Thick, Painful or Ugly Scar?

You don’t have to live with that thick, painful and/or ugly scar. Whether it be from a cut, burn, surgical procedure or scratch, there are methods of improving both the color and raised nature of scars.

There are different types of scars and the treatment and prognosis differs depending on the type. Many normal scars can be darker or lighter than the surrounding skin. This is often due to sun exposure during the healing phase. It is caused by the new melanin (which gives the skin color) being exposed to the sun while it is maturing, leading to discoloration.

A more severe form of scarring is called hypertrophic scarring, which can be genetic or the result of poor healing in certain areas of the body, the foot being one of the most common locations. Hypertrophic scars are raised and can have color changes. However, they do not exceed the boundaries of the original wound (cut, burn or surgical).

The most severe form of scarring is called keloid scarring. This is a genetic condition that leads to severely enlarged and pigmented scarring that exceeds beyond the borders of the original injury. They can be caused by very small injuries, even a small scratch. Most people are aware by the teenage years that they are prone to keloid formation.

All forms of poor scar formation are treatable, with keloid scarring being the most difficult and least responsive. The treatments range from injection with steroids or chemotherapeutic agents, steroid gels or creams, silicone pads and/or surgical removal.

There are several ways to help prevent poor scarring, whether from a genetic condition or not. Avoiding sun exposure during melanin maturation is very important. I recommend sunscreen on a healing area for up to 6 months after it has healed to allow normal maturation. Using silicone padding over the scar can help reduce the thickness and raised nature of scars. Silicone has been found to reduce the formation of excess collagen that is attributed to causing a thickened scar. These can be used for a year or more to help improve scar appearance since skin healing and remodeling can last for up to 18 months.

Prevention of scarring by early recognition and intervention is the key to decreasing poor appearance. If you have a painful, enlarged or ugly scar, give us a call. You don’t have to live with it!

Wintertime Foot Care

It may still be warm in November but soon December will sneak up on us and it will be time to tuck our sandals away and pull out our bulky shoes for the cold weather.  Cold temperatures, even in Texas, can be hard on the feet.  The experts at Advanced Foot and Ankle Center in McKinney and Prosper, Texas are used to treating feet with “winter time blues.”  Cold weather can restrict blood flow to our feet, especially our toes.  This can in turn cause issues with dry skin since the decreased perfusion limits dermal nutrition.

A solution to cold feet, states Dr. Silvers, is to dress warm and to also wear a thick cotton sock.  In addition, the head is very vascular and wearing a winter had helps to warm the toes since the body does not have to keep the head warm when head heat escapes from the scalp. If patients complain of cold feet at night, many times wearing a hat to bed helps with this problem.

It gets pretty dry here in Texas and for that reason, dry, cracked skin is a common problem.  Dr. Silvers states that daily hydration with a good hydrating cream is helpful. In addition, a foot and ankle evaluation by a McKinney and Prosper, Texas podiatrist is also advised to rule out a fungal infection.  Our office carries great product that treat dry skin and skin fissures very well.  These products that you can find at our McKinney and Prosper Locations include Idonia Foot Cream and Lantiseptic Cream.  In addition, we offer a Sleep N Heel sock that provides occlusion to the skin so that deep fissures can heal quickly.  Please call our office at 972-542-2155 for more information.

Dr. Silvers states that he sees dry skin being a problem in post-menopausal woman due to the hormone changes that are occurring in their bodies.

We see ingrown toenail more often at the beginning of the colder season due to many people getting back into closed toed shoe gear more often.  A tight or constricting shoe can place pressure on the side of the toes forcing the nail fold into the toenail edge.  If a sore develops between the toenail fold and the toenail, and bacteria enters the skin, an infection can ensue.   It is not advised to try to dig out ingrown toenails on your own.  Many times nail salons do not have the appropriate tools and/or their instruments may not be sterile.   If your toenail looks red and is painful, consultation with a McKinney or Prosper Podiatrist is advised.

For more information on ingrown toenails please visit our website at www.nomoreingrown.com

Advanced foot and Ankle Center has offices in McKinney and Prosper Texas.  Dr. Silvers and Dr. Hadfield are residency trained foot and ankle specialists.

Are Flat Feet Genetic?

Are flat feet genetic?

Growing up, my mom often told me I had her arches and my dad’s toes.  I always thought it was a strange observation but once I became a Podiatrist I realized that she is right.  Unfortunately for me, I got the worst of both worlds.  It is true that your foot type is genetic, although it is not as cut and dry as getting your mom’s arches and your dad’s toes.  It is often more complex inheritance but looking at your parents’ feet can be a crystal ball into the future of your own.

There are several different types of flat foot.  There’s the pancake type that make a kid “heavy footed” when they walk.  There is a flexible type, where the foot appears to have an arch when sitting, but then it disappears with standing.  There is also a type called adult acquired flat foot, where there was a normal arch, but has since collapsed, sometimes over a short period of time.  Of these, the flexible flat foot is the most common and is fortunately the most responsive to treatment.

With all of these types of flat foot, other sometimes serious conditions can develop as a result.  The arch of the foot is designed to carry the burden of the body’s entire weight when standing, and transfer that force through the rest of the skeleton evenly, while absorbing shock, and creating a lever to push off of for quick and efficient walking.  When the arch collapses, these processes do not work correctly.  Consequently, the other joints of the foot and leg can become misaligned and lead to pain and arthritis.  Bunions, hammertoes are common conditions associated with flat foot.  Ankle, knee, hip and back pain/arthritis are also very common.

Determining which type of flatfoot you have is done with clinical examination, x-rays, and analysis of the way you stand and walk and sometimes an MRI.  Understanding the individual mechanics of each patient’s individual feet helps to make a custom plan designed specifically for you.

What can be done to avoid these painful conditions?  There is not one blanket answer that will cover them all, but there are many conservative therapies aimed at maintaining the arch, providing shock absorption and helping to prevent the further development of bunions, hammertoes and arthritis in the joints of the foot and leg.  Wearing proper shoes is a key in this conservative therapy, along with orthotic devices aimed at maintaining the arch, are essential in this process.  Children are especially responsive to these therapies because orthotic devices can help assist their feet in growing into a more proper alignment.

If conservative therapies are not enough, there are surgical options for correction as well.  These consist of implants to realign the joints, transferring and/or lengthening of tendons and cutting of bone to correct the angles of the bones and joints.  Surgery to correct a flatfoot is a last resort option in most cases, but can be very beneficial with the right timing to prevent bunions, hammertoes and arthritis over the long term.

Turf Toe

With football season now in full swing, turf toe is a commonly used term during games and on the sports channels.  So, what is turf toe?

Turf toe is a general term for injuries of the big toe joint, or first metatarso-phalangeal joint, and it actually consists of several types and degrees of injury.  This injury is very common amongst football players and has been seen with increasing frequency since more and more teams now play on artificial surfaces.  The injury is caused by the foot getting stuck on the artificial surface and the body’s momentum carrying the body weight over the big toe joint and hyperextending it.  These injures are not limited to football players, however.  They are common in baseball, basketball, volleyball and soccer as well.

The most common, and least severe form of turf toe is a simple hyperextension without significant damage to the ligaments.  There is often severe pain and swelling with this injury, however.  It often is recoverable within a few weeks and usually leads to no long-standing damage, if treated.

The more severe forms involve tearing of the ligaments around the joint and/or fracture of the sesamoid bones, which are two small bones on the bottom of the joint that are similar to the knee cap.  These injuries can be very debilitating if untreated and have ended many professional sports careers from improper care.

The diagnosis of turf toe is made with clinical examination, xrays and often an MRI.  Once diagnosed, the treatments range from immobilization in a boot, non-weight bearing with crutches and surgical correction if severe.

Many athletes are told to play through the pain, and that it is only a toe injury and therefore not severe.  If left untreated, the more severe forms of turf toe can lead to long lasting pain and early arthritis.  It is very important that these injuries be properly evaluated and treated to avoid an early exit from a promising career.