Tag Archives: Pedicure

Foot order or Smelly foot

English: Grown male right foot (angle 1)

English: Grown male right foot (angle 1) (Photo credit: Wikipedia)

Description:
Our foot sometimes gives out an unpleasant smell which is very much embarrassing.         ( medical term bromohidrosis)

click & see

It is a type of body odor that affects the feet of humans.The quality of foot odor is often reported as a thick smell. Some describe the smell like that of malt vinegar. However, it can also be ammonia-like. Brevibacteria are considered a major cause of foot odor because they ingest dead skin on the feet and, in the process, convert amino acid methionine into methanethiol, which has a sulfuric aroma. The dead skin that fuels this process is especially common on the soles and between the toes. The brevibacteria is also what gives cheeses such as Limburger, Bel Paese, Port du Salut, Pálpusztai and Munster their characteristic pungency.

Propionic acid (propanoic acid) is also present in many foot sweat samples. This acid is a breakdown product of amino acids by Propionibacteria, which thrive in the ducts of adolescent and adult sebaceous glands. The similarity in chemical structures between propionic acid and acetic acid, which share many physical characteristics such as odor, may account for foot odors identified as being vinegar-like. Isovaleric acid (3-methyl butanoic acid) is the other source of foot odor and is a result of actions of the bacteria Staphylococcus epidermidis which is also present in several strong cheese types.

Other implicated micro-organisms include Micrococcaceae, Corynebacterium and Pityrosporum.

Bart Knols, of Wageningen Agricultural University, the Netherlands, received an “IG Nobel” prize in 2006 for showing that the female malaria mosquito Anopheles gambiae “is attracted equally to the smell of limburger cheese and to the smell of human feet”. Fredros Okumu, of Ifakara Health Institute in Tanzania, received grants in 2009 and 2011 to develop mosquito attractants and traps to combat malaria. He uses a blend of eight chemicals, which is four times more effective than an actual human.

Causes;
The feet and hands contain more sweat glands than any other part of the body, with roughly 3,000 glands per square inch. Smelly feet are not only embarrassing, but can be physically uncomfortable as well.

Feet smell for two reasons: 1) shoe wear, and 2) sweating of the feet. The interaction between the perspiration and the bacteria that thrive in shoes and socks generates the odor.

Smelly feet or excessive sweating can also be caused by an inherited condition, called hyperhidrosis, which primarily affects men. Stress, some medications, fluid intake, and hormonal changes also can increase the amount of perspiration our bodies produce.

The main cause is foot sweat. Sweat itself is odorless, but it creates a beneficial environment for certain bacteria to grow and produce bad-smelling substances. These bacteria are naturally present on our skin as part of the human flora. Therefore, more smell is created with factors causing more sweating, such as wearing shoes and/or socks with inadequate air ventilation for many hours. Hair on the feet, especially on the toes, may contribute to the odor’s intensity by adding increased surface area in which the bacteria can thrive.

Given that socks directly contact the feet, their composition can have an impact on foot odor. Polyester and nylon are common materials used to make socks, but provide less ventilation than cotton or wool do when used for the same purpose. Wearing polyester or nylon socks may increase perspiration and therefore may intensify foot odor.[1] Because socks absorb varying amounts of perspiration from feet, wearing shoes without socks may increase the amount of perspiration contacting feet and thereby increase bacterial activities that cause odor

Treatments:
The best home remedy for foot odor is to soak feet in strong black tea for 30 minutes a day for a week. The acid in the tea kills the bacteria and closes the pores, keeping your feet dry longer. Use two tea bags per pint of water. Boil for 15 minutes, then add two quarts of cool water. Soak your feet in the cool solution. Alternately, you can soak your feet in a solution of one part vinegar and two parts water.

Persistent foot odor can indicate a low-grade infection or a severe case of hereditary sweating. In these cases, a prescription ointment may be required to treat the problem.

Treating Excessive Sweating:
A form of electrolysis, called iontophoresis, has been shown to reduce excessive sweating of the feet. However, it is more difficult to administer. In the worst cases of hyperhidrosis, a surgeon can cut the nerve that controls sweating. Recent advances in technology have made this surgery much safer, but may increase sweating in other areas of the body.

Prevention:
Methods of extinguishment may be used even before onset of the odor as prevention. However, a very effective and cheap way to prevent foot odor is with sodium bicarbonate (a mildly basic white salt also known as baking soda, bread soda, cooking soda, bicarbonate of soda, sodium bicarb, bicarb soda, or simply bicarb). Sodium bicarbonate

will create a hostile environment unsuitable for the bacteria responsible for the bad smell. Four pinches of it on each foot everyday are usually enough (two inside the sock and two on the insole of the shoe). Sometimes it might take one or two days before the shoes completely lose their old smell. Washing your feet and applying the sodium bicarbonate daily are also potentially useful solutions.

While there are a number of other remedies, sodium bicarbonate, if bought in a supermarket, costs approximately 20 times less than common odor-eaters or odor-killer powders.

Swabbing feet twice daily with isopropyl alcohol, found at your local drug store, for two weeks is a cheap and highly effective cure. One can also periodically remove their footwear, to reduce foot moisture and thereby reduce bacterial spawn.

Some types of powders and activated charcoal insoles, such as odor eaters, have been developed to prevent foot odor by keeping the feet dry. Special cedarsoles can be recommended for this purpose because of their antibacterial characteristics. Hygiene is considered important in avoiding odor, as is avoidance of synthetic shoes/socks, and rotation of the pairs of shoes worn

In general, smelly feet can be controlled with a few preventive measures:

•Always wear socks with closed shoes.
•Avoid wearing nylon socks or plastic shoes. Instead, wear shoes made of leather, canvas, mesh, or other materials that let your feet breathe.
•Bathe feet daily in lukewarm water, using a mild soap. Dry thoroughly.
•Change socks and shoes at least once a day.
•Check for fungal infections between toes and on the bottoms of your feet. If any redness or dry, patchy skin is observed, get treatment right away.
•Don’t wear the same pair of shoes two days in a row. If you frequently wear athletic shoes, alternate pairs so that the shoes can dry out. Give your shoes at least 24 hours to air out between wearings; if the odor doesn’t go away, discard the shoes.
•Dust your feet frequently with a nonmedicated baby powder or foot powder. Applying antibacterial ointment also may help.
•Practice good foot hygiene to keep bacteria levels at a minimum.
•Wear thick, soft socks to help draw moisture away from the feet. Cotton and other absorbent materials are best.

Extinguishment:

Once foot odor has begun, it can be extinguished, or at least alleviated, by either aromatic deodorants that neutralise the odor by their own smell, or by absorbers of the odor itself.

Among the earliest foot deodorants were aromatic herbs such as allspice, which nineteenth-century Russian soldiers would put in their boots.

Odor absorbers include activated charcoal foot insert wafers, such as Innofresh footwear odor absorbers.

General Tips: To tackle this problem, wash your feet with an antibacterial soap such as Neko and use a fresh pair of cotton socks daily. You can also apply deodorant to the soles of your feet. The best thing would be to buy another pair of work shoes and alternate wearing the two pairs so that the shoes have time to dry out.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Foot_odor
http://www.wolfpodiatry.com/library/1932/SmellyFeetandFootOdor.html

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Ingrown Nails

Onychocryptosis, commonly known as ingrown nails (unguis incarnatus) or ingrowing nails, is a common form of nail disease. It is a painful condition in which the nail grows or cuts into one or both sides of the nail bed. While ingrown nails can occur in both the nails of the hand and feet, they occur most commonly with toenails.

Ingrown nail

Causes
Causes include:

  1. poor maintenance, like cutting the nail too short, rounded off at the tip or peeled off at the edges (versus being cut straight across), is likely to cause ingrowth;
  2. ill-fitting shoes, like those that are too narrow or too short, can cause bunching of the toes in the developmental stages of the foot (frequently in the under 21s), causing the nail to curl and dig into the skin;
  3. trauma to the nail plate or toe, such as can occur by stubbing the toenail, dropping things on the toe and ‘going through the end of your shoes’ in sports, can cause the flesh to become injured and the nail to grow irregularly and press into the flesh;
  4. predisposition, like abnormally shaped nail beds, nail deformities caused by diseases, and a genetic susceptibility to nail problems can mean a tendency to ingrowth.

Symptoms:
Symptoms of an ingrown nail include pain along the margins of the nail (caused by hypergranulation that occurs around the aforementioned region), worsening of pain when wearing shoes or other tight articles, and sensitivity to pressure of any kind, even that of light bedding. Bumping of an affected toe with objects can produce sharp, even excruciating, pain as the tissue is punctured further by the ingrown nail. By the very nature of the condition, ingrown nails become easily infected unless special care is taken to treat the condition early on and keep the area as clean as possible. Signs of infection include redness and swelling of the area around the nail, drainage of pus and watery discharge tinged with blood. The main symptom is swelling at the base of the nail on whichever side (if not both sides) the ingrowing nail is forming.
Chronically ingrown toenail (that twice had failed wedge resections on both sides)
Treatment:

Treatment of ingrown nails ranges from soaking the afflicted area to surgery. The appropriate method is dictated by the severity of the condition. In nearly all cases, drainage of blood or watery discharge should mean a trip to the doctor, usually a podiatrist, a specialist trained explicitly to treat these conditions. Most practitioners agree that trying to outwait the condition is nearly always fruitless, as well as agonizing.
Alternative Medication:   Because of the possibility of serious complications, a physician should be consulted for treatment of severe and/or infected ingrown nails. Alternative treatments for treating ingrown nail include:

Ayurveda. Ayurvedic principles state that persons whose constitutions are dominated by vata and kapha have stronger nails and are prone to ingrown nails. Ingrown nails are treated with warm water soaks followed by application of a solution of equal parts tea tree and neem oils under the nails.

Herbal therapy. When an ingrown nail is forming, the toe should be soaked for 15-30 minutes in five drops each of hypericum and calendula tinctures diluted in 1/2 pint of warm water. Afterward, the toe should be wrapped in linen, placing it between the fold and the nail.

Homeopathy. Preparations of Hepar sulph or Silica in 6c potency may be taken every 12 hours for two weeks, to reduce the inflammation around the nail.

Hydrotherapy. To treat ingrown nail, the patient should soak the foot in hot, soapy water for 20 minutes, trim the nail square, wrap the toe in a hot compress, and cover it with a dry cloth overnight. In the morning, the patient should trim the nail into a U shape and place a bit of cotton between the nail and the fold. The cotton should be kept in place until the nail grows out.

Massage. If an ingrown nail is developing the patient should push the skin away from the nail. Repeated massage of the overgrown lateral nail folds can reduce pain and separate the fold away from the nail.

Home care:
In mild cases (not including the severe cases in the photos above), doctors recommend daily soaking of the afflicted digit in a mixture of warm water and Epsom salts and applying an over-the-counter antiseptic. This might allow the nail to grow out so it may be trimmed properly and the flesh to heal. A simple yet extremely painful procedure for mild ingrowth (i.e., where infection is absent) requires small scissors to trim the nail completely along the nail margin down to the lateral base. This hopefully allows the embedded piece of nail to be pushed back and out from the toe tissue. Note that infection may be somewhat difficult to prevent in cleaning and treating ingrown nails owing to the warm, dark, and damp environment in shoes. Peroxide is immediately effective to help clean minor infections but iodine is more effective in the long term as it continues to prevent bacterial growth even after it is dry. [N.B.: Iodine should not be used on deep wounds. In such cases a physician or podiatrist should be consulted.] Also, bandages can help keep out bacteria but one should never apply any of the new types of spray-on bandages to ingrown nails that show any discharge – preventing drainage will likely cause intense swelling and pain.

It is also advisable to walk around barefoot so that air has a chance to circulate. Infections often become more painful when they are not exposed to air because bacteria grows more quickly in warmer conditions eg. when the foot is impacted tightly in a shoe.

These home remedies are, in serious cases, ineffective:
when the flesh is far too swollen and infected, it will not allow for these procedures to work. Thus, these more severe cases, such as when the area around the nail becomes infected or the nail will not grow back properly, must be treated by a professional and the patient should avoid repeated attempts at this type of ‘bathroom surgery.

Phenolisation:
Following injection of a local anaesthetic at the basis of the toenail and perhaps application of a tourniquet, the surgeon will remove (ablate) the edge of the nail growing into the flesh and destroy the matrix area with phenol to permanently and selectively ablate the matrix that is manufacturing the ingrown portion of the nail (i.e., the nail margin). This is known as a partial matrixectomy, phenolisation, phenol avulsion or partial nail avulsion with matrix phenolisation. Also, any infection is surgically drained. After this date, other suggestions on aftercare will be made, such as salt water bathing of the digit in question. The point of the procedure is that the nail does not grow back where the matrix has been cauterized and so the chances of further ingrowth are very low. The nail is slightly (usually one millimeter or so) narrower than prior to the procedure and is barely noticeable one year later. The surgery is advantageous because it can be performed in the doctor’s office under local anesthesia with minimal pain following the intervention. Also, there is no visible scar on the surgery site and a nominal chance of recurrence. The procedure will fail in about 2 to 3 times out of a hundred.

Wedge Resection
Partial removal of the nail or an offending piece of nail. More complex than a complete nail avulsion (removal).

Here, the digit is first injected with a common local anesthetic. When the area is numb, the physician will perform an onychotomy in which the nail along the edge that is growing into the skin is cut away (ablated) and the offending piece of nail is pulled out. Any infection is surgically drained. This process is referred to as a “wedge resection” or simple surgical ablation and is non-permanent (i.e., the nail will re-grow from the matrix). The entire procedure may be performed in a physician’s office and takes approximately thirty to forty-five minutes depending on the extent of the problem. The patient is allowed to go home immediately and the recovery time is anywhere from a few days to a week barring any complications such as infection. As a followup, a physician may prescribe an oral or topical antibiotic or a special soak to be used for approximately a week after the surgery……....click  & see 
A resected wedge from the left side of the left big toe, shown to scale.

It should be noted that some physicians will not perform a complete nail avulsion (removal) under any but the most extreme circumstances. In most cases, these physicians will remove both sides of a toenail (even if one side is not currently ingrown) and coat the nail matrix on both of those sides with a chemical or acid (usually phenol) to prevent re-growth. This leaves the majority of the nail intact, but ensures that the problem of ingrowth will not re-occur.

Disadvantages: If the nail matrix is not coated with the applicable chemical or acid (phenol) and is allowed to re-grow, this method is prone to failure. Also, the underlying condition can still become symptomatic as the nail grows out over the course of up to a year: the nail matrix might be manufacturing a nail that is simply too curved, thick, wide or otherwise irregular to allow for normal growth. Furthermore, the flesh can be injured very easily by concussion, tight socks, quick twisting motions while walking or just the fact the nail is growing wrongly (likely too wide). This hypersensitivity to continued injury can mean chronic ingrowth; the solution is nearly always edge avulsion by the highly successful phenolisation.

CO2 Laser surgery

Following injection of a local anaesthetic at the basis of the toe and perhaps application of a small tourniquet, the surgeon will remove (ablate) the edge of the nail growing into the flesh and cauterize the matrix area by laser photocoagulation. This too is known as a partial matrixectomy or partial nail avulsion. Here too, the point of the procedure is that the nail does NOT grow back where the matrix has been cauterized and so the chances of further ingrowth is very low. The nail is slightly (usually one millimeter or so) narrower than prior to the procedure. Disadvantages: sutures are usually necessary, post-operative pain due to the wound and scar.
…………………………….Post-surgery toe with removed nail shard

Nail Avulsion (Removal)

While in some similar cases patients may wish to have the offending nail completely temporarily removed( Avulsion) , this procedure is not recommended by nail experts because the postoperative period is long and painful. Furthermore, complete removal of whole nail does not always prevent recurrences.In case of recurrence in spite of complete removal, and if the patient never feels any pain before inflammation occurs, the condition is more likely to be onychia which is often confused for an ingrown or ingrowing nail (onychocryptosis).

Complete removal of whole nail is a simple procedure. Here, anaesthetic is injected, the nail is removed quickly and painlessly and the patient can leave immediately. The entire procedure can be performed in around 10 minutes and is much less complex than a “wedge resection” as above. Note that the nail will grow back. However, in most cases it will cause further problems as it can become ingrown very easily as the nail grows outward. It can become easily injured by concussion and in some cases grows back too thick, too wide or deformed. This procedure can thus result in chronic ingrown nails and is therefore considered a generally unsuccessful solution, especially considering the pain involved.

Accordingly, in some cases as determined by a doctor, the nail matrix is coated with a chemical (usually phenol) so none of the nail will ever grow back. This is known as a permanent or full nail avulsion , or full matrixectomy, phenolisation, or full phenol avulsion . As can be seen in the images below, the nail-less toe looks much like a normal toe and fake nails or nail varnish can still be applied to the area.


If left untreated:

If an ingrown nail is left untreated, there exists a high risk of dangerous infection. When the skin around the nail gets infected, it begins to swell up and put even more pressure against the nail. Ingrown nails can produce a spear shaped wedge of nail on the lateral side of the toe which will progressively become more embedded into the toe tissue as the nail grows forward. In the worst case, the swelling will begin putting sideways pressure on the nail, causing it to grow at a slant. This will cause both sides of the nail to eventually become ingrown and swollen. Eventually the swollen parts of the skin will begin to harden and fold over the nail. An untreated ingrown toenail will cause a person to walk with a limp, which over a long period of time may cause further pain and injury to the foot, leg and back owing to improper distribution of weight. Other non-direct effects of seriously ingrown nails include lack of exercise, constant and unrelenting pain and pressure, the spread of infection, loss of appetite, inability to move around, and psychological effects (like anxiety, stress and feelings of despair). Amputation of the toe, foot or leg may be the final outcome if the infection is left untreated long enough for gangrene to set in. An untreated infection may also lead to a condition known as osteomyelitis, where the infection spreads to the bone of the infected digit. Once in the bone, the infection is more difficult to remove and may require the intravenous treatment of antibiotics. One should always consult a doctor when infection is present.

Prevention:
The most common place for ingrown nails is in the big toe but ingrowth can occur on any nail. Ingrown nails can be avoided by cutting nails straight across; nails should not be cut along a curve, nor should they be cut too short. Footwear which is too small, either in size or width, or those with too shallow a ‘toe box’ will exacerbate any underlying problem with a toenail.

Ingrown toe nails can be caused by injury, commonly concussion where the flesh is pressed against the nail causing a small cut that swells. Also, injury to the nail can cause it to grow abnormally, making it thicker or wider than normal or even bulged or crooked. Stubbing the toenail, dropping things on the toe and ‘going through the end of your shoes’ in sports are common injuries to the digits. Injuries to the toes can be prevented by wearing shoes most of the time, especially when working or playing.

One myth is that a V should be cut in the end of the ingrown nail; this myth is untrue. The reasoning of the myth is that if one cuts a V in the nail, the edge of the nail will grow together as the nail grows out. This does not happen – the shape of the nail is determined by the growing area at the base of the toe and not by the end of the nail. {(fACT: http://www.footphysicians.com/footankleinfo/ingrown-toenail.htm DATE: September 21, 2007}}

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://findarticles.com/p/articles/mi_g2603/is_0004/ai_2603000454
http://en.wikipedia.org/wiki/Ingrown_nail