Ask the Doctor

Question:

After having a fungal infection i now have 3 brittle thickened toenails. i am even embarrased to wer sandals. any home remedy that you can suggest. thank you.

Answer:

The reason why so many people experience failure in getting rid of fungal infections in the feet is that they have not been made aware of something called the “circle of infection”.

In skin fungal infections, it works something like this:  Fungal spores land on skin -> from the skin, spores get into shoes -> warmth, internal dampness and darkness of shoes plus dead skin cells provide perfect environment for spores to germinate- > shoes (usually closed shoes) are packed away -> person has treatment which resolves skin infection -> person puts on shoes next season -> fungal spores land on skin -> circle begins again.

Breaking the circle takes a mental commitment to do whatever it takes to prevent re-infection. Fungi and their cousins yeast infections and mould are not destroyed by anti-bacterials such as Dettol or Savlon. Fungus is not destroyed by household laundry (even at 90 degrees) or detergents.  Two inexpensive “weapons” if you like, are effective – UV radiation (good old sunshine) and household bleach (to be used on things only, not on your feet!!!).

Consult a podiatrist to get your fungal infection properly diagnosed (other conditions such as psoriasis, for example, can mimic a fungal nail infection). He or she will take nail samples for laboratory analysis so that the most appropriate medication is indicated for the species of fungus/yeast. There is no home remedy that can safely be used on skin or toenails to effectively clear a resistant infection.

Question:

I have diabetes, and a small sore has developed on my foot. Do I really need to go to the trouble of seeing a podiatrist? Isn’t that overkill?

Answer:

Stop reading this, and call your podiatrist now! When you call to make an appointment, be sure to say that it is urgent – that you have a wound. Tell the office that you also have other complicating factors (diabetes, circulation problems, a previous amputation). Even doctors with a full schedule of appointments will understand and squeeze you in or at least give you advice over the phone until you can be seen.

A foot ulcer precedes 85 percent of amputations. Appropriate and early treatment of foot wounds increases the likelihood of healing these wounds. Waiting even a few days can be disastrous.

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