"After my athletic injury, I had met with several doctors in the Northern Virginia area… many were quick to diagnose, quick to jump into surgery, and quick to misdiagnose. Dr. Pontell not only examined my foot via MRI, Xray, Ultrasound and in person – he explained EVERYTHING to me... After completely healing, at 38 years old I can run longer, and run faster than I ever had been able to run before – even before my injury. I’m in the best shape of my life. I tell everyone all the time that I am able to do what I do because of him - my foot he reconstructed is a million times stronger than my uninjured foot." -A.D.
"I went to Dr. Hallivis based on his reputation and his extensive experience. He definitely stood up to his reputation. He was professional, friendly, approachable and knew everything there was to know about my problem. He treated me and my pain resolved in 2 days. His office ran on time and his staff was warm and helpful. I would recommend him to anyone with a foot problem.” - M.H.
Nail and Fungus Problems
A chronic infection caused by various types of fungus, Athlete’s foot is often spread in places where people go barefoot such as public showers or swimming pools. The condition ranges from mild scaling and itching to painful inflammation and blisters. It usually starts between the toes or on the arch and may spread to the bottom and sides of the foot.
If your condition is not serious, over-the-counter and prescription powders, lotions, or ointments can often help treat scaling, itching, and inflammation. Consult us before taking any medication. Foot soaks may help dry excessive perspiration, but you should contact our office first. If your Athlete’s foot does not improve, we may prescribe stronger medication.
Many people don’t realize they have a fungal nail problem and, therefore, don’t seek treatment. Yet, fungal toenail infections are a common foot health problem and can persist for years without ever causing pain. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish. Left untreated, however, it can present serious problems.
Also referred to as onychomycosis, fungal nails are infections underneath the surface of the nail, which may also penetrate the nail. Fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate, which ultimately can lead to difficulty and pain when walking or running. Symptoms may include discoloration, brittleness, loosening, thickening, or crumbling of the nail.
A group of fungi, called dermatophytes, easily attack the nail and thrive on keratin, the nail’s protein substance. In some cases, when these tiny organisms take hold, the nail may become thicker, yellowish-brown, or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks may frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.
Nail bed injury may make the nail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete’s Foot or excessive perspiration. Since fungal nails are usually more resistant and more difficult to treat than Athlete’s foot, topical or oral antifungal medications may be prescribed. Permanent nail removal is another possible form of treatment for fungal nails.
After a fungal nail infection has cleared up, you can take steps to prevent the infection from coming back.
Keeping the fungus under control will help prevent a fungal infection of the skin from reinfecting the nail. Before bed, thoroughly wash and dry your feet, and apply a nonprescription antifungal cream to the entire foot from the ankle down. Use the cream every night, then gradually apply it less often. Keep your feet dry. Dry feet are less likely to become infected. Apply powder to your dry feet after you take a shower or bath.
- Don’t share nail clippers or nail files with others.
- Don’t share shoes or socks with others.
- Try not to injure your nail, such as by cutting it too short (trauma to the nail may lead to infections).
- Wear dry cotton socks, and change them two or three times a day if necessary.
- Wear dry shoes that allow air to circulate around your feet (tight, enclosed, moist shoes contribute to fungal toenail infections).
- Wear shower sandals or shower shoes when you are at a public pool or shower.
Follow basic foot care guidelines and you more than likely can head off most common foot fungus problems.
You can prevent fungal nail infections by taking these simple precautions:
- Exercise proper hygiene and regularly inspect your feet and toes.
- Keep your feet clean and dry.
- Wear shower shoes in public facilities whenever possible.
- Clip nails straight across so that the nail does not extend beyond the tip of the toe.
- Use a quality foot powder (talcum, not cornstarch) in conjunction with shoes that fit well and are made of materials that breathe.
- Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to “wick” away moisture faster than cotton or wool socks, especially for those with more active lifestyles.
- Disinfect home pedicure tools and don’t apply polish to nails suspected of infection.
Depending on the type of infection you have, over-the-counter liquid antifungal agents may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed, a process called debridement. Note: Please consult your physician before taking any medications.
In severe cases, surgical treatment may be required to remove the infected nail. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured and prevents the return of a deformed nail.
Black or darkened toenails are essentially bruised nails and can result from a variety injuries or problems. Darkened nails may occur as a result of the toe hitting the end or the top of the shoe toe area. Sometimes, the bruise can lead to a fungal nail infection.
Treatment may include trimming the nail back and applying a topical antifungal medication. If the skin under the nail is ulcerated, a topical antibiotic ointment should be applied.
Diabetic patients should contact our office for evaluation if they experience any change in the color of toenails. The pressure causing the bruised nail may lead to a small sore under the toenail, which can lead to infection.
Ingrown toenails, also known as onychocryptosis, is usually caused by trimming toenails too short, particularly on the sides of the big toes. They may also be caused by shoe pressure (from shoes that are too tight or short), injury, fungus infection, heredity, or poor foot structure. Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. A common ailment, ingrown toenails can be painful. Ingrown toenails start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected and the skin may start to grow over the ingrown toenail.
In most cases, treating ingrown toenails is simple: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present. Note: Please consult your physician before taking any medications. In severe cases, if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.
Ingrown toenails can be prevented by:
- Trimming toenails straight across with no rounded corners.
- Ensuring that shoes and socks are not too tight.
- Keeping feet clean at all times.