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Dr. Horlebein will be joining Advanced Regional Ankle & Foot Care LLC as a full time physician in Altoona PA, as of June 1st 2023. Feel free to call our office with any scheduling inquires/questions!

September 2021

Wednesday, 29 September 2021 00:00

Treating Toenail Fungus

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

Wednesday, 29 September 2021 00:00

Who Should I See To Treat Toenail Fungus?

Your podiatrist can help you take care of not only your feet and ankles, but also your toenails. One very common condition that podiatrists treat are fungal toenail infections. These infections often start as athlete’s foot, a skin infection, before spreading to the toenails, although they can also occur on just the nails. Symptoms of toenail fungus include changes in the texture, color, and shape of the nail. The nail may become crumbly, brittle, or thickened and develop yellow, white, or brown spots. In more severe cases, the nail can change shape, separate from the nail bed, emit a foul odor, and make wearing shoes uncomfortable. If you have toenail fungus, and particularly if you have toenail fungus and diabetes, it is suggested that you see a podiatrist for treatment.

If left untreated, toenail fungus may spread to other toenails, skin, or even fingernails. If you suspect you have toenail fungus it is important to seek treatment right away. For more information about treatment, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

Symptoms

  • Warped or oddly shaped nails
  • Yellowish nails
  • Loose/separated nail
  • Buildup of bits and pieces of nail fragments under the nail
  • Brittle, broken, thickened nail

Treatment

If self-care strategies and over-the-counter medications does not help your fungus, your podiatrist may give you a prescription drug instead. Even if you find relief from your toenail fungus symptoms, you may experience a repeat infection in the future.

Prevention

In order to prevent getting toenail fungus in the future, you should always make sure to wash your feet with soap and water. After washing, it is important to dry your feet thoroughly especially in between the toes. When trimming your toenails, be sure to trim straight across instead of in a rounded shape. It is crucial not to cover up discolored nails with nail polish because that will prevent your nail from being able to “breathe”.

In some cases, surgical procedure may be needed to remove the toenail fungus. Consult with your podiatrist about the best treatment options for your case of toenail fungus.  

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

 

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Tuesday, 21 September 2021 00:00

Everything You Need to Know About Corns

Corns are hard and thick areas of skin that form as a result of constant rubbing, friction, or pressure on the skin. They are patches of dead skin with a small plug toward the center. They may appear on the tops and sides of toes and can make walking painful.

Soft corns are typically thinner with a white color and rubbery texture. Soft corns tend to appear between the toes. Seed corns are another type of corn that appear in clusters and can be tender if they are on a weight-bearing part of the foot. Seed corns usually appear on the bottom of the foot and are likely caused by a blockage in sweat ducts.

While corns and calluses are somewhat similar, calluses are a bit different. Calluses are a patch of dead skin that can occur anywhere on the body. In comparison to corns, calluses are usually a bit larger in size. However, both corns and calluses are caused by increased friction on the skin.

There are some risk factors that may increase your chances of developing corns and calluses. If you have bunions, hammertoe, or a bone spur, you are more likely to develop a corn or callus on your foot.

While Corns and Calluses tend to disappear when the friction to the affected area ceases, the help of a podiatrist may be useful in the removal process. It is important to remove the dead skin around the area and this may be done in a few different ways. Moisturizing creams may be helpful in softening and removing the dead skin around the callus. You should never use razors or other pedicure equipment to remove your corns. Doing this may worsen your corn or callus and cause infection. 

In some cases, corns and calluses may be caused by abnormal foot structure or walking motion. In such a case, you should seek a podiatrist’s assistance in order to correct the issue.

Tuesday, 21 September 2021 00:00

Treatments for Foot Corns

A corn is a small area of thick, raised, and sometimes hardened skin that forms on the foot in response to friction and pressure. Corns can be uncomfortable and painful. Various methods are used to treat corns. At home, rubbing the corn with a pumice stone after a foot soak, using moisturizers to soften the skin, and wearing wider, more comfortable and supportive shoes or orthotic inserts can help ease the pain of a corn. If corns do not respond to home treatments, your podiatrist can help by trimming or pairing down the corn, or applying a chemical to peel away the dead skin and soften the corn. If the area around a corn becomes infected, your podiatrist can prescribe antibiotics to treat the infection. Corns that are caused by foot deformities, like bunions, can be prevented by surgically correcting the deformity. To learn more about how to care for foot corns, please consult with a podiatrist. 

Corns can make walking very painful and should be treated immediately. If you have questions regarding your feet and ankles, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

Corns: What Are They? And How Do You Get Rid of Them?
Corns are thickened areas on the skin that can become painful. They are caused by excessive pressure and friction on the skin. Corns press into the deeper layers of the skin and are usually round in shape.

Ways to Prevent Corns
There are many ways to get rid of painful corns such as:

  • Wearing properly fitting shoes that have been measured by a professional
  • Wearing shoes that are not sharply pointed or have high heels
  • Wearing only shoes that offer support

Treating Corns

Although most corns slowly disappear when the friction or pressure stops, this isn’t always the case. Consult with your podiatrist to determine the best treatment option for your case of corns.

If you have any questions please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Everything You Need to Know About Corns
Tuesday, 14 September 2021 00:00

Diabetic Foot Care

Diabetes affects millions of people every year. Blood vessels located all over the body are damaged due to diabetes—even the blood vessels of the feet. Neuropathy, or nerve damage, can result from slower blood flow in the legs and feet. In diabetic patients, neuropathy is very important to monitor, as diabetics are at risk for developing ulcers.

Always washing and thoroughly drying the feet are pertinent parts of diabetic foot care. There should be a focus on cleaning between the toes. Even if no pain is felt, the entire foot should be examined for redness and sores. Neuropathy can often mask the pain of sores and ulcers and can cause these conditions to be overlooked. Use a mirror to examine the underside of your feet if needed. It is recommended that diabetics wear well-fitting socks.

Patients with diabetes should have their doctor monitor their blood levels because blood sugar levels play a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised. It is very important to keep your blood sugar levels in the normal range, which can be determined by your physician. There are medications that may be prescribed to help with any neuropathy experienced by the diabetic patient. It is also advisable to visit a podiatrist if one is experiencing any conditions involving the feet, such as ingrown toenails, which in more severe cases can cause infection.

Diabetic feet must be inspected daily. Diabetic foot care at home is possible if a patient is provided with instructions from their podiatrist. Patients can relieve dry heels with creams or ointments. Suspected wounds should warrant an immediate call to the podiatrist. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation in its worst cases. Early treatment and daily inspection of diabetic feet are keys to staying healthy.

Tuesday, 14 September 2021 00:00

Proper Foot Care for Diabetic Feet

Diabetic patients are often aware of the link between foot problems and how their diabetes is managed. Complications can include a numbing sensation or tingling in the feet which may be the beginning of diabetic neuropathy. It may cause the inability to feel existing cuts, wounds, or bruises. If these ailments are left untreated, a diabetic ulcer may form, which may lead to amputation. Additionally, foot muscles may be affected in severely diabetic patients, which may change the alignment of the foot. Proper foot care management can begin with monitoring the glucose levels in the blood. A daily practice of good foot hygiene can consist of washing and drying the feet thoroughly, and special footwear may need to be worn. If you have diabetes, it is strongly suggested that you are under the care of a podiatrist who can help you to properly manage this condition, in addition to providing you with proper foot care advice.

Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other concerns about your feet, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

Diabetic Foot Care

Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.

The Importance of Caring for Your Feet

  • Routinely inspect your feet for bruises or sores.
  • Wear socks that fit your feet comfortably.
  • Wear comfortable shoes that provide adequate support.

Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.

It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.

If you have any questions please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Diabetic Foot Care
Monday, 13 September 2021 00:00

Are You Suffering From Ingrown Toenails?

If left untreated, an ingrown toenail can lead to more serious concerns, such as an infection. Knowing proper nail care can help in the prevention of an ingrown toenail. Give us a call, and get treated!

Tuesday, 07 September 2021 00:00

Solutions for Cracked Heels

Cracked heels can make life very frustrating and embarrassing when displaying the bare feet. Aside from being unpleasing to the eye, they can also tear stockings and socks and wear out shoes at a faster rate. When severe, cracked heels may cause pain or infection.

Cracked heels are a problem for those who are athletic, those who may walk a lot, and those who have especially dry skin. Those who use medication that dry the skin, those who swim often, wearing certain types of shoes, and those who are diabetic may have trouble with cracked heels. Seniors whose skin produces less oil may also have trouble with cracked feet. There is no one way to develop cracked feet, and there is no cure.

Today, the market consists of numerous products that have a variety of ingredients to promote healing. Some of these are over-the-counter. Others are prescribed by a doctor, especially for those who have chronic dry feet and heels.

Some doctors recommend wearing socks at night for those with rough skin. This helps further healing, and helps creams stay on longer and better absorb into the skin.

One way to alleviate dryness that causes cracked heels is by using moisturizers both day and night. Another way is to make sure the skin is clean and dry at all times. Using a pumice stone to buff away dead skin before putting on moisturizer can also help. Cracked heels will not respond to the cream unless the outer layer of skin is first removed through exfoliation. After exfoliation, lotion or ointment will be absorbed by the skin more easily.

Foods that produce healing and balance can also help the skin from within. Everything that is put into the body can either help it or hurt it. Taking supplements of omega-3 fatty acids and zinc can also be very beneficial.

Nevertheless, not all products are guaranteed to help treat cracked feet. Seeing a professional is best if other treatments options were unsuccessful. A podiatrist should be able to give the best advice to help with this problem.

There are two layers of skin that are called the dermis and epidermis. The latter is the outermost layer, and is where cracked skin often develops. Heel fissures is the medical name for cracked heels, which can come from standing on hard surfaces for the majority of the day. Additionally, wearing shoes that do not fit correctly may cause this condition to occur, and this can include wearing shoes that have an open back. There are medical conditions that may lead to cracked heels, such as diabetes, psoriasis and eczema. Patients have found mild relief when the feet are washed and thoroughly dried, followed by applying a good moisturizer to them. If you have cracked heels, it is suggested that you consult with a podiatrist who can effectively treat this ailment, and advise you on proper foot care techniques.

If the skin on your feet starts to crack, you may want to see a podiatrist to find treatment. If you have any concerns, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

Cracked Heels

It is important to moisturize your cracked heels in order to prevent pain, bleeding, and infection. The reason cracked heels form is because the skin on the foot is too dry to support the immense pressure placed on them. When the foot expands, the dry skin on the foot begins to split.

Ways to Help Heal Them

  • Invest in a good foot cream
  • Try Using Petroleum Jelly
  • Ease up on Soaps
  • Drink Plenty of Water

Ways to Prevent Cracked Heels

  • Moisturize After Showering
  • Skip a Shower
  • Keep Shower Water Lukewarm
  • Don’t Scrub Your Feet

If you are unsure how to proceed in treating cracked heels, seek guidance from a podiatrist. Your doctor will help you with any questions or information you may need. 

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Solutions for Cracked Heels
Wednesday, 01 September 2021 00:00

Ingrown Toenail Care

An ingrown toenail is a nail that has curved downward and grows into the skin.  This typically occurs at the nail borders, or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and gently massaging the side of the nail.  In most cases, however, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

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