Many people present to Westside Podiatry Centers with nail problems. These problems can range from extremely painful problems that can cause infections and dangerous situations for people with diabetes, to cosmetic problems that effect how a patient feels at the beach in the summer. The problems can be seen in young children and the elderly. When the problems are seen in children they are usually from an injury or an inherited disorder. The older a patient gets the more likely the problem has been acquired from all the years of abuse we put our feet through daily.

One of the first thing we learn is to cut our nails straight across. This rule, like all rules is a good one but there are exceptions to every rule. If you have a normal thickness and shaped nail, it is best to cut the nail straight across to avoid problems. However if your nails are misshapen and curled into the sides of the nail grooves, it may be best to cut the nail down the sides a bit to keep the nail from growing into the skin.

Ingrown nails occur when the side of the nail literally cuts through the skin in the fold and becomes infected from all the bacteria found on feet. This is very painful and often forms an associated abscess filled with pus. If you take antibiotics to resolve the infection, this still leaves you with a nail cutting through the skin which needs to be dealt with.

Under local anesthesia in the office, a podiatrist will remove the offending nail border to allow the cut skin to heal. Often the nail will grow back and become ingrown again. This is because the nail root which produces the nail is misshapen and curled. If this is the case, the nail will continue to become ingrown. To correct this, the doctor may elect to remove a small portion of the nail root to prevent that part of the nail from growing back. This is a very simple highly successful procedure done in the office under local anesthesia that will leave a narrower nail that does not chronically grow into the skin.

Fungal nail problems can range from a cosmetic problem to a painful functional problem. Fungus is found everywhere and we as humans cannot avoid it. The same fungus that causes athletes feet infections can infect the nails and cause the nails to become thick and yellow and difficult to cut. Fungus likes to grow in warm dark moist conditions which most feet are found in daily. Some people fight off fungus better than others and never have a problem; however some people are highly susceptible to recurrent fungal infections.

Changing the environment in your shoes by keeping the feet cool and dry reduces the chance fungus will grow. Use cotton blend socks, foot powder, avoid nylons and avoid shoes that are not made of leather. Shoes and socks that can breathe and wick away perspiration moisture help keep the feet dry.

Treating fungus in nails is difficult because the nail is hard and topical creams and liquids cannot penetrate the nail to get under it to where the fungus grows. The new medication Lamisil, seen advertised on television, is one of the most effective medications we have to treat the nail fungus, but it is not appropriate for everyone. Women who are pregnant, breast feeding or trying to get pregnant cannot use the medication. Anyone with liver disease should avoid the medication because of one of the possible side effects to the liver. Therefore, when you are taking the medication, you need some blood tests to determine if the medication is affecting the liver. In the rare event the medication does effect the liver, the doctor will take you off the medication since your liver is more important than your toenails. You can live without a nail but you cannot live without a liver.

These common nail problems are a much greater risk for patients with fragile feet such as people with diabetes, neuropathy or vascular disease. These problems can be the start of serious infections and in some cases lead to amputations. So when blood is noticed under the nails or the nail is falling off on its own, patients with fragile feet should have their feet examined by a podiatrist.

People who like to paint their nails should be careful since leaving the nails painted with polish 24/7 can create a great environment for fungus to grow. It is OK to paint the nails for a week at the beach or a special occasion, but to leave them painted all the time increases the risk of a fungal infection developing, since the polish traps the fungus under the nails and creates a great environment for growth.

Many other diseases and conditions can lead to nail problems, and it is important to remember that your local podiatrist can help you with several options and treatments for your nails.

Dr. James Farrell is a licensed

podiatrist at the Westside Podiatry Center in Skaneateles. He can

be reached at 685-3338