Skin and Nail Foot Conditions
There are a wide variety of skin and nail (dermatology) conditions that podiatrists treat.
By far the most common of these are:
- Painful corns
- Uncomfortable calluses
- Cracked heels
- Thickened and deformed toenails
- Fungal skin and nail infections
Care and treatment for these conditions is a core service that our experienced Brisbane podiatrists provide each and every day.
Corns
What is a corn?
A corn is a common term used to describe an (often painful) region of very hard dense tissue in the outer layer of the skin. Corns can form just about anywhere, but most frequently occur under the bony weight bearing parts of the foot, and other bony areas that are exposed to abnormally high pressures (e.g. joints of the toes).
Usually, when skin is exposed to repetitive direct pressure, it will begin to thicken as a result of this stress. This is a protective mechanism, and is known as a callus. Calluses can occur elsewhere on the body, such as on hands and fingers when they are also exposed to similar frequent and repetitive stress (e.g. using tools at work, playing stringed instruments).
Hard dense callus under the 2nd MTP joint, caused by abnormally high pressure affecting this location. This is affected by a variety of factors including the internal bony architecture of the foot, and the broader biomechanical function of the foot and lower extremity.
When a callus is continually stressed enough, the hard skin can become even more organised and dense and form a very hard conical plug - a corn. This is where the 'peak' amount of pressure is placed against the underlying bone.
Corn overlying one of the small joints of the 2nd toe. This is due to contracture of the toe and pressure coming down against the joint from closed toe shoes.
A 'soft' corn, by contrast, is essentially identical, but is more commonly between toes where they are maintain a much higher moisture content, and usually less dense (softer) and more diffuse. They are more prone to skin ulceration if left untreated.
An interdigital 'soft' corn caused by pressure against the small joint of the small toe from the adjacent toe. These can often be very painful.
How do you treat corns?
Corns and callused can typically be easily and painlessly removed by our podiatrists using sterile surgical instruments. Once removed there is usually immediate and dramatic relief from pain and discomfort.
However, unless the cause of the corn is addressed (e.g. through changes to footwear, or addressing the biomechanical factors causing pressure on the location), then corns and calluses will usually come back over time. Sometimes this occurs within weeks or months - depending on lifestyle, work, exercise, footwear choices and individual anatomical factors.
Our podiatrists will spend considerable time with you explaining these causes, and helping you with solutions and advice to minimise the frequency and severity of recurrence.
Nail Disease and Deformities
Deformity
With age, it becomes more common for nails to become affected by the effects of previous episodes of damage, along with the effects of a lifetime of wearing shoes. Those who have had a very active sporting life, or have been in occupations that involve prolonged weight bearing (as opposed to office/desk jobs) are more likely to see the cumulative effects of even quite minor and trivial injuries have a lasting effect.
Severe thickening and deformity of the 2nd toenail due to past injury and trauma.
Significant nail deformities due to trauma are called onychogryphosis. This medical term describes irregularity and thickening of the nail plate, due to permanent damage to the nail root tissues (matrix). Unfortunately, this damage cannot be undone, and is permanent.
Nails affected by onychogryphosis can become difficult to care for, and can be painful if they put pressure on the surrounding soft tissues of the toe. Some people will require periodic professional assistance from a podiatrist to care for and manage these types of nail deformities. In more severe cases they may benefit from part or all of the nail to be permanently removed via a minor surgical procedure under local anaesthetic.
Trauma
Toenails are frequently the recipient of injuries, especially with barefoot activities, sports and certain occupations.
Acute damage to the nail can cause bleeding under the nail plate (subungual haematoma), or damage to the nail bed or tissues around the nail. Sometimes the nail can be partially of completely torn away from the nail bed. These injuries can be very painful.
Our podiatry team can provide rapid and immediate care of acute nail trauma.
A direct 'head on' injury to the nail plate causing damage to the nail root region behind the nail. This condition is known as 'retrograde paronychia' and can become a chronic problem causing extended periods of pain and infections unless cared for properly.
Infection
Toenails are a frequent location for infection, in particular fungal nail infections. Fungal infections thrive in warm, dark locations - so the interior of a shoe is the perfect environment to promote and support fungal infections.
In Brisbane, and the rest of Queensland they can be particularly prevalent, as it is hot and humid for much of the year.
Fungal nail infections can be very stubborn to treat, and require a range of approaches including topical or oral medications, strict hygiene, increased UV/sun exposure, and removal of larger sections of contaminated and infected nail tissue.
Severe and extensive fungal nail infection affecting the entire nail plate of the big toe.