January 24, 2018

First All-in-One Cosmetic/ Anti fungal Cream for Nail Health

Discolored, brittle, and thickened nails are often a sign of a fungal infection. This type of infection is referred to as Onychomycosis, and is difficult to get rid of. Typically patients will use generic over the counter anti-fungal creams until the fungus thickens and more advanced treatment options are needed. Most anti-fungal creams do a great job of riding the skin from infection; however they have trouble penetrating the hard nail surface. In a way, the fungus is protected by the nail, which is why it’s so pesky to get rid of. This is why many patients must use a combination of different treatments (creams, prescription oral medications, lasers, and surgery) to combat the infection.

A new treatment cream called Tolcylen is now available and addresses many of the aforementioned issues that accompany nail fungus. Tolcylen is a one of a kind cosmetic COMBINATION therapy that includes penetrating agents to help the medication go through the hard nail surface and more directly attack the fungus. The cream contains renewal agents that reduce discolored, thickened, and brittle nails. This means that it can be used to improve the general appearance of nails affected by most nail conditions (trauma, psoriasis, bacterial infections, etc.). The cream works fast and can be used as a preventative medication for those who are commonly exposed to fungal spores. Regular application of this cream will keep your nails looking beautiful, while helping to protect them from infection. For more information please schedule an appointment with Dr. Mark Forman.



January 15, 2018

Do You Have Athletes Foot?

We’ve all heard of athlete’s foot, but what about its scientific name: Tinea Pedis? Tinea Pedis is a rash on the skin of the foot, the most common fungal skin infection to be exact. The condition is caused by a fungus that grows on (or even in) the top layer of the skin. The fungi that causes Tinea Pedis grows in warm, wet places (like between the toes).

This condition spreads rather easily, it’s extremely contagious. Most likely, people receive athlete’s foot by walking barefoot on contaminated surfaces near communal swimming pools, showers, or gym locker rooms. If your shoes are air tight, the fungi will continue to grow.

Tinea Pedis can make your feet and the area between the toes incessantly burn and itch. The skin of those areas may peel and crack. There are three types of athlete’s foot, and the symptoms might vary depending on the type you have.

1. Toe web infection occurs usually between the fourth and the fifth toes, where the skin is scaly, peeling, and cracking.
2. Moccasin type infection will start with some foot soreness and then progress to thick and cracked skin on the bottom of the heal. In the worst cases, toenails can become infected and potentially fall out
3. Vesicular type infection begins with an abrupt outbreak of fluid-filled blisters under the skin of the bottom of the foot. This type of athlete’s foot also is also classified as a bacterial infection

If you experience any of these conditions, make an appointment with Dr. Forman to check your feet. If Dr. Forman concludes that you have athlete’s foot, he will give you a series of topicals to apply to the infected area that will decrease the infection. For bad cases, Dr. Forman may prescribe a pill to alleviate the condition. Your foot will also need to be kept in a clean and dry.

To prevent another infection, make sure to wear shower shoes in public places many people are barefoot, or use talcum powder to keep your feet dry. And make sure to wash your foot as to keep it clean. With these preventative methods, your risk of getting athlete’s foot will be extremely small.


January 8, 2018

5 Stretches to Prevent Foot Pain

Many patients who come in with foot pain don’t understand the importance of stretching their feet on a daily basis. Below are 5 stretches that can help keep your feet limber and prevent injury.

1. The Towel Stretch: On the floor with your legs straight out in front of you, take a dish towel and place it around your toes and pull the towel towards your head (gently, but hard enough to feel the stretch). Hold for about 15-30 seconds and let go. Repeat three times.
2. Towel Lifts: Sit in a chair and place a towel on the floor and lift the towel with your toes. For a challenge, try lifting it with your little toes. Repeat 5 times for each foot.
3. Step Stretch: Stand with your toes on a step of a staircase with your heels off the edge. Lower your heels down for about 10-15 seconds, and then lift to return to the starting position. Repeat 7 times.
4. The Toe Stretch: In a chair with your feet on the floor, spread your toes apart for a few seconds and then release. Repeat 10 times.
5. The Foot Roll: Take a golf ball (tennis balls and frozen water bottles work just as well) and roll it back and forth from your toes to your heels. Do this for a couple of minutes on each foot.


November 21, 2017

Tips to Prevent Falling with Age

As we age our likelihood of falling greatly increases. Many commonly prescribed medications and degeneration of our eyes and ears greatly contribute to instability later in life. How can you combat this issue?
The first thing to do is make sure you are wearing supportive shoes. Highly supportive, stability, shoes have posting within the inner sole that helps to control your gait and increase overall body stability. Some examples of good stability shoes are the Brooks Beast, Hoka Arahi, New Balance 860, Mizuno Horizon, and Merrells.

In addition to supportive shoes, braces such as the Moore Balance Brace, or a simple ankle-foot orthosis (AFO), will aid in stability and prevent falls. These braces assist your muscles and joints in holding your body upright, so that you can remain active. Both of these braces can be comfortably worn under pants and inside of shoes.
Getting a good pair of shoes and supportive braces will help you to safely stay active and reduce your risk of falling. Be proactive and stop by your local running store to pick up a pair of stability shoes. Also, don’t forget to ask your doctor about different bracing that will help keep you moving this holiday season!


November 15, 2017

Even Your Feet Can Get Skin Cancer

Skin cancer in the lower extremity may have a very different appearance from those arising on the rest of the body.  Podiatrists are uniquely trained as lower extremity specialists to recognize and treat abnormal conditions as they present themselves on the skin of the lower legs and feet.

Because of this, a podiatrist’s knowledge and clinical training is of extreme importance for patients in the early detection of both benign and malignant skin tumors. Some of the common attributes of cancerous lesions include:

  • Asymmetry – If divided in half, the sides will not match
  • Borders – They look scalloped, uneven or ragged
  • Color – They may have more than one color which may be unevenly distributed
  • Diameter – They can appear wider than a pencil eraser

For other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or donut shaped edges, or discrete scaly areas.  If you notice a mole, bump or patch on the skin of a friend or family member that meets any of these criteria, encourage them to see a podiatrist immediately.

What are the Types of Skin Cancer of the Feet?

Skin cancers of the feet have several features in common with most being painless and a history of recurrent cracking, bleeding, or ulceration.  Frequently individuals discover their skin cancer after unrelated ailments near the affected site.  Some of the most common cancers of the lower extremity are:

Basal Cell Carcinoma: Frequently seen on sun-exposed skin surfaces, and with feet being significantly less exposed to the sun, Basal cell carcinoma occurs there less often.  This form of skin cancer is one of the least aggressive cancers in the body.  It will cause local damage, but only rarely spreads beyond the skin.  Basal cell cancers may appear as pearly white bumps or patches which may ooze or crust being similar in appearance to an open sore.  On the skin of the lower legs and feet, basal cell cancers often resemble non-cancerous skin tumors or benign ulcers.

Squamous Cell Carcinoma: This is the most common form of cancer on the skin of feet and is most often confined to the skin and do not spread, similar to basal cell carcinoma.  When advanced, some can become more aggressive and spread throughout the body.  It is important to bring attention to any new developments on your feet to your podiatrist for early diagnosis. Squamous cell carcinoma often begins as a small scaly bump or plaque, which may appear inflamed.  Sometimes there is a history of recurrent cracking or bleeding as well.  Occasionally they begin as a hard projecting callus-like lesion.  Though painless, squamous cell carcinoma may be itchy.  It may also resemble a plantar wart, a fungal infection, eczema, an ulcer, or other common dermatological conditions of the foot.

Malignant Melanoma: This is one of the deadliest skin cancers known and nonsurgical treatments are rarely effective, remaining experimental.  This type of skin cancer must be detected very early to ensure patient survival.  Melanomas may occur on the skin of the feet and on occasion beneath a toenail.  They are found both on the soles and on the tops of your feet.  As a melanoma grows and extends deeper into the skin, it becomes more serious and may spread throughout the body through the lymphatics and blood vessels.

Prevention is Key

The best way to prevent skin cancer is to avoid sunbathing and tanning salons.  Sunscreen should be used frequently and before any prolonged exposure to the sun.  All skin lesions should be checked and if changes are detected in a mole or skin lesion, if you are even mildly suspicious about the appearance of one, you should contact your podiatrist immediately.

People who have had melanoma once are at an increased risk for developing it again.  You should watch your skin carefully and take note of any unusual marks or moles, especially ones that change in shape, size, or color.  Protecting your skin from additional sun damage is very important, as well as scheduling an appointment with your podiatrist.


November 8, 2017

What should you eat after surgery?

Recovering from surgery can be long and grueling. An often overlooked aspect of recovery is diet. Eating the right foods will not only make the recovery process more tolerable, but help to decrease overall recovery time. What exactly should you eat?

Lean Proteins
Lean proteins, such as eggs, fish, turkey, and legumes, will help to provide the body with the amino acids necessary for cell regeneration. Essentially, these types of proteins will help to effectively knot the body’s tissues back together.

Fiber and Magnesium
Many people face digestive upset and constipation after surgery. This is often due to medications prescribed after their operation (antibiotics and pain medication). Eating foods high in fiber, such as prunes, beans, oatmeal, and bran flakes will increase the ease of bowel movements. Additionally, a simple over the counter magnesium supplement will help to induce regular bowel movements.

Dairy Products
Antibiotics are typically prescribed after surgery, as these help to prevent infection. However, they do kill beneficial bacteria in your gut. Eating foods such as yogurt, cheese, and kefir will help restore this bacteria and improve immune function.

Vitamins A,C,D, and E
Vitamin A (dark green and orange vegetables) and Vitamin C (citrus fruits, berries, bell peppers) help the body’s ability to heal wounds. Vitamin D (fish, orange juice, sunlight exposure) is essential for bone growth and repair. Vitamin E (vegetable oils, nuts, milk, and eggs) protects the body from damaging free radicals. Increasing your daily intake of these vitamins will improve your body’s ability to absorb important nutrients

Water is essential for the body’s ability to process waste. Increasing water consumption will help reduce many common post surgical symptoms (nausea, constipation, etc.). A minimum of eight glasses per day is recommended.


October 16, 2017

You change as you age, but so do your feet

If you want to age gracefully, it is also important to maintain foot health in order to help you properly move about.  Mobility is important for gaining the independence that is needed to help our aging population remain active and healthy.  Foot ailments make it difficult and sometimes impossible to work or participate in social activities.  Just as you need to prepare a newborn’s health by visiting doctors, you need to maintain proper foot health to prevent various foot ailments that could disrupt your life.

Foot problems can be prevented

There are more than 300 different foot ailments and some can even be traced back to heredity, with the majority of foot pain being treated by your podiatrist to eliminate any problems.  For the aging population, most of these foot ailments stem from the cumulative years of neglect or abuse, but even people in their retirement years, foot problems can be treated successfully, and pain relieved.

As a person ages, their feet tend to spread and lose the fatty pads that cushion the bottom of the feet.  Additional weight can also affect the bone and ligament structure. Older people, consequently, should have their feet measured for shoe sizes more frequently, rather than assuming that their shoe sizes remain constant. Observing preventive foot health care has many benefits for you, the patient.  Preventive measures can increase comfort, limit the possibility of additional medical problems, reduce the chances of hospitalization because of infection, and lessen requirements for other institutional care.

Remember these health tips for feet

When it comes to your feet, it is important to take extra precautions and properly care for your feet.  Some common foot health tips include:

  • Properly fitted shoes are essential; an astonishing number of people wear shoes that
    don’t fit right, and cause serious foot problems.
  • Bathe your feet daily in lukewarm (not hot) water, using a mild soap, preferably one
    containing moisturizers, or use a moisturizer separately.
  • Trim or file your toenails straight across.
  • Pantyhose or stockings should be of the correct size and preferably free of seams.
  • A shoe with a firm sole and soft upper is best for daily activities.
  • Shop for shoes in the afternoon; feet tend to swell during the day.
  • Walking is the best exercise for your feet.
  • Do not wear constricting garters or tie your stockings in knots.
  • Never cut corns and calluses with a razor, pocket knife, or other such instrument;
    use over-the-counter foot products only with the advice of a podiatrist.
  • Inspect your feet every day or have someone do this for you. If you notice any redness,
    swelling, cracks in the skin, or sores, consult your podiatrist.
  • Have your feet examined by a DPM at least twice a year.


Toenail Fungus: Prevention and Treatment

If you fancy open-toed footwear or enjoy basking barefoot, then you need to pay attention to the health of those toenails. A fungal infection – also known as onychomycosis – doesn’t disappear on its own, and if contracted and left untreated, the fungus will spread and eventually lead to the destruction of the nail. Toenail fungus is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail becomes darker in color and smells foul. It is also one of the most difficult conditions to cure due to the fact that before it can be treated, you have to determine what caused it with the help of your doctor.


You may have nail fungus if one or more of your nails are:

  • Thickened
  • Brittle, crumbly, or ragged
  • Distorted in shape
  • Dull, with no shine
  • A dark color

Fight off Fungus

Your risk of developing toenail fungus (onychomycosis) can be minimized by following these tips:

  • Keep nails clean and cut short
  • Dry feet and the spaces in between your toes thoroughly after washing them
  • Avoid sharing nail clippers or footwear
  • Wear properly fitting shoes that allow your feet to breathe
  • Spray your shoes with an antifungal medicine
  • Thoroughly clean nail clippers and other pedicure tools between uses (when visiting a nail salon, ask questions to assure the vicinity is clean)
  • Don’t apply nail polish to nails suspected of infection

Home Care Tips

If you have a mild fungal nail infection or are concerned about the risks of taking antifungal pills, try an antifungal medicine that you can apply directly to the skin. Some people find that tea tree oil or cream works well for this condition and can also treat athlete’s foot as well. Additionally, you should go barefoot as much as possible and if your feet get cold, be sure to wear dry, clean, socks. Moist socks and shoes breed fungal growth. Do not wear your sock or hosiery more than one day without washing.

When to Visit a Podiatrist

The area below and around the nail can get red and inflamed due to infection or due to an intense natural reaction to the fungus. Additionally, an odor may also arise in the case of infection. If self-care steps haven’t eliminated the fungus, it’s time to schedule a visit with your podiatrist. Not all cases of toenail fungus require treatment with medication, but a prescribed anti-fungal cream may be appropriate based on the type of fungus that is causing the infection.

If you observe any abnormal changes in your toenail, it is important to visit your doctor for a prompt foot assessment. If left untreated, a toenail fungus can lead to serious complications, including the possible loss of your nail, or a bacterial infection.

This newsletter/website is not intended to replace the services of a doctor. It does not constitute a doctor-patient relationship. Information in this newsletter/website is for informational purposes only & is not a substitute for professional advice. Please do not use the information contained herein for diagnosing or treating any condition.