Services at Dulwich Podiatry Limited
We offer a full range of Podiatric treatments, click a link to skip to that section:
- Corns and Calluses
- Nail Surgery
- Prosthetic Toenails
- Verrucae Removal
- Verruca Needling
- Laser Therapy
- Soft Tissue and Sports Injuries
Corns and Calluses
Corns and calluses occur as a reaction of the skin to the pressures on it. Sometimes this is pressure from shoes, sometimes there is a structural or functional cause. Corns and calluses can be painlessly removed. More importantly, the Podiatrist can give advice or provide treatment to target the cause and aim to prevent further recurrence.
Ingrowing toenails can occur when a nail has been damaged or is deformed. The nail grows into the skin causing pain and sometimes leading to infection. This condition can be treated conservatively, but surgery may be necessary to prevent recurrence. Surgery is performed under local anaesthesia. Usually only part of the offending nail is removed, although it is possible to remove the whole nail if it is very deformed.
Fungal, broken or damaged nails can be rebuilt using an acrylester resin from Wilde-Pedique. The prosthetic nail is attached to any remaining nail and has the look of a healthy nail which then grows with the natural nail. Total nail prosthetics are also possible, although these may need to be held in place with a surgical glue.
Verrucae are caused by a viral infection. In most cases the verruca is painless and, given time, will resolve without treatment. Painful or spreading verrucae can however cause distress. A wide range of verrucae treatments are available including Cryosurgery (freezing), traditional acid treatments, herbal remedies, low level laser therapy and surgical removal.The treatment of choice will depend on a variety of factors and the options are discussed in detail to enable an informed choice.
Verruca needling is a highly effective treatment for stubborn and recurrent verrucae. It works by disrupting each individual papilli in the verruca and creating a portal from the viral tissue to the adipose tissue, allowing the immune system to attack the lesion directly. In this way treating a single lesion (usually the ‘mother’ lesion) can cause spontaneous remission satellite lesions. The procedure is carried out under local aesthetic and most people report only minor soreness for a few days.
Verruca needling has been around for 40 years. It was first described in America in 1969 and is used routinely in the United States. It has only recently crossed the water, which is why its use as a treatment modality is still uncommon in this country.
Low Level Laser Therapy can be used as an adjunct to the treatment of a variety of conditions including plantar fasciitis, tendonitis and other soft tissue injuries, diabetic ulceration, verrucae and can also be used to increase healing times following nail surgery.
Wavelengths of light stimulate the body’s healing cells, helping the body to heal itself. Treatment is painless; low level lasers do not cut or burn nor harm the skin. Treatment has no side effects although there are some contra-indications to this form of therapy.
Soft Tissue and Sports Injuries
There are numerous injuries that occur as a result of keeping fit. These can include muscle sprains, tendon and ligament problems and in rare cases, fractures. It is best to get the problem assessed in its early stages rather than trying to ignore it and carry on. This will generally allow for a speedier recovery and resumption of activity.
Particular foot types may be more prone to injury and may benefit from the prescription of orthoses (see below).
Podiatric Acupuncture is a quick, safe and effective way of relieving foot and joint pain, as well as being an alternative holistic treatment for veruccae. Sterile acupuncture needles are used and manipulated in the various trigger/pressure points found in the foot to aid recovery and provide relief. The needles stimulate the release of natural painkillers called endorphins, which help relieve the discomfort associated with painful disorders. The process also reduces inflammation around the affected structure. Acupuncture can be used to reduce painful symptoms associated with below knee and foot conditions such as Morton’s Neuroma, Plantar Fasciitis, Achilles Tendonitis, Calf pain, Bunion pain and Hallux Limitis/Hallux Rigidus. The number of treatments required varies from patient to patient. At your acupuncture consultation the Podiatrist will advise you on the treatment regime specific to your condition.
Biomechanics and Orthoses
A biomechanical examination is used to assess foot and lower limb function. Foot pain can be caused by poor foot posture or other structural problems. Common problems include heel pain, pain in the ball of the foot (metatarsalgia) and flat feet. If the foot is hypermobile or out of alignment it can result in pain or injury in the foot/knee/hip/lower back.
Orthoses are 3-Dimensional insoles that control the way the foot functions therefore keeping it in better alignment. These may be issued ‘off the shelf’ with a generic prescription or custom made to fit and correct the foot more accurately.
People diagnosed with diabetes can develop foot complications including loss of sensation in the feet. This can result in damage that you may be unaware of eg. standing on a sharp object or a toenail digging in. People with diabetes should have annual foot assessments to monitor any loss of sensation. Numb feet should be always protected and checked regularly for damage.
Diabetes can also affect the blood supply to the feet, causing a delay in the healing of any wound and increasing the risk of infection. The circulation to the feet is also checked during a diabetic foot assessment.
Foot Health Checks
Healthy feet are essential to keep you mobile and it is a good idea to have an annual foot check, just as you would regularly have your teeth checked, to ensure they are in good shape. People with diabetes in particular should ensure their feet are checked annually as problems may occur undetected.
Athlete’s foot is caused by a fungal infection and is characterized by itching, cracked or peeling skin. Although it is frequently found between the toes it can also occur on dry skin elsewhere on the foot.
Athlete’s foot is usually treated with antifungal creams or sprays. If left untreated the fungus can spread to the toenails. It is important that hosiery and footwear are also treated to prevent re-infection.
Fungal toenail infections
Fungal infections in the toenails often occur with Athlete’s foot, but can occur on its own. The toenails become thick and discoloured. This infection can be difficult to treat, especially if the nail bed is involved.
There are a number of ways this infection can be treated: oral medication, application of a topical anti-fungal or through intensive light therapy (eg. PACT). Regular thinning of the nail plate increases the effectiveness of the treatment.
Photodynamic Therapy for Fungal Toenails (PACT)
Photodynamic therapy has been used in medicine since the 1990’s. A photo-sensitizing gel is put on the affected area and is activated by exposure to light, destroying only the diseased cell. Unlike human cells, fungi possess a cell wall which can be stained with a sensitising dye which is harmless to human cells but makes the fungi sensitive to a specific wavelength of light, destroying it.
Not every case of nail discoloration is caused by a fungal infection. Trauma, psoriasis and other conditions can cause similar symptoms. Likewise, long term infection can damage the nail bed, causing the nail to regrow thickened or discoloured. It is important to be clear whether a fungus is present in the nail, prior to commencing treatment.