Author: footandankle

What is Toenail Fungus?

You may have noticed one or more of your nails are slightly discolored. Instead of a healthy-looking toenail, it may appear white or yellow-brown in color. This can be a sign of toenail fungus.

Onychomycosis, or toenail fungus, is a common infection that occurs underneath the nail surface. If you’re suffering from toenail fungus, fungi have found their way between your toenail and your toenail bed. Toenail fungus isn’t confined to a single toe. It can occur on one toe or on many toes at the same time.

The thicker toenails fungal nails cause are often difficult to trim and can make walking painful when wearing shoes. If you’re suffering from toenail fungus, you’ll notice a progressive change in your toenail’s quality and color. It’s normal to feel embarrassed or upset about the discoloration and misshapen nature of a toenail(s) affected by this infection.

What Causes Toenail Fungus?

Anyone can get a fungal nail infection. Your toenails are especially vulnerable to fungi in damp areas where you are likely to be walking around barefoot. Think of your local swimming pool, locker rooms, gyms, and showers. Any injury to the nail bed, even pressure from your shoes, can make you more susceptible to infection.

A particular type of mold called a dermatophyte causes tinea unguium, which is the most common nail fungus. Dermatophytes cause 90% of all toenail fungal infections and need keratin to grow. Keratin is the main building block of your nails and is what makes them hard. This, in combination with the fact fungal infections grow best in dark, moist environments, means your feet and toenails are more susceptible to this particular fungus than other areas of your body.

There are a few factors that can make you more prone to fungal nail infections. If you:

• Suffer from chronic diseases like diabetes
• Have circulatory problems
• Have immune deficiency conditions
• Have had athlete’s foot in the past or have fungal skin infections on other parts of your body
• Have a skin condition like psoriasis that affects your nails
• Walk barefoot in damp public areas
• Have hyperhidrosis (a disorder that makes you sweat a lot)
• Have a toenail injury

Toenail fungus is a common condition, especially as you start to age!  While toenail fungus affects approximately 1 in 10 (10%) people overall, that number jumps to 1 in 2 (50%) people for those older than 70.

What Are Common Symptoms of Toenail Fungus

Toenail fungus is often ignored because the infection can be present for many years without causing any pain to the patient. Symptoms of nail fungus can include a nail or nails that are:

1. Thickened
2. Brittle or ragged
3. Discolored
4. Cloudy in some spots
5. Crumbling at the edges
6. Misshapen
7. Separated from the nail bed —leaving space between your nail and the skin underneath
8. Smelly
9. Cracked

What Can I Do at Home for My Fungal Toenails?

There are a few things you can do at home to help treat your fungal nails. Daily cleansing can help temporarily suppress mild toenail infections. Over-the-counter liquid antifungal agents may also help with fungal nails, however, these over-the-counter treatments may not prevent a fungal infection from coming back. It’s important to remember trying to get rid of the infection without the help of a qualified medical professional, like a podiatrist, can lead to more problems.

Should I See a Podiatrist for Fungal Nails?

The short answer is yes!

Some people like to try self-care steps when they first start to notice the signs of toenail fungus. These at-home options may clear mild cases of fungal toenails. However, it’s a good idea to see your local podiatrist if you notice your toenails are becoming increasingly discolored, misshapen, and thickened.

The earlier you seek professional care from your podiatrist, the greater your chance of success at getting your nails clear and back to normal.

It’s important to see your podiatrist if you’re experiencing swelling or pain around the nails, having difficulty walking, or if you’re bleeding around the infected nails. It’s especially important to see your podiatrist if you’re a diabetic and think you’re developing toenail fungus. 

If you’re suffering from a severe case of nail fungus, it can be painful and cause permanent damage to your nails or lead to other serious infections that spread beyond your feet.

How to Diagnose and Treat Fungal Toenails

Luckily, it’s a straightforward process to determine if you’re suffering from a fungal toenail infection, and your podiatrist can do this in the early stages of infection by performing a lab test in which a small sample from underneath your nail is taken and analyzed or by performing a culture test.  

You and your podiatrist will decide on the best course of action to clear your toenails of a fungal infection. Treatments can vary depending on the severity and nature of the infection. 

Toenail fungus is known for being tricky to treat. You may need to treat toenail fungus for many months to get rid of it completely. And unfortunately, toenail fungus often comes back.

Treatment can include topical or oral medications, antifungal medications, and temporary or permanent removal of the infected nail. The most effective toenail fungus treatment for you will depend on your specific symptoms and situation, and your podiatrist will take several factors into consideration before recommending a treatment plan for you. 

Unfortunately, it can be a long and frustrating process to completely clear up the infection. It’s important to remember toenails grow slowly, and it may take 12 to 18 months before you see the complete resolution of fungal nails, even with the correct treatment.

How Do I Prevent Toenail Fungus?

There’s no foolproof way to guarantee you won’t ever get toenail fungus. But here are a few steps you can take to help prevent it:

• Wear flip-flops in public showers, locker rooms, and around swimming pools. Don’t be barefoot in these places if you can help it!
• Keep your feet clean and dry. Fully dry your feet after a bath or shower.
• Don’t share nail clippers with other people.
• Keep your toenails short and clean.
• Don’t be aggressive with your nail trims. Trim your toenails straight across, and don’t round the edges!
• Change your socks regularly.
• Wear shoes that fit you correctly. Nothing too tight or loose around your toes.
• Clean your nail trimmer before each use
• If you’re a diabetic, make sure you’re following all foot care recommendations from your podiatrist or health care provider.

Why Choose a Foot and Ankle Surgeon?

Each of our doctors at Western Montana Foot and Ankle are board-certified surgical specialists. They have more advanced training than any other healthcare provider when it comes to your feet and ankles.

It’s key to remember you shouldn’t let a treatable condition like toenail fungus prevent you from wearing the shoes you want to wear. Toenail fungus is nothing to be ashamed of and one of our podiatrists at Western Montana Foot and Ankle can help you clear the infection.

What is a Tailor’s Bunion or Bunionette?

You’ve probably heard about bunions. Since an estimated 30% of Americans have had a bunion at some point, you probably know someone who’s had a bunion! But have you ever heard of the less common tailor’s bunion?

While regular bunions usually affect the big toe, a tailor’s bunion, or a bunionette, affects the fifth metatarsal or little toe. 

Don’t let the cute name fool you. Bunionettes can become quite painful and problematic. They can also impact your ability to wear your favorite pair of shoes.

Where Did the Tailor’s Bunion Get Its Name?

This deformity got its name hundreds of years ago when tailors often sat cross-legged on the floor all day to work. In this position, the outside edge of their feet rubbed on the ground. That friction eventually led to a painful bunionette at the base of their little toe.

What Causes a Tailor’s Bunion?

Tailor’s bunions are often caused by wearing shoes that are too narrow across the toes. High heels and pointed-toe shoes are the worst culprits in this area. They usually leave even less room for your toes than your typical shoes. This causes rubbing and pressure that over time can result in a bunionette. The bone will bow outward, which creates a bony bulge on the outside edge of your foot. This typically occurs where your pinky toe meets your foot.

Did you know you can be genetically predisposed to bunions? Genetics can also play a role in whether you develop not just a bunionette but your typical bunion as well, regardless of what types of shoes you wear. Thanks, mom and dad!

Other Causes of a Tailor’s Bunion Include:

• A protruding fifth metatarsal bone which causes the little toe to move inward
• Bone growth (bony spur) on the side of the fifth metatarsal
• Arthritis
• An inverted foot which causes you to walk with your feet leaning out.
• Loose ligaments in your foot – also called a splayed foot
• Tight calf muscles that can impact how you stand or walk

If the tailor’s bunion becomes severe enough, you may notice your little toe starts to turn in towards your other toes. Over time, your bunionette may get to the point where you’ll have a toe growing over or under your other toes. This deformity can affect how you stand and walk.

Common Signs and Symptoms of Bunionettes

Tailor’s bunions are characterized by a bump on the outside edge of the little toe. The size of the bunionette can vary. They may start small and then increase in size over time.

Other signs of a tailor’s bunion include:

• Red, swollen, and/or a callus on the outer edge of your pinky toe
• Pain and burning over the site of the enlargement
• Pain worsens over the course of the day, but this pain does not radiate to other parts of your foot.
• Narrow or pointy-toed shoes make pain worse
• Being barefoot usually relieves pain

What Can I Do About My Tailor’s Bunion?

Diagnosing a tailor’s bunion is usually a straightforward process. Typically, the bunionette is easy to spot by both you and your doctor. Your podiatrist may also use X-rays to view the extent of the deformity and to see if there are any additional problems with the bones of the little toe.

While a tailor’s bunion won’t usually pose any serious threats to your health, it may affect your quality of life. Pain is never something you have to live with.

If you’re dealing with a tailor’s bunion, there’s good news. Bunionettes can be easily addressed with both surgical and non-surgical treatments. Depending on the severity of your tailor’s bunion, conservative treatment options may alleviate your pain without the need for surgery.

Non-Surgical Treatments

• Wearing wider shoes that have plenty of room in the toe area so you’re not forcing your toes to crowd each other. 
• Avoid wearing narrow, high-heeled, and pointed shoes.
• Padding the painful area with moleskin or a silicone pad may help relieve pressure and reduce rubbing against your shoes.
• Finding a way to reduce the callus (if present) may also give you relief.
• Custom orthotics can help depending on your specific foot type
• Stretches to release tight calf muscles
• Icing the bunion can reduce pain and inflammation. To avoid skin damage, avoid applying ice directly to the skin.
• Pain and inflammation can sometimes be managed by over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. These types of medications can help lessen your symptoms and swelling.

When Is Surgery Needed?

Your podiatrist may recommend surgery when conservative non-surgical treatments are not providing you relief from your symptoms or your tailor’s bunion becomes so large that you’re unable to wear most shoes.

You’ll be happy to know that surgical options for your tailor’s bunion are usually straightforward and have a good success rate.

Your surgical options will vary depending on the severity of your bunionette. Surgery may be as simple as shaving off a small portion of the growth that is causing your pain.  Or it can be more complicated and involve the realignment of muscles, ligaments, and tendons that have shifted because of the bunionette. Sometimes this means the bones themselves need to be shifted and moved so they can be realigned with a pin or screw to hold them in the corrected position as the bone heals. 

Your recovery time will depend on which surgical procedure, or combination of procedures, you and your podiatrist agree upon.

Why Choose a Foot and Ankle Surgeon?

Foot and ankle surgeons are the leading experts in foot and ankle care. Each of our podiatrists at Western Montana Foot and Ankle are doctors of podiatric medicine and are board-certified surgical specialists. They have more education and specialized training that focuses only on the foot and ankle than any other healthcare provider. 

If you or someone you know has a bunionette or tailor’s bunion that is affecting their quality of life, don’t hesitate to reach out to one of our foot and ankle surgeons here at Western Montana Foot and Ankle. We are privileged to serve our patients and look forward to getting you back on your feet and enjoying everything Western Montana has to offer.