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Skin and Nail Conditions

Learn more about the different conditions we treat.

Click the underlined treatments for more information

Ingrown Nails

Ingrown Toenails

Ingrown nails occur when the edges of the nail grows into the skin surrounding the nails. Patients often present with painful toe(s) with swelling around the affected nail, redness, pus or even abscess.  

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Common causes of ingrown toenails include:

  • Pressure from ill-fitting footwear

  • Improper nail trimming 

  • Trauma on the toe

  • Fungal nail infection

  • Abnormal shaping of the nail plate - flat, wide, curled, pincer-like

  • Any disease that cause an abnormal nail plate (i.e. psoriasis)

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Treatment options:

  • Remove the offending nail spicule - a conservative treatment performed by a podiatrist with sterile instruments.

  • Footwear changes - good fitting shoes with wide and deep toe box is recommended to prevent excessive pressure on the toes

  • Proper nail trimming technique - cut your nails straight across and keep the nails at moderate length (not too long / too short)

  • Nail surgery (Nail avulsion with phenolisation) - Permanently remove the offending portion of the nail with an in-office minor and minimally invasive surgical procedure is recommended for recurrent cases.

Fungal Nail Infection

Fungal Infections

Fungal nail infection (also known as Onychomycosis) is mostly seen in people who frequently use wet public spaces such as public pools / showers, gyms, saunas etc, as fungi thrive in moist and warm environment.

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Causes / risk factors: ​

  • Occlusive footwear

  • Hyperhidrosis (excessive sweating)

  • Trauma / nail injury 

  • Tinea pedis (Athlete's foot)

  • Most commonly seen in elderly with impaired immune system, people with diabetes, and with poor peripheral circulation


Signs and Symptoms:

The infection nail plate may present with:

  • White, yellow and / or brown-black discolouration 

  • Thickened and crumbly debris under the nail plate

  • Nail plate sometimes lifts from the nail bed

  • White discolouration on the superficial nail plate

The infection usually starts at the free edges of the nail, which will then spread down the side towards the nail matrix / base of the cuticle. 

Treatments:

  • Mechanical debridement with filling / clippers to remove the affected nails

  • Use topical antifungal treatment as directed for a minimum of 6 months

  • Maintain personal hygiene

  • Oral antifungal may be prescribed if the diagnosis of fungal infection is confirmed with cultured testing (Note that oral antifungal treatment has a high risk of side effects compared to topical antifungal application)

Tinea Pedis (Athlete's Foot)

Tinea pedis is a skin infection due to fungus. Fungi thrive in warm, moist environments. This infection is usually spread by dermatophytic spores, which can often survive in harsh conditions.


Cause: 

  • Public, wet places such as public pools and gyms

  • Occlusive footwear

  • Hyperhidrosis (excessive sweating) - more likely to have recurrent episodes of infection

  • Underlying immunodeficiency or system immune suppressive medications


Signs and symptoms:

  • White, maceration in between the toes

  • Small vesicles or blisters on the soles of the feet

  • Red rash patches with dry, scaling skin on the soles

  • Itching


Treatment:

  • Keep the skin dry and clean ​

  • Avoid barefoot walking in wet public places such as pools, public showers

  • Air dry and sun dry footwear (especially the inner lining)

  • Treat infection area with broad-spectrum topical antifungal such as Lamisil, Canestean as per directed

  • Maintain personal hygiene

Verrucae Pedis (Plantar Wart)

Warts

Verrucae Pedis (Also known as Plantar Wart) is a viral growth, usually at the bottom of the foot, caused by Human Papilloma Virus (HPV). It is most commonly found at the base of the toes, forefoot or heels. The skin is most vulnerable to HPV infection when there's a skin break, tiny cuts or other weak spots on the foot. It is also more commonly found in kids or elderly with weak immune response. 


Signs and symptoms:

  • Wart lesions usually appear as small, rough, grainy growth on the bottom of the foot that interrupts the normal lines and ridges of the skin

  • Hard, thickened skin over a well-demarcated spot on the skin

  • Black pinpoints or mosaic appearance 

  • Pain or tenderness upon weight bearing 

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In most cases, no treatment is required for a healthy individual who has plantar warts, as the immune system is able to fight against a viral infection by itself. Depending on a person's immunity or the severity of the presenting symptoms, further treatment is warranted.


Treatment options:

Callus/Corns

Callus and Corns

A callus is a large, broad and diffused area of thickening of the skin underneath the foot due to repetitive pressure. More commonly found at ball of the foot, it can get annoying and quite painful to walk on if left untreated. 

​A corn is a small, deep and focal area of thickening of the skin due to repetitive and excessive pressure, more commonly found on or in-between toes. Due to its presentation, it is more painful to walk on compared to callus. 

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Cause:

  • Poorly fitting footwear 

  • Underlying foot problems leading to uneven pressure on the feet such as: 

    • Biomechanical issues - flat footed, high arch foot type 

    • Foot deformities in the toes or feet - bunions, lesser toe deformities 

    • Bony feet

When there is uneven pressure on the feet leading to bone rubbing against the skin, the body responds by producing thickening of the epidermis layer of the skin. 

 

Treatment options:​

  • Removal of the hard skin via sharp debridement by a podiatrist / trained health profession

  • Biomechanical assessment to determine the cause of callus and corns 

  • Address the biomechanical issues to reduce and / or prevent the re-occurence 

  • Orthotic therapy to redistribute pressure under the feet 

  • Footwear modification to ensure your current footwear fits your feet correctly and comfortably

  • Customised toe prop / wedge to reduce the rubbing friction in between toes

Cracked Heels

Heel fissures (cracked heels) is a common condition that occurs when skin on your heels becomes dry, hard and begins to crack. Often, the appearance may be a cosmetic concern but if left untreated they can become deeper and be painful, bleed, or become infected.

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Signs and symptoms:​

  • Dry, hard, thickened skin (callus) around the rim of the heels

  • Cracks around the rim of heels

  • Painful

  • Bleeding 

  • Infection or ulceration


Causes: 

  • Walking barefoot or open-backed footwear that leave the heels exposed to air and dries the skin

  • Standing and walking for long periods

  • Increased weight

  • Other health conditions such as diabetes, atopic dermatitis, psoriasis, poor circulation or nutrition

  • Genetics - type of skin

  • Climate conditions - low humidity, dry summers and winters.​​


Treatment options:

  • Removal of the hard skin by a podiatrist or trained health professional

  • Pumicing of the hard skin by yourself

  • Regular moisturising to hydrate the skin - ask us about a good and suitable moisturising cream!

  • Footwear modification - wearing enclosed shoes can help reduce the incidence of cracks and fissures

  • Insoles may help re-distribute the weight of the heel

  • Antibiotics or a referral might be required for infected heels depending on severity

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