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  • NAILS

    Nail Fungus:
    A fungus is an organism that lives in warm moist areas. Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older.
    Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail.
    Many people have difficulty with their toenails and need assistance in caring for them. A foot and ankle surgeon can diagnose the cause of toenail problems and recommend treatments.

    Treatment:
    Topical antifungals need to be applied around the cuticles and skin. Before the application, clean under your nails with a toothbrush to loosen as much debris as possible. Gently clean with Peroxide first, then mild soap and water. Oral antifungal treatments benefit from a daily clean routine.

    Medicare Coverage and Your Nails
    Medicare coverage can often be confusing. The rules and regulations can easily be misunderstood by patients. One misconception is that Medicare covers only surgical procedures, and not medical care or routine foot care.

    In truth, Medicare will cover routine foot care under certain conditions. According to the Medicare Rules and Regulations Manual, "Certain foot care procedures that are generally considered to be routine -- e.g., cutting or removal of nails, calluses or corns -- may pose a hazard when performed by a nonprofessional person on patients with a systemic condition that has resulted in severe circulatory problems or areas of desensitization in the legs or feet. Routine foot care performed under these circumstances is covered."

    The manual also states, without certain co-conditions, routine foot care “services are not covered, no matter whether they are performed by podiatrists, medical doctors, or osteopaths. They are:
    1. Routine foot care. This includes the cutting or removal of corns or calluses, trimming of nails, and routine hygenic care, except as noted above.
    2. Treatment of flat-foot conditions, including arch supports.
    3. Treatment of partial dislocations.

    For our patients that do not qualify for Medicare coverage we have a self-pay price for routine nail care $35.00. Sometimes, this service is cheaper than the Medicare Replacement's Co-pay. Speak with our office coordinator.

    Nail Care:
    Discontinue harsh nail products; switch to gentle or children’s nail polish. Non-acetone nail polish removers should only be used, because they may dry the nails and surrounding tissue. Daily supplement with Biotin. Allow nine months to see results. Like your skin, nails can get overly dry or “waterlogged.” Use common sense as far as water exposure.
    Moisturizers are beneficial as well as nail conditioners. Do not remove your cuticles - push them back. Make sure your nail instruments are sanitary. Consider buying your own.
    After a manicure or pedicure, ask your salon to apply sunscreen to prevent sun damage and nail polish from fading. Allow nails to rest one to three months per year from cosmetic procedures such as over grooming, press-on nails, acrylic nail sculptures, and adornments.

    What Is an Ingrown Toenail?
    Ingrown nail
    When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.
    If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.
    Physician care:
    After examining the toe, Dr. Pulapaka will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.
    Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. After applying a local anesthetic, the doctor removes part of the nail’s side border. Some nails may become ingrown again, requiring removal of the nail root.
    Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If Dr. Pulapaka has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved. Please see our soaking instructions.
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