Ambulatory Foot Care
Serving PASADENA, MD 21122 and Surrounding Areas including Glen Burnie, Severna Park, Arnold
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Foot & Toenail Care

Foot & Toenail Care

New Patients Welcome
Most Insurance Accepted
In Practice Since 1990

New Patients Welcome  |  Insurance Accepted  |  Practicing Since 1990

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Calluses

A callus is a thickened area of skin on the foot caused by pressure and repeated rubbings, such as from a shoe or sock. The rubbing causes the skin to produce a layer of protective skin (a callus). Calluses vary in size and can become painful.

 

There are a number of treatments for painful calluses. People who have calluses are cautioned against performing “bathroom surgery,” as this can lead to cuts and infection. We can evaluate the cause of the calluses and recommend the treatment most appropriate for your condition. However, if the underlying cause of the callus is not treated or removed, the callus may return.

Corns

A corn is a small circular thickened lesion in the skin of the foot. It usually forms due to repeated pressure on the skin, such as the rubbing of a shoe. The name "corn" comes from its resemblance to a kernel of corn. A corn is different from a callus in that it has a central core of hard material.


There are a number of treatment options for corns. When corns get hard enough to cause pain, we will recommend the treatment option most appropriate for you. However, if the underlying cause of the corn is not treated or removed, the corn may return. It is important to avoid trying to remove a corn at home or using medicated corn pads, as serious infection may occur.

Warts

A wart is a small growth on the skin that develops when the skin is infected by a virus. Warts can develop anywhere on the foot, but they typically appear on the bottom (plantar side) of the foot. Plantar warts most commonly occur in children, adolescents and the elderly. Plantar warts are caused by direct contact with the human papilloma virus (HPV). This is the same virus that causes warts on other areas of the body.
There are two types of plantar warts:
  • A solitary wart is a single wart. It often increases in size and may eventually multiply, forming additional satellite warts
  • Mosaic warts are a cluster of several small warts growing closely together in one area. Mosaic warts are more difficult to treat than solitary warts
The symptoms of a plantar wart may include:
  • Thickened skin - A plantar wart often resembles a callus because of its tough, thick tissue.
  • Pain - Walking and standing may be painful. Squeezing the sides of the wart may also cause pain
  • Tiny black dots - These often appear on the surface of the wart. The dots are actually dried blood contained in the capillaries (tiny blood vessels). Plantar warts grow deep into the skin. Usually, this growth occurs slowly with the wart starting small and becoming larger over time

To diagnose a plantar wart, we will examine the patient’s foot and look for the signs and symptoms of a wart. Although plantar warts may eventually clear up on their own, most patients desire faster relief. 


Although many folk remedies for warts exist, patients should be aware that these remain unproven and may be dangerous. Patients should never try to remove warts themselves. This can do more harm than good.

 

The goal of treatment is to completely remove the wart. We tend to use topical acid treatments of varying strengths. Surgery to remove the wart is an option but rarely needed.

 

If there is no response to treatment, the further diagnostic evaluation may be necessary. In such cases, the surgeon can perform a biopsy to rule out other potential causes for the growth.

Relief for Toenail Troubles

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This digging in of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.

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. However, even if the toe is not painful, red, swollen or warm, a nail that curves downward into the skin can progress to an infection.

Causes of Ingrown Toenails Include

  • Heredity: In many people, the tendency for ingrown toenails is inherited
  • Trauma: Sometimes 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
  • Improper trimming: The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail.
  • Improperly sized footwear: Ingrown toenails can result from wearing socks and shoes that are tight or short
  • Nail conditions: Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot or poor circulation.
 
After examining the toe, we will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.
 
Sometimes, a minor surgical procedure will be needed to ease the pain and remove the ingrown nail. After applying a local anesthetic, the offending nail border is removed. Some ingrown nails may recur requiring permanent removal of the nail border (both borders, entire nail).

All Types of Toenail Problems

• Diabetic conditions
• Fungal nails
• Ingrown toenails
• Nail trauma

Personal Nail Care Treatments

Here at Ambulatory Foot Care, you'll find both temporary and permanent solutions for your toenail troubles. Dr. Mickenberg is here to personally educate you about every step of your treatment in a caring, personal environment.

Put your trust in a board-certified, highly experienced podiatrist. Call us to schedule your appointment today. Patients of all ages are welcome!

Fungal Toenails, Trauma Nails, and Athletes Foot

Although there are many potential causes of thick nails such as psoriasis, diabetes, vascular disease, there are two main reasons for thick, dystrophic toenails-Fungus and Trauma. It is important to identify the proper cause of nail dystrophy because the treatments and prognosis can be quite different.  

 

The most common cause of yellowed, thick and /or deformed toenails is a fungal infection of the toenail. The fungus that infects the nail, most commonly, is the same fungus that causes athletes foot. It tends to be slowly progressive, damaging the nail to a greater and greater degree over time. The infection usually starts at the tip of the nail and works its way back. It usually is not painful and often not noticed until it has gotten well established. A single toenail or any number of nails can be affected. 

An injured toenail may be thick and deformed as well but tends to be more uniform in color. This is because the nail matrix (root) has been damaged and is usually unfixable. However, as you know, life is not just black and white but there are shades of gray, such is true with a thick toenail. A thick injured toenail can also have fungal contamination which is not the causative agent. This is just like what came first the chicken or the egg. In fact, the current thinking is that all fungal nails had some level of trauma to the nail plate which allowed the germ under the nail. The secret of success is whether that matrix is involved or not.  


Treatment options for onychomycosis or fungal nails can include no treatment, oral medication, topical medication, periodic debridement of the thickened nail, as well as laser treatment. These treatments will all fail to attain the desired outcome if the nail was trauma-induced. 

 

Treatment options for injured toenails can include no treatment, nail debridements, softeners, and permanent removal of the nail plate.
The exact cause of thick nails will help decide the treatment and prognosis. Symptoms of Athletes Foot and Hyperhydrosis (sweaty feet) may be alleviated by aerating the toe web spaces using lamb's wool in between the toes, alternating shoes daily if possible so shoes can dry out, applying anti-fungal powder to shoes, avoiding nylon/synthetic socks/stockings, changing socks 2-3 times during the day, wearing well-ventilated shoes or sandals, using and anti-fungal cream, and applying a roll-on antiperspirant to the foot (not in between the toes).

Call (410) 255-0040 for an Appointment

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