Why is my toenail so funky looking, and what can I do about it!?!

So, your toenail doesn't look like it did when you were seventeen.

To be honest, your face probably doesn't look the same either, but this is a podiatry blog, not a plastic surgery one, so I will get back to the subject at hand: your toenails!

Maybe your toenail is yellowing, thickening, white and flaky, or maybe crumbling like a poorly built starter home. Either way, there are reasons why your toenail has decided to become a rather unsightly part of your skin, and there are things you can do about it. The most likely culprit is: toenail fungus (onychomycosis). That being said, it is a good bet that if you have toenail fungus, that you also have a fungal infection of the skin of your feet as well. Some studies say it is a 100% probability. Most podiatrists or dermatologists can give you a pretty definite "yes" or "no" just by simply looking at your toenails as to whether you do indeed have the honor of having a toenail infected with fungus. Sometimes a small sample of your nail will need to be sent to a lab to get the final and definitive approval of some lab geek that spends his or her day testing toenail parts for the presence or absence of fungus (and you thought your job stunk).

If the lab results come back positive for fungus, you are left with five basic options:

1. Do nothing. There are worse things than having a funky toenail.
2. Use topical antifungals.
3. Use oral antifungals.
4. Use laser therapy.
5. Use a mixture of topical and oral antifungals as well as laser therapy.

Topical antifungals (prescription topicals) are effective in the treatment of toenails fungus, just be prepared for a slow, long slog of daily applications, for up to one year or more. The effective rate is hard to get a good idea of, as so many patients simply give up using topicals after months of treatment without seeing any improvement. Oral antifungals, the historical gold standard of toenail fungus treatment, are usually taken over a three month course, and the treatment also suffers from slow progress, but taking a pill is much easier than bending over to put medicine on your toenails every day for months on end. The negative of the oral medicine, however, is drug interactions, possible liver damage, and weird side effects such as loss of taste and smell! Blood work is recommended prior to starting oral therapy and during the course of medication as well in order to monitor the effect on your body. Laser therapy, the newest from of treatment, has no side effects and shows an effectiveness rate very similar to the oral medication (generally in the 85% range in my experience). If you have neuropathy or nerve loss sensation you should probably not get laser therapy as you might suffer a burn from the laser. There are usually three to four treatments and they are usually spaced out over a few weeks. Unfortunately, laser therapy is not covered by insurance, and can be expensive.

No matter which form of treatment you choose upon, treatment of your skin is imperative as well, with topical antifungals and anti-fungal foot powder as well. Throw away any disgusting yard shoes or house slippers that you got back in college. They are nothing more than reservoirs of foot disease and should bring shame upon your otherwise good family name. Bleach your bath tub and bath mats and go on a cleaning binge.

It is best to see a podiatrist to check out your toenail problems not only so you can get the right treatment for your toenails, but also to give you a definitive diagnosis that you in fact do have toenail fungus. Eczema, psoriasis, and allergies to dye in your shoes among other things can cause your toenails to get funky. No point in spending your precious time and money treating a non-existent toenail fungus!

Got a funky foot or toenail?

Come see Dr. Z!

Zimmermann Podiatry
Erik Zimmermann, DPM
923 W. Dixie Ave. Suite B
Leesburg, FL 34748
(352)435-7849
www.drzpodiatry.com

Quick shoe review: Saucony Redeemer running shoe

For the first time in about 10 years I am wearing a pair of shoes that is not a set of ASICS Gel-Kayanos. Yesterday I put on a pair of Saucony Redeemer running shoes. Kimberly fro Gear For Multi-Sport (clermonttristore.com) in Clermont, FL recommended the Saucony Redeemer shoes due to her knowledge of foot types and biomechanics. She thought that the Saucony Redeemer could give me more motion control than the ASICS Gel-Kayano and that they would not be as stiff as the Brooks Beast (the most rigid of anti-pronation shoes).

After 24 hours I can say that I really enjoy the feel of my new shoes. They offer great arch support but also offer a little more cushion than the ASICS Gel-Kayano and are very comfortable. Beating the Gel-Kayano is quiet an achievement, as the Gel-Kayano is one of the greatest all around shoes there is, especially for one that offers some motion control.

I think that the Saucony Redeemer will be a great fit for most average to above-average pronators, and for those that find the rigidity and the weight of the Brooks Beast to be a little too much. If you have foot pain, go check out Zimmermann Podiatry or a place that has experts on staff and a great selection of spectacular shoes, and you should be back to your old self in no time.

Keep on walking!

Zimmermann Podiatry
Erik Zimmermann, DPM
www.drzpodiatry.com

923 W. Dixie Ave. Suite B
Leesburg, FL 34748
(352)435-7849

Get your feet right with podiatry and the right shoes!

In the office we see many patients with complaints of severe foot pain, sometimes for years. Many of these patients are at their wits ends and ready to have surgery in order to get back on their feet again. I am no longer surprised to see these patients, almost all of whom are wearing either inexpensive shoes or flip-flops or shoes that are made for a different foot type. Usually I can refer them to a place like Gear for Multi Sport, in Clermont, and the patients get professionally fitted for the right shoes, and voila!!! They are back on their feet again, pain free! So if your feet hurt, go see a podiatrist. You may not need surgery, you might just need professional advice as to what shoes or inserts you might need.

Come in to see Zimmermann Podiatry for all of your foot problems.

Erik Zimmermann, DPM

Don’t let foot or heel pain, foot problems such as unsightly toenail fungus, skin problems, or diabetic foot care issues keep you down. Dr. Zimmermann has over 15 years experience in keeping patients on their feet and getting them back to their old selves in no time! The office of Zimmermann Podiatry is staffed with the nicest front desk staff you will find, and the office is a one-stop shop for all of your foot care needs. X-rays, diagnostic ultrasound, blood flow testing, and laser treatment for fungal toenails are available in the office, a virtual one-stop shop!
Conservative treatment of painful, thick, fungus toenails as well as calluses are treated professionally and provide great relief from these chronic, unsightly, and painful conditions. For those that wish to kill the fungus in their toenails, Laser therapy is FDA approved for the treatment and cure of just this problem! Common problems such as heel pain, sprains, strains, and other foot pains are all treated after a thorough diagnosis, using the most up to date technology available, including custom orthotics. Numbness and neuropathy issues, commonly seen in diabetics, have recently had a breakthrough in treatments with new topical compounds that have shown a great reduction or cure of these painful symptoms in many patients.
All diabetics need to be aware of the very serious problems that can occur to their feet, and all should visit a podiatrist regularly for diabetic foot care. Simple toenail and callus care of a diabetic patient, done by a skilled podiatrist, has proven to be one of the most beneficial things a diabetic can do in order to ensure their overall health as well as the health of their feet.
So come on down to see Dr. Zimmermann and his staff! Our office is located at 923 W. Dixie Avenue, Suite B, Leesburg. Call 352.435.7849 or visit the website: www.drzpodiatry.com