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When a toenail is ingrown, the nail is curved downward and grows into the skin, usually at the nail borders (the sides of the nail).
If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. Home treatment is strongly discouraged if you suspect you have an infection, or if you have a medical condition that puts your feet at high risk -- for example, diabetes, nerve damage in the foot, or poor circulation. January 9, 2013 By Staff Editor Leave a Comment An ingrown toenail is a condition that occurs when the edge of a nail grows into the surrounding skin. When the nails are not trimmed properly, it is also possible for ingrown toenails to occur. When left untreated, an ingrown nail will often develop into an infection that, in serious cases, could spread through the toe and into the bone. The method of treatment varies depending upon how deeply the nail has grown into the skin, whether an infection is present and the patient’s overall health. Following treatment, it is necessary to maintain proper foot hygiene to prevent the nail from becoming ingrown again.
Toenail fungus laser treatment and removal in Los Angeles, Santa Monica, Brentwood, Beverly Hills, Marina Del Rey & West Hollywood, Burbank Including Glendale. Ingrown toenail can result from a number of things, but poorly fitting shoes and toenails that are not trimmed properly are the most common causes. When your toenails are trimmed too short or the edges are rounded rather than cut straight across, the nail may curl downward and grow into the skin. Poor eyesight and physical inability to reach the toe easily, as well as having thick nails, can make improper trimming of the nails more likely. Skin along the edge of the nail will appear to be growing over the nail, or the nail may seem to be growing underneath the skin.
If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, go to the doctor right away. If this does not work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist) or a skin specialist (dermatologist).
If your ingrown nail does not heal or keeps coming back, your doctor may remove part of the nail. Using scissors, your doctor then cuts along the edge of the nail where the skin is growing over.
Sometimes your doctor will use a chemical, electrical current, or another small surgical cut to destroy or remove the area from which a new nail may grow. This condition may become serious in people with diabetes, poor circulation, and nerve problems (peripheral neuropathies). If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, your risk for complications is higher. If you have any of the conditions listed below and have tried over the counter remedies with no success. If you have been injured and have pain, swelling, numbness, weakness, redness, or an inability to put weight on your foot or ankle.
You have persistent or recurrent pain for more than 2 weeks, or pain that doesn't respond to over the counter remedies. You have any signs of infection: pain, swelling, redness or red streaks on your foot or leg, drainage, increased heat, pus, elevated body temperature, 100 degrees or more.
Any mole, open sore or skin abnormality that changes color, shape, size, cracks, bleeds or otherwise is unusual. Many Achilles tendon injuries occur slowly over time, beginning with mild tendonitis which feels like a slight stiffness or tight sensation at the back of the heel, due to inflammation around the Achilles tendon. In children, there is a common condition called Calcaneal Apophysitis which involves inflammation of a growth plate at the back of the heel. Ankle pain is a very common condition that can result from many medical conditions or injuries. Ankle instability is a condition that one can be born with, but can also result from an injury such as an ankle sprain. There are multiple forms of arthritis that can affect the feet and ankles, the most common of which that strikes many people is known as Osteoarthritis or Degenerative Joint Disease. Bone spurs involve an overgrowth of normal or arthritic bone around a joint or within connective tissue. Description -- the bunion deformity, also known medically as Hallux Abductovalgus involves a progressive angulation of the big toe joint which results in prominence of the first long bone at the base of the big toe. Hard callouses under the forefoot are sometimes known as Intractable Plantar Keratoses and form either because of hammertoes or because one of the metatarsals or long bones in the forefoot is either longer or closer to the ground with respect to the others which results in excessive pressure on the skin and formation of a painful callous.
This condition involves a disorder in which exposure to cold, even briefly, results in the fingers or toes becoming cold, often resulting in bluish discoloration and pain. A ganglion cyst is a fluid filled sac that forms due to a weakening in the connective tissue layer around a joint or tendon.
Haglunds deformity is an enlargement of the heel bone at the back of the heel that is often very painful because of irritation that occurs between the skin over the enlargement and the back of the shoe.
Hallux limitus is a term used to describe a painful arthritic restriction of motion at the big toe joint. Hammertoe deformity is a term used to describe a condition of the lesser toes and sometimes the big toe in which the toes buckle upward often resulting in painful painful callouses on tops of the toes and underneath the forefoot. Hammertoe deformity is often a progressive condition, the earlier conservative management with custom molded orthotics is instituted,A the lower the likelihood that surgery will become necessary.
Plantar Fasciitis is a very common condition involving pain on the bottom of the heel associated with activity. Ingrown toenails are often caused by hereditary structure of the nail, but can become more symptomatic because of physical activity level or pressure from shoe gear.
In- toed gait, also known as being "Pigeon Toed", is often a sign of a deformity known as Metatarsus Adductus, especially when found in children. A rather surprising number of people have this condition where one leg is longer or shorter than the other, because of a multitude of factors. Painful lumps in the bottom of the arch are often caused by a condition called Plantar Fibromatosis, which involves the formation of hard bumps on the bottom of the foot. Unfortunately, many patients end up contracting fungal infection of their toenails at nail salons.
A neuroma is a condition of the foot in which a nerve becomes compressed between two of the long bones in the forefoot resulting in trauma to the nerve and pain.
There are 28 bones in the human foot, 21 of them in the forefoot or from the middle of your arch forward. Plantar warts are caused by a viral infection of the skin as a result of human papilloma virus. The sesamoid bones are two small bones located under the big toe joint in the foot; they are named after sesame seeds, for thier similar shape.
Many conditions that affect the sesamoids can easily be treated with conservative measures such as padding, custom molded arch supports or orthotics, medication, physical therapy, and cortisone injections. ABNORMAL MOLES, SORES, and LESIONSAny abnormal mole, sore, lesion or area of the skin that becomes discolored, changes in size, becomes painful, or bleeds without injury could be a sign of skin cancer and therefore should be evaluated by a podiatrist.ATHLETES FOOTAthletes Foot is a fungal infection of the skin caused by an organism called a dermatophyte.
Foreign bodies or inclusion cysts are extremely common conditions affecting the human foot. PSORIASISPsoriasis is a genetic skin disorder that involves the formation of dry skin scales that are often very itchy.
Many sprain injuries of the foot and ankle are improperly treated after initial evaluation in the emergency room. Perhaps one of the most common problems Dr Gavin deals with on a daily basis are simple sports injuries, sprains, overuse injuries and "weekend warrior" pain. Excessively sweaty or stinky feet can result from Hyperhidrosis- hyperactive sweat glands, or Bromohidrosis, which is essentially the same condition with a bad smell coming from bacteria that colonize the feet and shoes. The Tailors Bunion deformity involves an enlargement on the side of the foot at the base of the pinky toe.
Timely diagnosis with appropriate diagnostic testing is essential in many cases to prevent permanent nerve damage. It is essential when dealing with numbness in the feet to determine whether the numbness is due to a metabolic disorder, a compression of the nerve higher up in the body in the hip or lower back, or due to a localized compression of the nerve in the tarsal tunnel itself.
However, even if your toe isn't painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection. For example, if you have had a toenail fungal infection or if you have lost a nail through trauma, you are at greater risk for developing an ingrown toenail.
It most commonly affects the big toe, but it is possible for any toenail to become ingrown. Nails that are not trimmed properly and shoes that do not fit properly are the most common causes. This is especially important for anyone who has poor circulation to the foot, diabetes or nerve damage in the foot or leg. An infection can be very difficult to get rid of and can cause fungus that is also difficult to remove. We will keep you posted on specials, events, and breakthroughs in the area of esthetic medicine.


We will keep you posted on special offers, events, and breakthroughs in the area of esthetic medicine. Although the vast majority of the Wikipedia® encyclopedia articles provide accurate and timely information please do not assume the accuracy of any particular article.
This is a condition that frequently affects children between the ages of approximately 8 --12 years of age but can occur earlier or later. Gavin utilizes diagnostic ultrasound and MRI to accurately assess and diagnose Achilles tendon conditions and Achilles spur formation. A partial list includes history of ankle sprain, arthritis, damage to the cartilage, a condition called impingement syndrome, pronation deformity or flat feet, limb length inequality, and metabolic conditions such as gouty arthritis. Conservative treatment for ankle pain often consists of oral and topical anti inflammatory medication, ankle braces, physical therapy treatments, ultrasound-guided Cortizone injections, and custom molded orthotics.In some cases, conservative therapy fails and surgery becomes necessary. Often a simple ankle sprain, or "rolling the ankle" can result in only mild pain and swelling that resolves, but an underlying problem exists. They often form as part of another process, such as arthritis, tendonitis and plantar fasciitis, in which case a heel spur forms.
These callouses can also be caused by a failure of the first long bone to conract the ground properly due to other conditions such as bunion deformities.
This results from a reactive constriction of the blood vessels called vasospasm- the blood vessels close off and tissues are deprived of vital oxygen and warmth. Many people make the mistake of believing that if they can walk on their foot, then it can't be broken.
Over time, the toes change from being flexible to the deformity being rigid and inflexible.
Other ingrown toenail problems can come from distortion of the toe nail itself from infectious processes like fungal infection of the toenail. In this condition, the feet point inward, towards each other resulting in problems with walking and running because the patient literally trips over thier own feet. The problem can occur in the long bones of the leg, or in the joints of the foot, ankle, knee, or hip. Any Lump or bump that doesnt appear normal can possibly represent a tumor or cancerous growth, and should be evaluated by a Doctor.
Dermatophyte infections are often caused by the same fungal organisms that cause athletes foot infections. The condition starts as an area of discoloration involving the distal tip of a toenail or toenails. Pain associated with the big toe joint can be caused by bunions, arthritis,tendonitis, gout, nerve entrapment, capsulitis or inflammation of the joint, sesamoiditis or inflammation of two small bones in the big toe joint, and many other things. The virus isA spread by direct contact, usually when a person steps on the bare floor, shower floor, or swimming pool where someone else has stepped that has the virus.
This treatment is performed with weekly visits, and avoids the necessity for surgery therefore no scar tissue is produced in ridding the body of the infection.
These small bones perform an integral role in the weight bearing structure of the big toe joint. Dr Gavin at the Foot & Ankle Institute uses the latest diagnostic techniques including diagnostic ultrasound, CAT scan and MRI to evaluate sesamoid problems. This condition most often occurs because of overuse of a specific set of muscles on the front of the leg that are responsible for supporting the arch during a specific portion of each step we take.
Once known as ringworm, the fungus enters the layers of the skin and survives by metabolizing proteins within our skin structure. Often slivers, Staples, needles and all manner of Metallic, glass or wooden objects end up getting stepped on an embedded in the bottom of our feet. There are many types of prescrition medications that can alleviate the symptoms of psoriasis, but to this day, it cannot yet be cured. Often these problems start out mild, but can turn into real problems if left undiagnosed and untreated. Hyperhidrosis is a very common condition involving increased activity of the eccrine or oil-producing sweat glands in the soles of our feet. This condition is the result of enlargement or prominence of the 5th metatarsal or 5th long bone in the foot.
The tarsal tunnel is defined as a fibrous structure on the inside of the ankle behind the ankle bone made up of strong connective tissue compartments that are occupied by the flexor tendon to the big toe, the flexor tendon to the lesser toes, the posterior tibial tendon which is responsible for providing the majority of support to the arch in our foot, as well as the largest artery and nerve in the human foot. The compression of the tibial nerve can sometimes come from swelling around tendons, soft tissue masses or fluid filled cysts, varicose veins, or a structural problem where the tarsal tunnel is narrowed resulting in pinching of the nerve against the tendons that it shares space with in the tarsal tunnel. This is in part due to genetic factors but is certainly made worse by the types of shoegear women wear.
In other cases, an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running. Shoes that are either too big or too small cause extra pressure that can lead to ingrown nails. It is also necessary to seek medical attention if there appears to be an infection around the nail. While the general prognosis for an ingrown toenail is good, is is important to see your doctor before any complications develop.
If you walk often or participate in athletics, a shoe that is even a little tight can cause this problem. Shoes that you wear for walking briskly or for running should have plenty of room also, but not be too loose. Chronic tendonitis of the Achilles tendon can often lead to a complete rupture of the Achilles tendon.
In some cases, an injury to the growth plate can result because of a fracture in the plate without any injury or trauma. If you suffer from chronic ankle pain, accurate diagnosis and treatment is essential for long-term joint health.X-rays, diagnostic ultrasound, and MRI study are some of the tools that Dr.
Sprains involve stretching and often rupturing or tearing the ligaments on the outside of the ankle. In general, the cartilage in the joint deteriorates, and large painful spurs form at the top of the big toe joint restricting motion.
This often causes pain from pressure in shoe gear, as well as pain under the ball of the foot because of the effect ofA the hammertoe transferring pressure back to the ball of the foot. This condition has many causes, and is best often treated in childhood with bracing, stretching in physical therapy, and use of custom molded orthotics or arch supports designed to train the patients feet to walk with better alignment. The discoloration is often white or yellow to brown in color, and spreads from the tip of the nail on backwards, and can spread from nail in two nail.
Pain under the base of the smaller toes can result from hammertoes, pinched nerves, tendonitis,stress fracture, capsulitis, metatarsalgia or pain in the long bones of the forefoot, and many other causes.
The virus enters the skin cells and utilizes the nucleus of the cell to reproduce -- it redirects the function of our cells to make more viral cells.
Prescription medications are available that can successfully eradicate the virus with little or no discomfort. We actually walk on these bones, located underneath the first metatarsal or first long bone at the base of the big toe.
In some cases, conservative therapy fails and surgery is needed to reshape or remove a problematic sesamoid bone. This condition is most often very easily treated with conservative treatment consisting of rest, avoidance of impact activity for a period of time, anti-inflammatory medication, supportive taping of the foot, physical therapy, and finally custom molded arch supports. In many cases, ankle sprains are evaluated initially and when no broken bones are found, patients are told to wear an air cast or ace bandage for a few weeks, then return to activity. This occurs because the bone is enlarged, bent, or the angle between the 4th and 5th bones is increased.
Similar to carpal tunnel syndrome, patients with tarsal tunnel syndrome often suffer from problems with tingling, numbness, burning sensations and pain on the bottom of their feet.
Gavin utilizes an entire range of diagnostic testing in order to properly assess and evaluate conditions causing numbness in the feet.
For people who walk or participate in athletics frequently may have problems even if the shoe is only slightly tight.
Sometimes chemicals, electrical current or another incision are used to prevent the nail from growing back.
Any injury of the Achilles tendon should be taken very seriously because of the importance of this anatomic structure to our ability to walk normally.In adults, long-standing Achilles tendon pain that occurs at the back of the heel bone can be due to an enlargement of the heel bone itself causing pressure on the Achilles tendon and the overlying shoe.
Because of the importance of the growth plate in determining the overall shape of the heel bone, heel injuries in children should also promptly be identified, evaluated and treated.
If the ligaments do not heal properly, which often results if the injured ankle is not immobilized after the sprain, the ankle becomes weak and prone to repetitive sprains. People can develop stress fractures with no history of injury or trauma in any of the bones in the foot and ankle. Conservative management of hallux limitus or arthritic big toe joint can include changes in shoe gear, custom molded orthotic devices, physical therapy, and Cortizone injections.
Limb length inequality can result in a tilt or angulation to the pelvis which then results in curvature in the spine, shoulders, and neck.
Pain with burning sensations in the toes is often caused by an entrapment of an enlarged or inflamed nerve called a Morton's Neuroma.This is but a short list of the many conditions that can cause pain in the ball of the foot.


Plantar warts also fool the body into growing blood vessels into the area in order to feed the infectious process, much like a parasite.
These medications work by specifically targeting the process the virus uses to reproduce, instead of traditional acid compounds that cause chemical burns, but can be used in conjunction with acid compounds for a combined effect in cases of more deep seated or resistant infections.
In essence, they prevent the tendons that flex the big toe from damage throughout a lifetime of walking, jumping, and running. Arch supports are usually the best way to treat this condition, but are also essential in preventing this condition from recurring, and should be used on a permanent basis even if symptoms have resolved completely.Click to view Image #1.
The result is that the torn ligament never heals properly, and the patient goes on to have problems with chronic pain and instability. This is often accompanied by a hammertoe of the 5th toe and the 5th toe lies on top of or underneath the 4th toe.
The condition is often related to activity, and worsens with prolonged standing and walking. In some cases, conservative therapy fails and surgical intervention if becomes necessary which involves release or widening of the tarsal tunnel and removal of any mass or cyst that is compressing the nerve. Testing often consists of blood tests, neurological testing to evaluate function of the nerves, diagnostic ultrasound, and MRI.
Dr Gavin reccommends you first get fitted with dress orthotics, then worry about which shoes will work.
Sometimes the repeat sprains are less painful than the initial injury; this can be deceiving. The treatment for bone spurs varies quite considerably and depends upon thier location and root cause. The result of the deviation of the big toe joint is a progressive subluxation or partial dislocation of the big toe joint which can cause pain from the enlarged bump rubbing on the shoe as well as deep joint pain from damage which occurs to the cartilage inside of the joint.
Hallux limitus is a progressive condition, and surgical intervention frequently becomes necessary.
Chronic problems with ingrown toenails are very easily addressed with a simple procedure done in the office which involves removing the ingrown portion of the nail, using a laser or chemical to destroy the ingrown portion of the nail root much like a dentist performing a root canal. Over-the-counter treatments include topical acid and liquid nitrogen products which are usually only effective with smaller warts. The sesamoids themselves are prone to many different painful conditions including swelling, or sesamoiditis and other conditions such as arthritis, gout, fractures, disclocation, displacement from bunion deformity, and loss of circulation- called avascular necrosis- to name a few. If you are having problems with pain under your big toe joint, avoid tight fitting shoes or shoes with hard soles- athletic shoes are best. Our ligaments are responsible for holding our bones together at our joints, and when they are sprained or torn, joint function can be severely compromised resulting in permanent and progressive damage to the cartilage.
The majority of sprains can be healed through conservative or non surgical treatment if the injury is recognized and treatment rendered in timely fashion soon after the injury. Many patients with Tailors Bunions have redness over the prominence from rubbing on shoes.
Symptoms associated with toe problems can often be alleviated by simply avoiding narrow, pointy shoes that put pressure on these areas. These repeat injuries can lead to rupturing more ligaments and tendons, and can also result in an ankle fracture.
Often changing shoegear to alleviate pressure can help, but many cases require custom molded orthotics, medication, cortizone injections or physical therapy. The damage that occurs to the cartilage from the bunion deformity is irreversible; medical technology to this day cannot directly replace the cartilage in smaller joints.
Raynauds patients should always keep thier fingers and toes warm and avoid exposure to cold altogether. Many of the problems that develop as a result of flat feet occur because Pronation Deformity leads to an inherent instability in the feet. This results in permanent removal of the ingrown portion of the nail -- The patient grows a nail, with a straight edgeA instead ofA the painful ingrown part.Click to view Image #1. Some cases fail to respond to conservative treatment and necessitate surgical intervention. Because the infection often goes very deep into the skin layers, more aggressive treatment is necessary. Because the sesamoids are subjected to immense pressure with every step we take, when there is an injury or problem with them, it can be quite painful.
If the problem persists, evaluation with xrays and ultrasound should be performed.Click to view Image #1.
Gavin in the office, and very seldom requires anything more than office visit and local anesthetic. In some cases, multiple ligaments are torn or instability results from improper care after a severe sprain. High heeled shoes aren't the best thing for you, but if you choose shoes with heels 2" or lower, you can minimize the risks. Furthermore, weakness in the ankle ligaments causes the joint surfaces of the ankle to contact improperly, resulting in rapid development of arthritis, which is irreversible. Just because your flat feet don't hurt now, that doesn't mean that they won't hurt or develop painful conditions in the future. If you have stepped on something and removed it yourself, but are unsure if anything is remaining in your foot, remember that any signs of infection are likely indications that a portion of the foreign body remains and needs to be removed.
In these cases, surgical repair of the ligaments may be necessary, and in some cases tendon transfer or graft surgery becomes necessary. Continuing to walk with a stress fracture can result in failure of the healing process or the bone may fully fracture. In some cases, the nerve on the side of the foot becomes entrapped causing excruciating pain. In short, the joint can easily be destroyed.Conservative management for this condition involves physical therapy and use of a high quality fitted ankle brace. Because the cause of the spur can vary based on underlying pathology, surgery often is not as simple as removing the spur, but requires correction of the causative condition as well.A  Dr Gavin uses physical examination, patient and family history,A xrays, ultrasound, MRI and CAT scans to accurately image bone spurs and any impingement or pressure caused on surrounding structures.
Some patients respond very well to low doses of blood pressure medication that worksA to reverse the vasospasm. If you have flat feet, you should be evaluated by a podiatrist to see whether orthotics, or custom molded arch supports would be helpful in your case. In actuality, torn ligaments in the foot and ankle usually take between six -- eight weeks to heal, and in many cases should be completely immobilized during the healing process so that the body can repair the damage and restore strength and integrity to the structures. In these cases, a simple cast of walking boot could have remedied the situation, but surgery ends up being the final result.In many cases, the ER Doctor is right, and there are no broken bones.
Like the Bunion deformity, Tailors Bunions involve a deviation of the joint surface which can lead to arthritis and permanent damage to the cartilage.
Surgery is available to repair the torn ligaments, and in some cases, a tendon transfer procedure is performed to recreate the ankle ligaments and prevent further sprains. Conservative treatment for arthritis often involves oral and topical anti inflammatory medication, custom molded orthotics, physical therapy, and Cortizone injections.
Timely diagnosis and treatment is the key to success here; waiting too long can often make the outcome of treatment less certain because of the nature of underlying conditions doing irreversible damages to joints, tendons and ligaments. Because foot structure is genetically inherited, if you have flat feet there is a good chance that your children will as well.
Limb length inequality is often first recognized by podiatrists, physical therapists and chiropractors during a routine examination and treatment. Gavin uses prescription topical treatments and oral anti fungal treatments with removal of the infected portions of the nail as well as a new revolutionary method to treat this condition with a quick painless procedure using state of the art technology performed in the office.
Gavin utilizes both primary repair techniques to repair the anatomy in its natural state, and also uses both synthetic and biological graft materials to repair and or replace damaged ligament structures when necessary.
Conservative management involves changes in shoegear, modification of existing shoegear, padding, injections and custom molded orthotics. The condition often responds favorably to conservative treatment with custom molded orthotics in mild to moderate cases, severe cases usually require fabrication of an entire lift under the sole of the shoe on one side to compensate for the inequality. In cases that fail conservative therapy, surgery is available to remove the bump of bone or reposition the 5th long bone if necessary.
If you are told you have this condition or are aware of its existence on your own, custom molded arch supports should be used consistently to prevent problems from recurring because of compensation for the condition. Dr Gavin uses state of the art surgical techniques so that walking is often permitted after surgery, but must be in a protective walking boot.Click to view Image #1. If its been two weeks, and you're still in pain or can't bear weight; schedule an appointment.
This involves introducing a small fiber-optic camera into the heel through a small incision, and using the same micro surgical instruments that are used in carpal tunnel surgery to lengthen the fascia and alleviate pain causing plantar fasciitis.
As with many conditions, early diagnosis and treatment is essential to prevent the infection from spreading to multiple nails.



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