Plantar Warts: Causes and Treatments

Although it can be quite tempting to go barefoot this summer, it can also put you at risk of contracting a strain of the human papillomavirus (HPV) known as verruca, or plantar warts. Viruses thrive in warm, moist places such as public bathrooms or swimming pools, and can occur as a result of direct contact with the virus (commonly through tiny cuts or abrasions on your feet).

While it’s nearly impossible to avoid contact in the general public, it’s important to note that exposure is common, especially in younger children who have yet to build up an immunity, and tend to spread the virus among their friends and family. Therefore, while you should always keep your feet protected by wearing shoes or flip-flops in public places, it’s also important to make sure that communal surfaces at home, as well as your socks and shoes, are being disinfected to prevent the virus from spreading.

Remember: every person’s immune system is different, so a person’s response to the virus will be different, too, even if they’re from the same family.

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Plantar warts are generally small, fleshy growths on the bottom of your feet and are often mistaken for plantar corns or calluses, due to the thicker skin that tends to develop. A plantar wart, however, will generally have the appearance of tiny black dots near the surface caused by capillary hemorrhages that form underneath the skin. As a general rule, we suggest patients to seek treatment from a podiatrist, as attempting to remove them at home can lead to serious problems, such as infection, if removed incorrectly.

Once in the office, plantar warts are easy to diagnose and may require a simple scraping of the skin or biopsy to confirm. After that, there are several different treatment options to consider, such as: topical acids, liquid nitrogen, YDL laser, or an excision(s). Depending on the size of the wart and quantity, all of these options are available and your podiatrist will be able to discuss which treatment will work best for you.

If you or someone you know believes they may have a plantar wart, feel free to contact our office at (248)348-5300 or request an appointment on our website. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing.

Pedicure Pointers from a Podiatrist

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With the warm weather fast approaching, it’s that time where many people slip out of their winter boots and directly into the pedicure chair for some much-needed TLC.

Unfortunately, not all pedicure facilities offer clean and proper foot care, and often lead to foot infections and other common ailments. If you’re planning a trip to the local nail salon, please review our advice on things to pay attention to:

  • Make sure that the instruments used are clean and sterilized (we suggest bringing your own set of pedicure utensils).
  • Make sure foot tubs or basins are drained after performing a pedicure to get rid of all the bacteria present (going first thing in the morning is recommended).
  • Make sure the technician’s hands are clean.
  • If you are diabetic, pedicures are not advised. Visit your podiatrist before receiving a pedicure to identify any potential risks.
  • Cuticles serve as a protective barrier against bacteria, so it’s important not to cut them, as it increases the risk of infection.
  • Nails should be cut straight with slightly rounded edges, as other tools with a curved shape can increase the risk of developing an ingrown toenail(s).
  • Foot razors should never be used to remove dead skin (we suggest soaking your foot for 5+ minutes in warm water and then removing the dead skin with a pumice stone). A foot razor can lead to permanent damage if used incorrectly and can easily cause infection if too much skin is removed.
  • If your toenails are thick and/or discolored, do not use nail polish to cover them up. Nail polish locks in moisture and doesn’t allow the nail bed to breathe, which encourages fungal growth. For special occasions, we recommend using an anti-fungal nail polish instead, which is available for purchase in our office.

If you have any questions regarding pedicures or any issues that have developed as a result of a pedicure, feel free to contact our office at (248)348-5300 or request an appointment on our website. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing.

Why Does My Foot Fall Asleep?

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Have you ever experienced the sensation of your foot falling asleep? It may have happened while you were watching TV or working on the computer, and when you went to stand up an hour later, you found that your foot was completely numb.  While many believe the “pins and needles” feeling occurs due to the lack of blood supply being sent to your foot, this experience is actually referred to as paresthesia, which occurs when too much pressure is placed on a nerve.

Causes of temporary paresthesia:

  • Sitting in the same position for long periods of time
  • Wearing shoes that are too tight
  • Sitting or lying in a way that restricts blood flow to the lower limbs

Symptoms of paresthesia:

  • Prickling
  • Tingling
  • Itching
  • Burning or cold skin

When you sit for long periods of time, your nerves (the tiny threads/wires that run throughout your body, carrying messages to the brain) are temporarily compressed and unable to send messages back and forth, thus temporarily disrupting the connection. As a result, your feet don’t feel anything.

As soon as you change your position, though, your nerves are no longer compressed and the feeling in your foot will slowly start to return. And while it’s important to remember that everyone experiences “sleepy feet” every once in a while, it shouldn’t happen often without reason. If you experience chronic paresthesia, it may be the result of an underlying neurological disease or traumatic nerve damage, and you should consult a podiatrist immediately to obtain an accurate diagnosis.

Other issues that may cause paresthesia:

  • Neuropathy
  • Fibromyalgia
  • Autoimmune Diseases
  • Vitamin Deficiency
  • Hypothyroidism
  • Radiculopathy
  • Disorders affecting the central nervous system
  • A tumor or vascular lesion

Our podiatrists, Marc A. Borovoy, DPM and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing, including paresthesia. Feel free to request an appointment on our website or call us at (248)348-5300.

It’s Skin Cancer Awareness Month

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With more than 3.5 million skin cancers diagnosed annually in the United States, the Centers for Disease Control has officially declared May as Skin Cancer Awareness Month. With its ability to develop anywhere on the body, many assume if a certain area is protected from the sun that it’s safe, but according to the American Podiatric Medical Association, that assumption is not always correct. In many cases, skin cancers derive from exposure to the sun’s harmful UV rays, but skin cancers of the feet are most often related to “viruses, exposure to chemicals, chronic inflammation or irritation, or inherited traits.”

Additionally, while it’s important to attend yearly visits to the doctor to check for any skin abnormalities, most general practitioners tend to overlook the feet, which is why it’s important to schedule yearly visits with a podiatrist, too. Almost always, skin cancer can be cured if it’s found and treated in its early stages, and since skin cancer can often resemble a fungal infection, plantar wart, ulcer, hematoma, or other common skin conditions of the foot, most people don’t know to seek treatment until it’s too late.

According to Health and Age, survival rates are dramatically lower when melanoma is found on the foot because it often goes unnoticed until it becomes a serious problem. If not caught in the early stages, the fatality rate is about 50% within 5 years of diagnosis.

Common cancers of the feet include:

  • Basal Cell Carcinoma
  • Squamous Cell Carcinoma
  • Malignant Melanoma

What should you look for?

While many have been told to pay attention to their bodies and perform self-examinations, most people don’t know exactly what they’re looking for. Thankfully, the American Academy of Dermatology has developed an easy-to-use checklist to make it easier to identify abnormal skin lesions, known as the ABCDEs of Melanoma.

  • Asymmetry – If the lesion is divided in half, the two sides do not look alike.
  • Borders – Borders look scalloped, uneven, or irregular.
  • Color – Varies from one area to another, in different shades.
  • Diameter – The lesion is wider than than 6 mm (may be smaller when diagnosed).
  • Evolving – Lesion that looks different from others, and/or changes in size and color.

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The 3 most common areas to find skin cancer on your feet are:

  • Soles of feet
  • Between toes
  • Under toenails

While the ABCDE’s are a great reference to utilize when performing self-examinations, they should NOT replace your annual visits to the doctor.

Other warning signs specifically for skin cancer of the foot:

  • A sore that does not heal
  • Spread of pigment from the border of a lesion to surrounding skin
  • Redness or a new swelling beyond the border of a lesion
  • Change in sensation such as itchiness, tenderness, or pain
  • Change in the surface of a mole including scaliness, oozing, bleeding, or the appearance of a bump or nodule

If you notice something abnormal on your foot or ankle, specifically moles and freckles since they’re not commonly found on the soles of feet, it’s important to schedule an appointment with a podiatrist as soon as possible. Podiatrists are trained to recognize abnormal skin conditions of the foot and ankle, and since skin cancers can have very different appearances, a podiatrist’s knowledge and training is vitally important for early detection.

Diagnosis and Treatment:

The initial diagnosis of skin cancer is determined through a clinical examination and a skin biopsy. The biopsy involves taking a small sample of the skin lesion and sending it to a laboratory where a skin pathologist can examine the tissue. If the lesion is determined to be cancerous, a podiatrist will then recommend the best course of treatment for you.

“A couple of years ago, I had a patient come in complaining about heel pain from a growth on the bottom of his foot,” Dr. Marc Borovoy, a podiatric physician shares. “There was nothing inherently abnormal about the lesion, but after reviewing his medical history, I decided to perform a skin biopsy. The next day, I had to call the patient and let him know it was skin cancer.”

“Unfortunately, it’s more common than most people think and it’s not always obvious, even if you do follow all of the steps they tell you to,” he continues. “I always tell my patients how important it is to schedule regular follow-ups with [podiatrists] because we have the ability to examine the foot and ankle in greater detail. For most people, it can be extremely difficult to examine their feet on a weekly basis simply because of the location.”

Skin Cancer Prevention:

Prevention of skin cancer on the feet and ankles is similar to any other body part, so it’s important to follow these precautions:

  • Flip flops do not provide protection against the sun, so be sure to wear water shoes or socks and shoes.
  • If any of your skin is unprotected by clothing or shoes, be sure to use adequate sunscreen (we recommend reviewing EWG’s Guide to Sunscreens).
  • Inspect all areas of the feet daily, including underneath your toenails, between your toes, and the soles of your feet.
  • If you wear nail polish, it’s important to remove it, so that you can inspect underneath the toenails.
  • Avoid UV rays

Remember, skin cancer in the foot or ankle will often go unnoticed in its early stages, so it’s important to follow the aforementioned preventive steps, as well as routinely seeing your podiatrist, to seek treatment before it progresses to a more advanced stage.

If you or someone you know happens to notice any suspicious or abnormal lesions, it’s important to seek treatment as soon as possible to ensure a proper diagnosis and plan of care. Dr. Marc Borovoy and Dr. John Miller are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing, including skin cancer diagnosis. You can request an appointment on our website or feel free to call us at (248)348-5300.

Nicolas Cage Suffers Ankle Fracture on Set of New Film

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Several days ago it was revealed that actor Nicolas Cage had experienced a painful injury in a “freak accident” on the set of his new film, #211. After being rushed to the hospital while on location in Bulgaria, it was eventually announced that the star had suffered from a broken ankle.

Initially, the response to the star’s injury was to perform a surgical procedure in Bulgaria, however, Cage made the decision to return to Los Angeles for treatment and according to Deadline, has now decided to postpone filming for a total of 6 weeks to allow his injury time to heal.

As of now, the exact details of how the injury occurred are still unknown, but since a severe ankle sprain and a broken ankle can have similar symptoms, it’s important to have every ankle injury evaluated by a podiatrist.

Common symptoms of a broken ankle include:

  • Immediate and severe pain
  • Swelling
  • Bruising
  • Tenderness when touched
  • Inability to put any weight on the injured foot
  • Deformity, particularly if there is a dislocation as well as a fracture

Depending on the severity of the fracture (i.e. how many bones making up the ankle joint are broken) two possible options could have been discussed: conservative or surgical. If the fracture was minimal, meaning the break was minor and not out of place, it could’ve been treated with a brace or cast to protect the fracture while it heals. However, if multiple bones were broken and the ankle became unstable, Cage would’ve been looking at a surgical route to re-position the misplaced bones.

“Most ankle fractures take approximately 8 weeks to heal properly,” says Dr. Marc Borovoy, a podiatric physician who treats ankle fractures on a weekly basis. “Given his [Cage] situation, I agree with the decision to undergo surgery, and I’d also recommend a few weeks of physical therapy to help restore the flexibility and strength in his ankle.”

If you or someone you know experiences any type of ankle injury, it’s important to seek treatment as soon as possible to ensure a proper diagnosis and plan of care. If you have any questions regarding ankle fractures or any other foot or ankle issue(s), please feel free to visit our website or call us at (248)348-5300.