Skin & Nail Conditions

A fungal infection occurs when a fungal organism grows uncontrollably on the foot or nails. Athlete’s foot (Tinea Pedis) and fungal nails (Onychomycosis) are the most common fungal problems with feet. These infections, particularly fungal nails, can persist for years without ever causing pain. Therefore, many people don’t realize they have a fungal skin or nail infection and don’t seek treatment. Fungal nails, characterized by a change in the nail’s color, thickness and appearance, are often considered nothing more than unsightly. However, if left untreated, these infections can present serious problems.

Fungal infections of the skin and nails are caused by a wide variety of fungi. You may be exposed to fungus a variety of ways, but it commonly spreads through contact with damp communal areas such as locker rooms, showers, and around pools. Fungal infections of the skin can eventually spread to the nails if left untreated.

Ingrown toenails or incurvated nails occur when the corners or sides of the toenail dig into the skin, often causing infection. Also known as onychocryptosis, ingrown toenails can start as mild swelling and tenderness. If left untreated, they may become painful, red, and infected and the skin may start to grow over the ingrown toenail. A common ailment, ingrown toenails can be painful.

Ingrown toenails are usually inherited with the nail plate growing too wide for the toe it lies upon. Then shoe and sock pressure cause the nail plate to ingrow or incurve into the flesh. This makes trimming these toenails difficult, and often a person will trim them back too short particularly on the sides of the big toenails. They may also be caused by pressure from shoes that are too tight or short, an injury, a fungus infection, or poor foot structure.

Ingrown toenails need treatment by a podiatrist in order to be fully resolved. Your medical provider may choose from several treatment options depending on the severity and symptoms of your ingrown nail. In most cases, a portion of the toenail may need to be trimmed or removed and the matrix (growth area) cauterized for permanent correction.

If infection accompanies the ingrown nail, your provider may suggest a minor medical procedure that removes the nail and infected tissue. This may also include the use of chemical solution to permanently cauterize the growth area. 

Warts are caused by a viral infection that can occur on any part of the body. When they occur on the bottom of the foot (plantar surface), they are often rough in texture like a callus and may look like a hard blister, thus the name plantar warts. You may be able to identify a wart or grouping of warts by the small, black pinheads that appear at the center of the wart which are blood vessels which feed the virus.

Warts occur when a virus, specifically one in the human papillomavirus (HPV) family, infects the upper layers of skin through a scratch or small opening. This virus can enter through a blister or other skin irritation and particularly like moist, sweaty feet.

Warts can grow and spread to other parts of the body. We recommend that all areas on the feet and hands be treated by a podiatrist. Treatment options vary but could include chemical solutions, freezing, excision, and laser therapy. Often aggravating the area by any means will stimulate an immune response and all warts with spontaneously resolve.

Surgery is not commonly needed to remove warts. Wart excision can be performed as an in-office treatment with a local anesthetic and has limited recovery time.

A subungual hematoma is the scientific name for blood collecting under the nail. It will appear as if the skin under the nail is bruised.

Subungual hematomas are most commonly caused by direct trauma or injury to the nail. However, blood may slowly begin to pool under the nail in people who wear tight-fitting shoes or are involved in vigorous activities such as playing sports, running or dancing. Even long-distance runners and hikers can develop subungual hematomas over time.

Most subungual hematomas cause pain and pressure as blood builds up under the rigid nail plate. This pain can be treated by relieving this pressure. Your FAAWC provider will use a painless heated tip that makes a small hole in the nail plate to allow the collected blood to drain providing immediate relief. Minor injured nails may grow out with no further problems. Severely damaged nails may fall off on their own and then regrow.

Subungal hematomas often resolve with minor treatment and time. However, a nail which is severely damaged and painful can necessitate more serious medical intervention to remove the nail plate and relieve the pain and pressure.