Podiatry Information Hub

What are corns & callus?

Corns and calluses refer to an area of tough thickened skin. They're similar in that they’re made up of the same deadened skin (keratin) and form due to localised pressure, so they generally occur on high pressure areas of the feet.

Corns differ to calluses in that they form a central core (a cone shape) that pushes into deeper levels of skin. The pain that you may feel is that of walking on a pebble.

Why do I have a corn or callus?

Almost everyone will have a corn or callous at some point in their life, so you're not alone!

They form as your skin’s own protective mechanism for the underlying tissue, joints, or bone. However this protective mechanism can go overboard and become a problem when too much keratin is formed. 

This may occur due to:

• Pressure placed on the foot becomes out of balance or extra friction falls on particular areas of the foot. This can be seen in people with bunions, hammer toes, feet that are extremely flat or high-arched
• Wearing footwear that is too tight, narrow, or high
• Poor fitting socks
• Thin/fragile skin
• Certain medical conditions
• Smoking

More on corns…

There are actually different types of corns. 

Hard corns: The most common type of corn. These appear as a small area of concentrated hard skin up to the size of a small pea, usually within a wider area of thickened skin or callus.

Soft corns: These develop in a similar way to hard corns but they are whitish and rubbery in texture, and appear between toes where the skin is moist from sweat or inadequate drying.

Seed corns: These are tiny corns that tend to occur either singly or in clusters on the bottom of the foot. They’re usually painless.

Neurovascular corns: These are generally quite painful and difficult to treat because they incorporate fine nerve endings and minute blood vessels. Early treatment is encouraged to prevent neurovascular corns.

Treatment for corns & calluses

The most important thing to remember about treating corns and calluses is never to do it yourself without seeing a specialist first. Calluses are generally symptoms of other problems, so it’s really important to have a podiatrist examine your feet to work out what could be causing the pressure. 

Over-the-counter remedies such as corn paint or plasters generally only treat the symptoms, not the underlying problem. They can also easily damage the healthy skin surrounding the corn if not used properly. Commercial preparations should only be used following professional advice. 

In people with poor circulation or with medical conditions such as diabetes, the use of medicated corn plasters can be very dangerous.

Our podiatrists will gently remove calluses and corns to have you feeling much better in no time. 

We may also:

• Recommend regular maintenance to keep you pain-free
• Check and advise you on the fit of your shoes
• Give you padding and or deflection materials to use to prevent recurrence
• Discuss if orthotics are necessary to improve your foot function and reduce pressure/friction

What are fungal nails?

Fungal infections are one of the most common foot problems. This is because they thrive in warm, moist environments like sweaty socks and shoes and underneath nail polish. 

Fungal infections can cause the nails to thicken, discolour, deform, crumble and split. Most often the main concern is cosmetic, as they are unsightly, but on rare occasions they can be painful.

How do I know if I have a fungal nail infection?

Commons signs of a fungal infection include toenails that are:

• Cracked
• Lifted
• Discoloured
• Thicker than they should be
• Crumbly
• Painful

The best way to get properly diagnosed is to see our expert podiatrists who are trained to identify multiple nail pathologies. If your podiatrist is unsure they can test a sample of your nail on the spot.

How do you treat fungal nail infections?

Fungal nail infections are a common complaint and there are a variety of treatment options available to rid your nasty fungi! Unfortunately, treatment for fungal toenails can be a lengthy process. Fungal toenail infections that have been present for a long time are generally more resistant to treatment, and regardless of the type of treatment; the nail infection will always have to grow out.

The best line of treatment is to make a booking with one of our podiatrists who will ensure that the most effective treatment plan is put in place from the get-go. This could save you a lot of time, frustration and money.

Probably one of the most common conditions we see at Prescott Podiatry is pain in or around the heel. This pain may also extend into the arch or into the achilles tendon and can affect people of all ages. Pain in the heel can range from a dull ache, stabbing pain, pain on rising, tightness and or burning in the heel and arch.

Conditions such as Plantar Fasciitis, heel spurs, and achillies tendonopathy can often cause pain to the point where your ability to complete day-to-day activities is hindered. 

Although plantar fasciitis is the most common cause of heel pain, it’s important to recognise that there are a multitude of factors which can contribute to why you would get pain in and around your heel.  Our podiatrists will analyse, identify, assess and diagnose major causes of your heel pain and manage it accordingly.

So what is plantar fasciitis?

The plantar fascia is a thin fibrous band of connective tissue that overlies all the muscles in the bottom of our feet. It’s like a big rubber band acting as a shock absorber, so while you’re moving, your plantar fascia is too - it’s no wonder it’s prone to overuse and degeneration!  

In the early stages, it’s very common to experience pain in the heel of your foot during the first few steps out of bed in the morning. It usually improves as the foot warms up, but if left untreated the pain will often become more prolonged throughout the day.

Why do I have plantar fasciitis?

Often, there’s more than one reason you may be suffering with plantar fasciitis. This condition is multi-faceted and questions you may ask yourself include:

• Are on your feet for long periods of time, on hard floors, or wearing high heel shoes?
• Are you overweight?
• Do you have flat feet or an unusually high arch foot type?
• Did you take up a new form of exercise or suddenly increase the intensity of your exercise?
• Do you have leg length differences?
• Do you have an abnormal gait cycle?
• Do you experience calf muscle shortening/tightness?
• Do you have weak foot muscles?
• Do you have any underlying medical conditions such as rheumatoid arthritis or lupus (systemic lupus erythematosus)?
  

How will you treat my heel pain?

At Prescott Podiatry, we use a three-step approach to treatment of heel pain:

1. Identify the structure/s that are causing your heel to hurt
2. Determine the mechanism of pain
3. Implement a treatment plan that is tailored to your individual needs.

Treatment may include: 

• Padding/strapping,
• Stretching and or strengthening exercises
• Massage
• Shockwave
• Orthotic therapy
• Activity modification
• Footwear advice
• Heat application
• Foot mobilisation

We understand how debilitating heel pain can be and we want to keep you moving! If you have heel pain, make an appointment today with one of our podiatrists to kick-start your way to a pain free day.

What is an ingrown toenail?

An ingrown toenail occurs when the nail grows into the skin on one or both sides of the nail bed, which is often painful and may or may not be accompanied by a toenail infection. Most commonly ingrown toenails occur in the big toe, but can also affect smaller toes. Ingrown toenails are a common problem that can affect both adults and children. 

Why do I get ingrown toenails?

Ingrown toenails generally develop due to one or more of the following:

• Incorrect toenail cutting technique (i.e. cutting too much or not enough, or tearing your nails instead of cutting them)
• Natural toenail shape/structure (i.e. curved/involuted, broad and/or thick)
• Wearing socks and/or shoes that don’t fit correctly
• Trauma, such as stubbing your toe

What are the treatment options?

Firstly, treating an ingrown toenail doesn’t need to be painful! 

Ingrown toenails can be treated two ways:

1. Conservative Treatment

Conservative treatment under the care of a podiatrist generally involves:

• Carefully removing the offending toenail edge/spike, with or without local anesthetic
• Applying a dressing and giving you daily self-care instructions (if necessary)
• Referring you to your doctor to get an antibiotic prescription (if necessary)
• Identifying the reason/s why the ingrown toenail developed

2. Surgical Treatment

Occasionally an ingrown toenail will not respond to conservative treatment. This is more likely if it’s very severe or has existed for a long time. In this case, our podiatrists may recommend a small surgical procedure to permanently remove the offending toenail edge/spike. This can be performed by our podiatrists and is a low-complication procedure with a high success rate. 

Here at Prescott Podiatry, we have all the experience and knowledge to tend to even the most painful of ingrown toenails. Your precious toes are in our capable hands.

What are warts or verrucas?

A wart is an infection caused by the HPV virus, which can invade your skin through small cuts or breaks. Over time, the wart develops into a hard, rough growth on the surface of the skin. A wart is most commonly seen on the bottom of the foot (known as a plantar wart), but can also appear on the top. 

Children, teens, and people with allergies or weakened immune systems are more vulnerable to the wart virus.

Are warts contagious?

YES! Because warts are caused by a virus, they are highly contagious and often appear when our immune system is a little compromised. 

The most common way to get one is direct skin-to-skin contact. However indirect contact, such as being barefoot in wet areas, sharing towels, socks and shoes with someone who has a wart, will highly increase your chances of becoming infected with the HPV (wart) virus.

How do I know if I have a wart?

Diagnosis of a wart should always be made by a professional, especially before attempting to use store bought products to treat your wart. Most plantar warts are diagnosed based on their appearance. In some cases, your podiatrist may scrape a sample of skin cells from the wart and send the sample to a pathologist for microscopic evaluation.

Wart Treatment

Warts will often resolve themselves as our body fights off the virus. However this can be a slow process that takes months or even years. This, plus the fact they can be painful, is why many people decide to proactively see a podiatrist or doctor to help them find the best option to treat their wart.

There are plenty of old wives’ tales out there about treating warts - we’ve heard everything from applying duct tape, banana peels or Vicks Vapour Rub! All treatments used on warts aim to disrupt the area so the immune system will act to eliminate the virus. 

Many people try over-the-counter treatments first, however most are made of low-concentration salicylic acid which often isn’t strong enough to kill the warts and commonly damages the healthy, surrounding skin. In our opinion, warts should always be treated by a professional. 

Here at Prescott Podiatry, we like to treat warts in a holistic manner and try to provide a comfortable and painless experience for both kids and adults. 

Our treatments may include:

• Discussing the current state of your immune system and looking at ways to boost your immunity. This may include collaboration with other health professionals.
  As warts are a virus, it may be recommended to boost the immune system and leave them to heal spontaneously. However, as they’re highly contagious, painful and can spread, it is often recommended to keep a close watch of them and seek help if they become unmanageable.
  
• Chemical cautery is often the first line of treatment used for plantar warts. This involves specific chemicals used under close supervision in conjunction with careful debridement, in an effort to breakdown the wart tissue and initiate an auto-immune response. Single warts usually require between 4 and 8 treatments. Multiple warts may be more resistant and take longer to eradicate.
  
• Prescribed Medications. For those who have warts numbering in the dozens or even hundreds, simple acids or surgery will not work due to the sheer number of warts that need to be treated. In these cases, your doctor may prescribe medications such as high doses of Vitamin A or Cimetidine.
• Microwave therapy. Swift microwave therapy described here

Warts are a common but tricky problem and with so many wart treatment options available, it can be hard to know what option to choose. The best line of treatment is to make a booking with Prescott Podiatry so we can ensure the most effective treatment plan is put in place from the get-go. This could save you a lot of time, frustration and money.

We have access to a breakthrough treatment for plantar warts called Swift Therapy. It’s a new technology that was developed in the UK and has been licensed for the general treatment of skin lesions (warts/verruca). 

How it works is that microwave energy is delivered through a special probe that’s applied to the skin and the probe generates heat within the verruca to treat the wart. (Don’t worry, it’s completely safe!)

Recent research has found that this approach, called local hyperthermia, is much more effective at causing cell death within the wart than freezing or acid. Plus it means there’s no smoke, no anaesthetic, and no dressings. 

With a few exceptions, most people with skin verruca / warts on their feet are able to have this treatment. Our podiatrist’s will carry out an assessment prior to treatment and be able to advise you on this.

Microwave energy?! Is that safe?

Yep, it’s safe. Microwaves are a form of non-ionising radiation, which means they don’t cause damage to the DNA of living things. In fact, this technology is used in a number of every day devices - like your mobile phone, bluetooth and Wifi!

How does Swift work?

Swift therapy works by using a hand-held probe to deliver microwave energy to a precise and predetermined depth at the site of the wart/verruca. 

When your body's cells are infected with the human papilloma virus (HPV), the virus has the ability to 'hide' in the body so that your immune system has no idea it’s present.

Microwaves heat the virally infected cells to 42-45 degrees, sending them into a state of stress and making them visible to your immune system, allowing it to identify and rid the body of the virus.

How does Swift compare to other wart treatments?

Swift leaves the area intact and doesn’t disrupt healthy tissue, meaning there’s no painful lesion and no need for any dressings.  

Other wart treatments, like cryotherapy, salicylic acid, electrotherapy and excision, work by irritating the tissue and hopefully 'tricking' the immune system into recognising certain cells are infected with the HPV virus. While these treatments do work for some people, overall success rates are only around 40-50%. Additionally, these treatments often result in a painful lesion that needs to be kept dry and will need redressing, and treatment length can vary from daily to weekly and can be ongoing for months.

Does it hurt?

The rapid heating of the verruca/wart can cause some discomfort, but it’s a quick treatment and the discomfort only lasts a very short time. Some people liken the sensation to putting your foot in a hot bath and quickly removing it. Most people find it’s like nothing even happened after about 2-3 minutes of treatment finishing. 

How often will I need to come for Swift treatment?

We generally place treatments 4 weeks apart and most people will need 3 treatments. Some people may need additional treatments, particularly if their verruca is longstanding, however we will discuss your specific needs during our consultations. 

Is there any preparation required prior to treatment?

Generally, no prior preparation is required. However if your verruca/wart is overlayed by a substantial callous, we may reduce this a few days prior to receiving your first Swift treatment. We’ll let you know if anything is required though, so you won’t be left wondering.