Winter and your Feet

Winter and your Feet

This year we have had a very late and cold winter. Due to the significant low temperatures I have been seeing a lot of people with complaints of cold, discolored feet. Many of these patients are young healthy woman and are concerned about losing the circulation in their feet. Many of these patients state that they have never had these symptoms before and are concerned. After testing and further questioning, these patients are diagnosed with Raynaud’s phenomenon.

What is Raynaud’s phenomenon?

Raynaud’s phenomenon is a condition of vasospasms, which means there is decreased blood flow due to the cold temperature or stress. This can cause the toes and fingers to turn different colors, including purple, red or blue. Other symptoms of this phenomenon are extreme cold extremities and pain. This phenomenon is not to be confused with Raynaud’s disease, which is a systemic condition usually caused by a disease process.

The three colors of Raynaud’s are white, which is the initial stage, when there is decrease blood to the toes. The second stage is blue fingers and toes, which is due to a decrease in the oxygen to the extremities. The third and last phase is when the toes turn red, which is when temperature increases and blood returns to the digits.

How is this diagnosed and treated?

Diagnosis can be made by either clinical appearance or via a biopsy. Many patients that first present with this have a confusing appearance to their toes. It looks like a mix of Raynaud’s and dermatitis (which is a skin irritation). A biopsy will deny or confirm the diagnosis.

There are many options for treatment. The first option for a mild case is to wait until the weather gets warmer or the stress decreases. Stopping to smoke and decreasing caffeine intake can also diminish the symptoms. There are topical medications that can be prescribed to help vasodilate, or increase blood flow to the digits. If a topical medication does not work there are oral medications, which are blood pressure medications. Since blood pressure medications vasodilator the arteries they will help to decrease the symptoms of the Raynaud’s. If a patient has a severe case, which is associated with other diseases, there is surgery to help decrease the symptoms. Lately, Botox has been used in extreme cases of painful Raynaud’s

In conclusion, during the winter months, it is important to keep your digits warm and not allow long times of exposure to cold climates. If you are unsure of what is causing your skin to change colors, please go to your physician for a consultation.

For more information, please visit our website at www.footnj.com

Alternative Treatment for Peripheral Neuropathy

Alternative Treatment for Peripheral Neuropathy

In my past blogs I have discussed peripheral neuropathy and how it affects the feet. For a review, peripheral neuropathy is when the feeling/sensation to the feet decrease to a point where there is numbness, tingling and burning. This becomes a dangerous problem if a patient can’t feel their feet and they get a cut or sore. Without being able to feel the injury, it becomes difficult to treat it and this can many times lead to infection, gangrene and amputation. Many diabetics suffer from this condition, but more recently I have seen people without diabetes suffer from similar symptoms.

It is important to find the cause of these symptoms and attempt to treat the cause. If treating the cause doesn’t help with the symptoms, then this condition can be treated with medication. Traditionally there have been strong prescription medications that have been used to reduce the symptoms. These medications have many negative side effects, which cause can noncompliance issues. In addition, many patients who need these medications will be on many other prescription medications and there is hesitation about adding “another medication” to one’s regime.

Therefore, we have an alternative treatment option that is all natural, has no reported side effects and doesn’t interact with other medications. In our office we dispensed a Vitamin Supplement called NeuRx-TF. It is a vitamin supplement consisting of 4 different vitamins, which are Alpha-Lipoic Acid, Benfotiamine (or Vitamin B1), Vitamin B6 and Vitamin B12. This specific vitamin, NeuRx-TF, is different than any over the counter equivalents. Many patients will purchase an over the counter Vitamin B12 complex and have minimal changes in their symptoms. It is the exact formulary of this vitamin that helps with neuropathy.

The most important aspect of this vitamin is that the ingredients are fat-soluble. It is the fat-solubility of this vitamin that allows it to be absorbed and metabolized in the body. It is this property that allows blockage of the pathways that destroy the nerves, which entail cause neuropathy. The Vitamin B6 and B12 component of this vitamin can help reduce clotting of the circulatory system and prevent plaque from forming in the small tiny arteries to the feet.

In conclusion, there are alternatives ways to treat neuropathic symptoms. Many patients suffer way to long before coming to seek treatment. I always tell my patients that earlier you seek treatment for neuropathy the better your outcome will be.

For more information, please visit our website at footnj.com

Laser Away Your Toenail Fungus!

Nail fungus is becoming more common in the U.S. According to the Department of Health
and Human Services, more than 35 million people in the United States get nail fungus. The fungus lives underneath the nail because the nail provides a safe, dark, damp place that actually protects the fungus while it grows. Nail fungus is more than a cosmetic problem. It can be painful and interfere with daily activities such as walking or playing sports. There is now a new option for treatment that includes a painless laser procedure to kill the fungus in the toenail with usually one treatment! And is 80-88 effective! Think about it, one 20 minute treatment by a painless laser and 6 to 9 months later, the toenails have grown out normal! Too bad we can’t figure out how to make them grow faster! The laser has given us a much better treatment option for eradicating toenail fungus. Unfortunately most insurance companies deem it cosmetic so they don’t cover it, but if you think about all the hassles, copays and the risk of side effects; the toenail laser looks like the best option for most patients.

How does the laser work?

This laser is designed to shine through your toenail and destroy the specific pathogens embedded in and under your nail causing the infection. The laser operates in the very tight spectrum of near infra red light, safely destroying the fungi, molds and yeasts that often cause onychomycosis.

Is this laser painful?

The gentle laser light beam has no effect on healthy tissue. There is no discomfort associated
with the treatment during or after. This treatment does not harm or affect your activity in any way. Is this treatment safe? There are no age or health restrictions or limitations. In clinical studies there have been no adverse reactions, injuries, disabilities or known side effects .As you may know, the use of the medication available today for treatment of fungus toenails, carries with it possible systemic involvement (commonly the liver and kidney). This laser does
not! The laser is safe for nursing mothers and patients on blood thinners.

Does my insurance pay for this?

Because this treatment is considered aesthetic (cosmetic), health insurance plans do
not cover this treatment. We accept major credit cards and bank checks. We also offer an
interest free 3 month payment plan.

How Much Does It Cost?

The laser treatment is applied to all of the toenails on both feet, even the ones that appear uninfected. This reduces the chance of reinfection and takes about 20minutes. The treatment fee is $400. If the infection is resistant or has not responded with normal nail growth, the nails may need another laser treatment. This often occurs when all ten nails are severely infected. An additional treatment within the first six months is free.



What Should I Expect at My Laser Treatment?

The consultation is usually just a short visit with the doctor to diagnoses whether or not you actually have toenail fungus and to discuss treatment options.
If you decide that laser therapy is for you, the procedure can often be performed that day. In order for this to be available for you, you must remove your toenail polish at least 24 hours in advance and wash your feet thoroughly prior to coming for your consultation. (Toenail polish remover is flammable and can cause sparking from the laser which can harm your toes!)You can resume normal activity right after the therapy. Toenail polish can be applied immediately, but it is recommended to take a two week polish holiday if you can.

And After My Laser Treatment?

You can also choose to have a KeryFlex application after the laser treatment FREE of charge ($125 value). KeryFlex is a nail reconstruction system that uses polymer resins and special activators to create a durable, yet flexible artificial nail when exposed to a certain frequency of ultraviolet light. KeryFlex is available only through a properly trained podiatrist, who can complete the application of the product. This is a medical grade product and NOT available in nail salons. The new toenail looks very natural and it’s hard to tell the new nail apart from the other nails.


1. If you get regular pedicures, bring your own instruments or go to a spa that sterilizes their
instruments in an autoclave.

2. Clean your toenail clippers with alcohol before you use them if you do your own toenails.

3. We also recommend you regularly clean your shoes with an antifungal like Mycosis
(we carry this product in our office) at least once a week and dry them with a hairdryer.

4. Changing socks regularly (even a few times a day if you have sweaty feet) and keeping your feet clean and dry is also helpful.

5. Keep your athletic shoes dry and also change them regularly. If you exercise regularly, buy your athletic shoes a half size larger than your street shoes so you won’t bash your toenails as your feet swell with exercise.

6. Don’t let your nail fungus go untreated, educate yourself on your options and consult with
your doctor.