of North Texas LLP in Grapevine!

This new patented laser technology kills the pathogens that cause toenail fungus (Onychomycosis)

The gentle laser light works through the nail

No side effects

Does not harm the nail or skin

Painless-no anesthesia needed

Usually only one treatment required

Shoes and nail polish can be worn immediately after treatment

How does the laser work?

This patented laser is specially designed to shine through your toenail and destroy the specific pathogens embedded in and under your nail causing the infection. The FootLaser operates in the very tight spectrum of near infa red light. Unlike CO2 lasers of the past, this laser safely destroys the fungi, molds and bacteria that often cause onychomycosis.

Is this laser painful?

The gentle laser light beam has no effect on healthy tissue. There is no discomfort associated with the treatment during or after. This treatment does not harm or affect your activity in any way.

Does it really work?

In the first clinical study, earlier this year, 88% of the treated patients grew out a normal looking nail after one treatment. After the one treatment, the nail plate should grow out normally in 6-12 months if there is a healthy nail bed. This result is comparable to the success rate for the oral pill, Lamisil, which you take for three or four months with some risk of side effects. Additional information can be found at www.pinpointefootlaser.com

Is this treatment safe?

There are no age or health restrictions or limitations. In clinical studies there have been no adverse reactions, injuries, disabilities or known side effects. As you may know, the use of the medication available today for treatment of fungus toenails, carries with it possible systemic involvement (commonly the liver and kidney). This laser does not!

Does my insurance pay for this?

Because this treatment is considered aesthetic (cosmetic), health insurance plans do not cover this treatment. We accept major credit cards and personal checks or you may use your Flexible Spending Account from work. We also offer an interest free payment plan through Care Credit.

How Much Does It Cost?

The laser treatment is applied to all of the toenails on both feet, even the ones that appear uninfected. This reduces the chance of re-infection and takes about 30 minutes. There is an initial consultation with the doctor, which costs $50, to see if you are a candidate for the treatment. This is credited towards your procedure fee if you proceed with treatment. The treatment fee is $850. If the infection is resistant or has not responded with normal nail growth, the nails may need another laser treatment. This often occurs when all ten nails are severely infected. An additional treatment within the first six months is discounted to $450.

To make an appointment for your initial consultation, call (817)416-6155 or contactus@faant.com

Thursday, March 19, 2009

A Safe Pedicure

You have been in your heels all day and you begin to daydream about you pedicurist. How great it would be to escape the kids, the hustle and bustle, and get your feet pampered. But it may cost you. Did you know that you may be on pedicure away from a nasty infection or even death! No, I am not exaggerating. In Texas, a young woman was cut by a pumice stone. The open wound got infected by bacteria lurking in the whirlpool. After 6 months of fighting off the chronic wound, the women contracted mrsa and this nasty infection caused her death. This could never happen at your salon right? Think again. You are at risk of getting a nasty infection at almost any salon. Here are some helpful hints to keep your feet safe but still pretty.

1) Ask Critical Questions!
Have you ever asked your pedicurist how they clean their tools or the foot spa. Take a look at the spa chair. Is it stainless steel? Are they cleaning the chairs in between customers? Does the spa treat customers with foot infections, nail fungus, or athlete’s foot? I am guessing you never thought to ask any of these questions. I am sorry to inform you that you will not like the answers.

2) Cleaned tools are disinfected tools
Most states only regulate tools to be sanitized. Though this has antibacterial properties, the only way to be sure that there are no bacteria or fungus is to disinfect the tools by an autoclave. Why you ask? When sanitizing, you are simply placing the tools into a solution. How do you know they were put into the solution for a long enough time? You don’t. You have to trust that they were properly sanitized. Yes just trust there is nothing nasty growing on that nail clipper. With an autoclave, markers are used that change color when the tool was properly disinfected at a high enough temperature for an appropriate amount of time. An easy way to avoid this controversy is to invest in your own set of tools to bring with you to the pedicurist. This will ensure that your nail clipper doesn’t have your neighbor’s nail fungus tucked into the hinge.

3) Find a spa that uses stainless steel spa chairs.
There have been several bacterial outbreaks that have been traced back to a spa. The cause is a mycobacterium that thrives in the plastic piping and filter of a pedicure chair. Fungus in the pipes! Gross! Many chair spas are made out of fiberglass which is very difficult to properly clean without damaging. The plastic piping is a haven due to its inability to never completely drain. This leads to cross contamination. You are basically putting your feet in water used by the customer before you, before them, before the one before and so on. The ideal pedicure chair should be stainless steel which is much easier to clean. It is also important for the chair to be pipeless to ensure you are not sharing the same water with every foot that has ever stepped in for a soaking.

4) Does your spa treat customers with foot infections, nail fungus, foot fungus?
Nasty stinky, fungus growing demands! When I say nail fungus, many of us think of an old man with thick nasty looking nails. You may be unaware that nail fungus infects woman of all ages just as prominently as men. Are they at your spa? A pedicurist should not be treating infected feet due to the high risk of cross contamination. They are strongly advised to refer the customer to a podiatric physician before working on their feet. None of this is regulated so your spa may be pumicing bacteria and fungus and putting you at high risk!

5) Avoid fake nails and nail polish

Fake nails are a haven for bacteria and fungus. What nail technicians refer to as fake nail greening is actually a pseudomonas bacteria infection. Your cuticle is your body’s natural defense system against infection. During a nail “workup” they push, damage, and remove your cuticle giving bacteria an open door to your into your body! Nail polish can also trap bacteria, but more importantly, you are unable to notice changes in your nail or under your nail due to the polish over coating. Changes in your nail or nail bed are signs of infections and should be attended to immediately. If you can’t resist the Hot Pink nails, try an antibacterial nail polish. Many podiatric physicians provide this in their office or on their websites.

6) Find a Podiatry Approved Nail Spa
Podiatric Physicians are more than just surgeon of the foot and ankle. They are foot specialist. They can advise you with all o f your foot and ankle issues. They can even advise you on proper pedicures. Some podiatrists provide pedicures in their office! They are very well aware of the risks involved in pedicures and can recommend a spa and techniques that will assure your safety.