In this time of "social distancing" due to COVID-19, it is important that we try to maintain our physical health as much as possible.  A good way to do this is through walking.  As most us now have more time and as spring weather approaches, it should be easier to enjoy a nice walk.  We should be cautioned though not to increase our walking too much, too soon.  By increasing the lengths of our walks too rapidly,we can injure ourselves.  This can be characterized by muscle strain, heel pain, arch pain or just plain fatigue.  It is important to wear shoes or sneakers in good condition, well fitting, with good room in the toe-box, good cushioning, and good support.  Light stretching both before and after walking may prevent muscle strain and injury.  Be careful and stay safe.

                                                                      Old Orthotics ?


                     Many of us have been wearing orthotics for many years with great success in relieving foot pain.  After a while though, the orthotics gradually break down and loses their effectiveness.  Although the orthotics look the same, they gradually lose their resilience and support.  This change is of course gradual and easily ignored until the discomfort returns to the heel or arch.  Depending on the size of the person and activity level, the orthotics generally remain effective between 2-7 years.  If you have been wearing orthotics for for a number of years, and you feel they are not as effective as they once were, it may be time to replace them.  Our office would be happy to evaluate your old orthotics.

olcylen Antifungal Treatment

                    

An exciting new product called Tolcylen, made by Marlinz Pharma is a topical medication used to right onychomycosis ( toenail fungus) and improve the cosmetic appearance of the toenails as well as renew the nails.

                    

Tolcylen antifungal has ingredients such as urea, lactic acid, propylene glycol, vitamin E, and jojoba oil  to penetrate and carry antifungal agents through the toenail plate.  Tolcylen also has agents that can soften, thin and lighten nails that are brittle and discolored.

                    

Unlike prescription products which have either disappointing results or are cost prohibitive, Tolcylen treats both the fungus infection and improves the appearance of the toenails in a few weeks.

                    

Tolcylen is dispensed only in physicians offices.  If you have been disappointed by previous treatments for fungus or unsightly toenails, Tolcylen may be the answer.

Tips for Proper Diabetic Footwear   

                                

(Borrowed from Dr. Comfort Shoe Company)

                    

Proper footwear is very important for preventing serious foot problems.  Athletic or walking shoes are good for daily wear.  They support your feet and allow them to "breathe".

                    

When buying shoes, make sure they're comfortable from the start and have enough room for your toes.  Don't buy shoes with pointed toes or high heels if you are diabetic.  They can put too much pressure on the toes.  If your doctor prescribes special diabetic shoes and inserts, be sure to get comfortable styles you'll enjoy wearing.  If you don't wear your shoes, you won't enjoy the health benefits your doctor intended.

                    

In addition to shoes, you may want to consider other footwear products to help protect your feet.  Good diabetic socks are specially designed to be seamless and wick moisture away from your feet.  This helps protect your feet against sores and infections.  Diabetic slippers are designed to give your feet the extra protection you need at home.

drcomfort.com

Diabetes and Smoking

                    

The risks inherent for diabetics are well documented.  Through no fault of there own, people with diabetes are at greater risk of blindness, kidney disease, neuropathy and vascular disease to name a few.  Unfortunately, they must endure a lifetime to adherence to blood sugar control and a healthy life style.  However, there are behaviors that people choose that directly increases the risks of diabetes.  Smoking is one preventable activity that preventable activity that puts diabetic patients at greater risk.

                    

One of smoking's most notable risks is that nicotine constricts blood vessels and decreases circulation to various parts of the body-particularly the feet.  Lack of circulation and oxygen being carried on red blood cells causes tissue death.  This also affects wound healing and slows healing from surgical procedures.

                    

For many reasons, diabetic patients should stop smoking.  For those that do quit, the benefits are immeasurable.  Although seldom easy, there are keys to quitting.  One must first be psychologically ready.  Those trying to quit need the support of family and friends.  Take advantage of medications to reduce the urge for nicotine.  Be patient with yourself and be willing to make changes to your routines and habits.  For more information, call;

American Lung Association 1-800 586-4877

American Cancer Society 1-800 227-2345

U.S. Department of Health and Human Services 1-877 448-7848

New Jersey Quitline  866 657-8677

Good luck

Evan Kelner, DPM   www.drkelner.com

http://njquitline.org/

Dry Skin of Feet

                    

As colder weather soon approaches, we must prepare for certain changes that can affect our bodies.  One of these changes is that our skin becomes more dry.  Cold air is a cause of dry skin.

                    

The feet in particular often become dry.  Rubbing and friction of the feet from improper foot structure or shoes can cause abnormal pressure on the skin causing skin damage, corns and callouses.  But there are other reasons that skin becomes dry.  Systemic diseases, medications, fungus infections and exposure to irritants and chemicals are some reasons skin becomes dry on feet.

                    

More than just dryness of the skin, patients experience tightness, itchiness, burning and pain of cracked heels.  Dry skin occurs when the skin becomes dehydrated.  Water in the layers of skin allow the skin to act as a protective barrier to outside elements.  Without this hydration, the skin cannot act effectively in this capacity.

                    

Treatment is directed to allowing for retention of water to the skin.  Several types of emollients, ointments, creams, moisturizers and topical steroids are commonly used.  People with dry skin should avoid soaking their feet in hot water as this draws moisture from the skin.  They should apply moisturizers to the bottom of feet and on shins after bathing.  Also "breathable" shoes made of leather or canvass should be worn.  Also socks should be worn with shoes or sneakers.

                    

Some of the more common skin products for dry skin are Eucerin, Bag Balm, Amlactin, Heel Balm, Urea creams, Carmol 40, Lubriderm and Sarna.

Bagbalm products

Eucerin products

Amlactin products

Heel balm

Lubriderm products

Sarna products

Athletes Foot

                    

Athletes foot, or tinea pedis, is the most common skin condition seen in a podiatry office.  Although very common, tinea pedis can be easily misdiagnosed.  This is because tinea pedis can present in a number of different ways.

                    

The most common way athletes foot presents is between the toes, where the skin becomes moist, red or white, irritated, and often itchy.  Another presentation of athletes foot is the chronic type, where the skin becomes dry, scaly and cracked on the bottom of the foot.  Tinea pedis can also be acute or inflammatory, where the skin becomes rough and red.  Fluid filled vesicles also appear.  

                    

All the types of fungus, ( there are at least three ) thrive in moist, dark warm areas.  This type of environment along with a genetic predisposition, enables the fungus to infect the skin.  This is the reason that there is such a high rate of recurrence with tinea pedis.

                    

In preventing the fungus infection, the environment that allows the fungus to flourish must be eliminated.  The feet must be kept clean and dry, and allowed to "air out".  Shoes should also be allowed to air out for a least 24 hours.  Breathable cotton socks are preferable to nylon.  For those who suffer from excessive perspiration, medicated powder can be effective in controlling moisture.

                    

For the majority of cases, topical antifungal medications are sufficient.  The topical medications are typically used for at least 2-3 weeks.  For those conditions unresolved by topical medications, a course of oral medication may be necessary.

                    

Fungus infections of the feet are more than a cosmetic problem.  Untreated tinea pedis can spread to the toenails, or other parts of the body.  Fungus infections of the skin can lead to bacterial infections, cellulitis and wounds in diabetics.

                    

If you think you have athletes foot, seek the proper medical attention.

Referenced from Podiatry Today, July 2018, Myron Bodman,DPM