Is It Safe to Have Pedicures?

By Dr. Belinda Dotter

"Is it safe to have pedicures?"

Yes! As long as you consider the following things:

1. Look around the pedicure area:  Is is clean?  Are dirty tools lying around?  When in doubt, change salons.
   
2. Bacteria and other organisms (such as fungus) can enter your skin through any broken skin, so any scratches, bruises, scabs, wounds or abrasions should not touch the foot spa water. Or if you're unsure, better to postpone the pedicure until the skin has healed.
   
3. Do not do the following 24 hours before the pedicure:  use hair removal cream, wax, or shave legs.
   
4. Find out how the salon cleans and disinfects the foot spas, how they are maintained between customers. The foot bath and instruments should be cleaned and disinfected after each customer.
   
5. Ask to see the disinfectant. Salons should use an EPA-registered hospital grade disinfectant.  If there is a label on the container stating "Hospital," "Medical," or "Health Care," then that product may be used as a disinfectant on surfaces in these environments.  You want the salon to use this type.  You may be labeled as a picky customer, but better picky than a foot infection.
   
6. Pay attention to how much time is spent between customers on cleaning the foot spa/bath.  Most hospital grade disinfectants need 10 minutes to fully work.  If the cleaner is used then rinsed within 3 minutes then that foot spa is not considered disinfected.
   
7. Do not use the foot spa if you are not sure it is disinfected and safe to use. Do not risk your health. You should report any problems to your state cosmetological board if necessary.

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Frostbite, Prevention and Treatment.

Dr. Belinda Dotter

This winter has been especially cold for long periods of time, quite different from our past winters that have been on the mild side. Frostbite becomes a risk every time we go out in sub-zero temperatures (and sometimes not even sub-zero temperatures). Frostbite is caused by either prolonged exposure to cold temperatures, or shorter exposures to very cold temperatures.

There are several symptoms of frostbite:  numbness, a pins and needles sensation, severe pain, itching, and burning are all common when the body part is warmed and blood starts flowing again. The skin may look white, grayish yellow, or black with severe frostbite.  Blistering is also commonly seen.

Here are some tips to avoid having frostbite on your toes and feet!

• The most important action for prevention of frostbite is: Plan Ahead! If you are planning outdoor activities, check the weather forecast frequently, and don’t ignore warnings about storms. Avoid activities, such as hiking and camping in freezing weather, if it’s beyond your experience level.
• Wear adequate clothing: Layering is key, with the inner layer being a fabric that wicks moisture from the skin. The outer layer should serve as a windbreaker. Mittens provide more protection than gloves. Wear two pairs of socks, with the outer layer being wool. Don’t forget hats and scarves!
• Increase physical activity when outside to stay warm.
• Don’t drink alcohol before or during cold weather exposure, since the alcohol may prevent you from realizing that your body is becoming too cold.
• Don’t smoke! Smoking constricts blood vessels and increases the risk for frostbite.
• Keep a cold weather emergency kit in the car: extra layers of clothing, blankets, and chemical hand warmers.

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

The Foot of Your Foot: The Great Toe

Lately, we have had quite a few of our patient’s over the age of forty complaining of pain in the big toe joint. Typically, forty is the age when early arthritis symptoms tend to manifest and, in the foot, we see the great toe joint as the most common. This is due to the mechanical load and the important role it plays in every step we take. When we walk, our big toe joint bends up to an impressive 75 degrees just before the foot leaves the ground. But, sometimes, due to unusual wearing and tearing of the cartilage in the toe joint, the toe becomes stiff and starts to hurt. This is called Hallux Limitus.

Hallux Limitus is a progressive arthritic condition that limits the motion and function of the big toe. Symptoms of this condition come on slowly. You may only notice a mild, temporary pain when you are in motion or when you move the big toe joint. Eventually, the pain may worsen and in some cases dorsal bunions or bone spurs may develop and cause additional pain. The big toe is extremely important for proper foot/ankle/knee/hip and even low back bio-mechanics so it is important you don’t go untreated.

Symptoms of Hallux Limitus are based on the stage in which you are in. Your symptoms may or may not include: Pain while active or when you move the big toe joint, stiffness in the big toe, increased pain or aches in cold or damp temperatures, difficulty bending big toe up and down, difficulty wearing shoes, especially high heels, and development of bone growths (bunions, bone spurs).

It’s important to know that these symptoms signify the early stages of this condition. Each of these symptoms will slowly worsen until you’ve reached a point of no movement within the big toe joint. Hallux Limitus is caused by one of four things: Genetics, injury, a long first metatarsal bone (or short second metatarsal), or an elevated first metatarsal bone.

Hallux Limitus is a progressive condition that can lead to further problems, including complete loss of motion in the big toe joint. It’s best to see your podiatrist in the early stages or before bone growths develop. Your doctor will begin with a physical examination so he or she can determine the range of motion within the joint. Imaging tests such as x-rays and MRIs are often used to determine whether arthritis is present, to see how much the joint has narrowed, and to evaluate the foots overall health.

Treatment options include:

• A Morton’s extension can be used to relieve pain. These durable semi-rigid medical devices can be found in podiatry offices, and they are designed to provide support and shift weight away from the big toe to reduce pain.
• Accommodative cushions made of foam work for Hallux Limitus, since it pads the big toe joint and protects it from painful shoe pressure.
• Turf toe plates limit the range of motion of the great toe joint, which makes this product ideal for treating both Hallux Limitus and Hallux Rigidus.
• Athletic or running shoes made especially for over-pronators (flat feet) can provide support. They are less flexible than conventional running shoes, which enables them to limit the motion of the joint.

If you believe you may have Hallux Limitus and you live in the Greater Dayton/Springfield area, give Community Foot Specialists a call. Your feet will be in good hands! 937-426-9500

The Ugly Truth About Uggs!

Buyers beware - the trendy Ugg brand sheepskin boots and their generic counterparts may be hurting your feet!  While they may look soft and cuddly, studies have shown that the slipping and sliding going on inside the boots combined with the limited arch support they provide is putting unnecessary strain on muscles, tendons, ligaments, and bones.

The makers of Ugg boots maintain that their boots provide more support than the knockoff variety, but many experts see no real difference between the two. 

If you want to continue to wear the popular boot, Dr. Allen Guehl, a Dayton-area podiatrist at Community Foot Specialists recommends that you do so sparingly and when you aren’t going to be doing a lot of activity.  They aren’t the type of boots you want to be wearing if you are walking or standing all day.  You may also want to add supportive insoles to help cushion your feet and provide more support. 

Feeling the Pinch this Autumn? Bunions May Be to Blame

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With the curtain closed on summer and sandal season, fall is the season during which Community Foot Specialists sees an upswing in patients whose feet are feeling the pinch in their closed-toe footwear. This seasonal phenomenon seems to focus on women, although there are men who have this issue. The common culprit? Painful bunions that were given room to breathe during sandal season, but now face close quarters of a fall boot or shoe.

Bunions are abnormalities that form on the joint at the base of the big toe in the form of a bony bump. They occur when the big toe pushes against the other toes, which force the big toe joint in the opposite direction. As time passes, the abnormal positioning of the toe enlarges the joint. This further crowds the toes of the foot and causes pain and discomfort.

Bunions can occur for a variety of reasons. One of the most common causes is tight shoes, although they can also come about as a result of an inherited structural or mechanical defect, a stress to the foot, or a medical condition.

To help avoid bunions, don’t wear pointed shoes. Choose footwear with a wide foot box to give all of your toes plenty of room. If bunions become so painful that they impede daily activities, the American College of Foot and Ankle Surgeons recommends discussing surgical options with your podiatrist. However, please note that Community Foot Specialists firmly believes in exhausting the most conservative foot care treatment options first before considering surgery.

Community Foot Specialists can be reached at 937-426-9500. Or you may visit our website to request an appointment, view common conditions we treat, or get any other info you might need.

Toenail Fungus in Dayton/Springfield, Ohio

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Thick, discolored toenails are a common complaint amongst our Dayton/Springfield, Ohio patients. Many of our patients avoid wearing sandals or swimming because they are embarrassed by their unsightly toenails. This is a problem Community Foot Specialists is happy to help you fix!

A fungal toenail (or onychomycosis) is one of the most common conditions our Dayton/Springfield podiatrist sees. People who have weak immune systems (often times diabetics, HIV patients, etc.) are more at risk for a fungal infection of the toenail.

What does an infected toenail look like? A toenail infected with fungus appears to be thickened and a yellowish color. The toenail often times will appear to crumble or become flaky.

What happens if left untreated? If you do not treat your fungal toenail, your entire toenail may become discolored and eventually begin to lift from the nail bed, often times causing your toenail to come completely off.

There are medications available that provide a complete cure, however, the process can be a little slow depending on how infected your toenail is. The more you put it off, the worse it may get so instead of worrying; call your local podiatrist at (937) 426-9500 so we assist you!

Children's Heel Pain: Not Just Growing Pains!

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If your child complains of heel pain, you should definitely take their complaints seriously. Children particularly those who are athletic/ physically active- may have what is called Sever’s disease. This condition occurs in children during their growth stages when the growth plate in the heel is injured. In early puberty, bones grow faster than muscles and tendons. Muscles and tendons become tight as a result and the heel is less flexible. When the child stands or bears any weight on his or her heel, injuring the heel and causing Sever’s disease. 

Signs that your child may be suffering from Sever’s disease include pain in one or both heels that usually occur with activity (usually around the time your child would begin a new sport or season), A tendency to tiptoe, walking with a limp, increased intensity of pain when running or jumping. Another sign is if your child’s heel hurts when you squeeze both sides toward the very back of the heel. The good news about Sever’s disease is that it is highly treatable with non-invasive methods. The first thing to do is to stop or limit any activity that causes the child pain. Treat the injured heel with ice for 20 minutes at a time, 3 times a day. Stretching exercises can also help lessen the pain of Sever’s disease: particularly those that stretch the hamstring and calf muscles and tendons on the back of the leg. These stretches should be performed 2 or 3 times a day and held for about 20 seconds in both legs, even if only one heel is experiencing pain.

If your child is having heel pain, contact Community Foot Specialists serving the Greater Dayton area in 6 convenient locations- 937-426-9500

Question of the Week: All About Shoe Comfort!

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By: Dr. Belinda M. Dotter

One of the most common questions asked in my Dayton area Podiatry office involves shoes.  What shoes are good?   How do I buy shoes? Am I doing the right thing about my shoe wear?

Shoes are near and dear to almost every woman's heart and many of us have at one time, preferred to be crippled but gorgeous, as opposed to comfortable but not-so-cute.  With these guidelines, perhaps we can find a happy medium.

•          Shoe sizes differ between manufacturers.  You can have your shoe size measured, but use it as a guideline.  Try half a size up or down your measurement.  Buy shoes later in the day, to accommodate for swelling.  Have your feet measured once per year, as age, pregnancy, and weight gain may increase shoe sizes.  If you lose weight, your feet also get smaller.  Not only will you need new clothing, but new shoes too (bonus!).  Do not buy tight shoes thinking that they will "break-in" later on.  Buy shoes that are comfortable from the start.
•          3 inch heel limit.  Stacked heels, wedges are vastly better than stiletto heels.  If you have "weak" ankles, or history of ankle sprains, strictly avoid stilettos as you will further injure your ankles.  Chronic stiletto heel wearers regularly develop achilles tendonitis and contraction of the achilles tendon, making it too tight and causing pain with every step.
•         Pick shoes with thicker soles.  More cushion, more support.  Constantly wearing flip-flops during the summer may cause many a foot pain.  Notice that when you wear them, your toes grip or flex, to try and hold the flip-flop in place.  You may develop plantar fasciitis (arch pain or heel pain) or hammertoes!
•          Limit wearing the same shoes every day.  It puts repeated pressure on identical areas of the foot, causing irritation and letting deformities further develop or worsen (such as bunions or hammertoes).  You may also re-infect your foot continually if you have athlete's foot!
•          Finally, orthotics.  There is a controversy about their increasing use, especially since custom orthotics cost hundreds of dollars and is not regularly covered by insurance.  Many foot problems are prevented and alleviated by orthotic wear, but some foot problems caused by overuse, overtraining, and being overweight won't be helped by them. Using orthotics heavily depends on the primary cause of your foot pain so discuss with your podiatrist how the orthotics will help you.
•        As a final note, Studies by Irene Davis, professor of physical therapy at the University of Delaware, found that "semi-custom" models (the lab uses a mold of the patient's feet to identify the best-fitting prefabricated insole) work as well as the totally customized, built-from-scratch kind.

If you are still having a hard time figuring out which shoes work best for you, stop by or call one of our six Dayton and Springfield Community Foot Specialists locations to speak with a podiatrist. We're here to get you (comfortably!) back on your feet! Call today, 937-426-9500

Everything You Need to Know about Warts

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By: Dr. Belinda M. Dotter

Plantar warts are noncancerous skin growths on the soles of your feet caused by the human papillomavirus (HPV), which enters your body through tiny cuts, breaks or other vulnerable sites on the skin of your feet.  Plantar warts often develop beneath pressure points in your feet, such as the heels or balls of your feet. This pressure also may cause a plantar wart to grow inward beneath a hard, thick layer of skin (callus).  Most plantar warts aren't a serious health concern and may not require treatment. However, plantar warts can be bothersome or painful so it's important to contact your Dayton/Springfield, Ohio Podiatrist at Community Foot Specialist so we can get you back on your feet. Call today for an appointment 937-426-9500

Signs and symptoms of plantar warts include:

• Small, fleshy, grainy lesions, or growths, on the soles of your feet
• Hard, thickened skin (callus) over a well-defined "spot" on the skin, where a wart has grown inwards
• Black pinpoints, which are commonly called "wart seeds" but are actually small, clotted blood vessels
• Lesions that interrupt the normal lines and ridges in the skin of your feet
• Pain or tenderness when walking or standing

Plantar warts are caused by an infection with the human papillomavirus (HPV) in the outer layer of skin on the sole of your feet.

There are more than 100 types of HPV, but only a few types are known to cause warts on your feet. Other types of HPV are more likely to cause warts on other areas of your skin or on mucous membranes.

Transmission of the virus
Each person's immune system responds differently to HPV, so not everyone who comes in contact with the virus develops warts. Even people in the same family react to the virus differently.

The HPV strains that cause plantar warts aren't highly contagious. Therefore, it isn't easily transmitted by direct contact from one person to another. However, the virus does thrive in warm, moist environments — such as shower floors, locker rooms and public swimming areas. Consequently, you may contract the virus by walking barefoot around pools or gyms.

The virus also needs to have a point of entry into the skin:

• Cracks in dry skin
• Cuts or scrapes
• Wet, softened, fragile skin from prolonged water exposure (macerated skin)

Multiple warts
If the virus spreads from the original site of infection, multiple warts may appear. These may include:

• Several individual warts at different sites on the foot
• "Kissing warts," a pair of warts that appear where two parts of the foot touch, such as a point of contact between two toes or between a toe and the ball of foot
• Mosaics, clusters of warts that essentially form a large, single lesion

Treatment options include the following:

• Freezing (cryotherapy). Application of liquid nitrogen with a spray canister or cotton-tipped applicator to freeze and destroy your wart. The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. The application itself can be painful, and cryotherapy can result in painful or tender blisters that resolve on their own.
• Cantharidin. Application of cantharidin — a substance extracted from the blister beetle — on your plantar warts. Typically, the extract is paired with salicylic acid, applied to the plantar wart and covered with a bandage. The initial application is painless, but the subsequent blister that forms may be painful. The dead part of the wart is clipped off in about a week.
• Immunotherapy. This therapy attempts to harness your body's immune system to remove tough-to-treat warts. This can be accomplished in a couple of ways. Injection on your warts with interferon, a medication that boosts your immune system's instinct to reject warts. Or injection of your warts with a foreign substance (antigen) that stimulates your immune system. Often, mumps antigens are used, because many people are immunized against mumps. As a result, the antigen sets off an immune reaction that may fight off warts. Interferon treatment may result in flu-like symptoms for a few hours after treatment. Both treatments may cause pain.
• Imiquimod (Aldara). This prescription cream applied directly to a wart is an immunotherapy medication that encourages your body to release immune system proteins (cytokines) to attack HPV. This treatment can result in severe inflammation near the site and damage to the tissues beyond the wart. If this occurs, the treatment is dropped. The drug may also result in flu-like symptoms that may lessen with a lower dosage.
• Minor surgery. This involves cutting away the wart or destroying the wart by using an electric needle in a process called electrodesiccation and curettage. Anesthesizing your skin before this procedure is required. This treatment is avoided if possible with plantar warts because of the risk of scarring.
• Laser treatment. A type of laser treatment called pulse dye laser treatment burns closed (cauterizes) tiny blood vessels. The infected tissue eventually dies, and the wart falls off. This treatment can cause pain and scarring.

To reduce your risk of plantar warts:

• Avoid direct contact with warts. This includes your own warts.
• Keep your feet clean and dry. Change your shoes and socks daily.
• Don't go barefoot in public areas. Wear sandals or flip-flops in public pools and locker rooms.
• Don't pick at warts. Picking may spread the virus.
• Don't use the same file, pumice stone or nail clipper on your warts as you use on your healthy skin and nails.
• Wash your hands carefully after touching your warts.

If you or you know someone who may be experiencing any of these painful plantar wart symptoms, call your local Springfield/Dayton, Ohio Podiatrist at Community Foot Specialist so we can find the best treatment option for you. Call and schedule your appointment today with any of our 6 conveniently located Greater Dayton offices. 937-426-9500