January 22, 2025 • 24 mins
What if your feet could tell you the secrets of maintaining their health and avoiding common skin conditions? On the LMD Podiatry Podcast, Dr. Lauren DaBakaroff and Jeremy Wolf, promise to enlighten you on this important topic. Join us as we unravel the mysteries of toenail fungus, warts, and dry skin, with a spotlight on why toenail fungus is the most prevalent. Discover why wearing shoes without socks or using public showers could invite unwanted fungal guests and learn to differentiate between fungal and bacterial infections. With insights on recognizing athlete's foot and simple home remedies like vinegar soaks, you'll be armed with the knowledge to keep your feet happy and healthy.
Our journey then takes us through the world of foot warts, focusing on those pesky plantar warts that can cause so much discomfort. We discuss how these viral invaders are often picked up in public areas and offer both over-the-counter and professional treatment options to address them. From salicylic acid patches to cryogenic freezing, you'll gain an understanding of how to effectively treat warts by first tackling the calluses that protect them. Armed with this information, you'll be equipped to fight back against these stubborn foot foes.
Lastly, we emphasize the importance of preventative care, especially as we age. Simple changes like avoiding barefoot walking in high-risk areas, maintaining proper foot hygiene, and opting for moisture-wicking socks can make a significant difference. We also cover how certain footwear choices can lead to issues like dermatitis. We invite you to share your foot health experiences in our community, with reassurance that experts like Dr. Tabakarov and Dr. Lauren are here to help. Cherish life by taking care of your health, and stay tuned for more insights on the LMD Podiatry Podcast.
To learn more, visit: LMDpodiatry.com or contact (954) 680-7133
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Welcome to the LMD Podiatry Podcast.
Trust us to get back on yourfeet.
Here's your host, Dr LaurenDeBakeroff.
Speaker 2 (00:15):
Well, hello, hello everyone, and welcome back to
another episode of the LMDPodiatry Podcast.
Your co-host here, jeremy Wolf,as always, joined by your host,
dr Lauren.
Speaker 1 (00:26):
DeBaccarat Dr.
Speaker 2 (00:28):
Lauren.
It's always a pleasure.
Truly, truly is All right.
So well guys, thanks everyonefor tuning in.
We got a fun one today.
We're going to talk a littlebit about skin conditions.
I'm going to demystify skinconditions, so why don't we
(00:48):
start with some basics here,From your lens as a podiatrist,
what are some of the most commonskin conditions that you see?
Walk on into your office, Seethe little arcades there.
Speaker 3 (01:00):
Number one Pun intended.
Yeah so number one skincondition, toenail fungus.
Toenail fungus.
There's a fungus among intended.
Speaker 2 (01:05):
Yeah so number one skin condition toenail fungus.
Toenail fungus there's a fungusamong us.
Speaker 3 (01:09):
Yes, Toenail fungus number one.
The next most popular one isprobably warts.
That's a big one.
And probably number three wouldbe dry skin and calluses of all
sorts.
Speaker 2 (01:27):
So fungus warts, okay , why are conditions like fungus
and warts so prevalent when itcomes to the feet?
Speaker 3 (01:37):
So when it comes to fungus, first of all, it's
easily contagious, so you canjust like bread gets moldy when
you see it in a bag, becausefungus grows from moisture.
So, too, the same thing happensif you wear shoes without socks.
You can actually develop funguson your skin, on the skin of
the foot leading to athlete'sfoot or on your toenails, just
(02:00):
by having too much moisture inyour foot.
Just by having too muchmoisture in your foot, if you
perspire a lot, if you sweat alot in your feet and you're not
using things to dry up your feet, for example, and that moisture
can help you lead into a fungusin your skin or on your
toenails, for example.
Another reason why toenailfungus is very common is because
(02:21):
when people share showers withother people and they don't know
where they went, if you usepublic showers and in south
florida, the number one is thenail flaws because, even though
they have the sterile packs,it's the, it's the what's it
called brush, the nail polishbrush.
That's what everybody gets itfrom, because it's the only
(02:43):
thing that doesn't getsterilized.
And even though people thinkthat the nail polish is so
strong and it has a lot ofchemicals in it, those chemicals
are not strong enough to killthe actual fungal spores that
are on the brush.
So, even though they give you apedicure and everything's great
, the second, they use the samepolish that they use on
(03:05):
thousands of other people.
You're going to get tons offungus Sounds lovely, that's
always great.
Speaker 2 (03:11):
If you go to get a pedicure, you spend a hundred by
whatever it costs to get apedicure, and then you end up
getting some kind of fungalinfection.
That's lovely, oh boy.
So talking about fungalinfections, what exactly is a
fungal infection?
Speaker 3 (03:28):
Elaborate, okay, infections.
What exactly is a fungalinfection like?
What's what we're elaborate?
Okay, so there are differenttypes of microorganisms, right?
So you can get a bacterialinfection, like if someone has
pus in their foot, that'sbacteria husk pus pus.
Speaker 2 (03:40):
Oh, pus, pus.
Okay, I think you said a husk.
No, no, I said what is anelephant husk?
Oh, that's a tusk.
I'm sorry, what is that doingin the feet, jesus, I digress.
Speaker 3 (03:50):
Continue.
There's different types, so youknow you have different.
You have viruses, bacteria andfungi, right?
So there's different types offungi, all Fungi all over the
world.
They grow in different places.
Your average mushroom that youeat, that's a fungus.
But there are types of fungithat they grow on bread, so
(04:13):
there's yeast mold.
Those are all types ofdifferent funguses and there's
different species and thingslike that.
And the same thing is bacteria.
You can have like a staphinfection, you can have a strep
(04:34):
infection.
Speaker 2 (04:35):
You can have pseudomonas infection.
So fungus itself.
It's a type of microorganism.
It just acts differently thanbacteria and a virus.
So here's a term that manypeople have probably heard
before Athlete's foot.
That is a form of fungus,correct?
Yeah?
Speaker 3 (04:45):
it's fungus of the skin.
Speaker 2 (04:57):
Fungus of the skin, of the skin of the foot.
So for somebody that is havingsome issues with the feet, what
are some typical signs somebodyshould look for and how can they
treat that?
When would it require youactually going to see a doctor
like yourself, or a home remedy?
What should people look out for?
Some signs?
Speaker 3 (05:10):
and so for a fractured foot or fungus of the
skin of your foot.
The most common sign is itching.
If your feet start itching.
The other thing is you get likethis scaly, flaky skin on the
bottom of your foot.
Speaker 2 (05:23):
Should I be getting my foot out now to do an
inspection?
Speaker 1 (05:25):
No, no, no.
We don't want to scareeverybody away.
Speaker 2 (05:28):
My face is scary enough looking A lot of people
confuse dry skin with athlete'sfoot.
Speaker 3 (05:35):
Okay, so dry skin your skin is just kind of like
ashy and then athlete's foot.
You can actually see it's amoccasin type, moccasin-like
distribution.
Basically it's a moccasin-type,moccasin-like distribution.
Basically it's like theselittle circular scales on your
foot and they flake off and insome cases they can be red and
sometimes they can cause someitching in your foot and that's
how you know it's athlete's foot.
(05:55):
Home remedies vinegar soakslike half vinegar, half water.
That'll help kill the fungus.
You can try over-the-countercreams, but if that doesn't
resolve on its own, then youprobably need a stronger
prescription that you can geteither from me or a primary
doctor why are fungal infectionsso dang stubborn to get rid of?
Speaker 2 (06:16):
like what?
What is it that that they justkind of it seems that when you
get something cooking on yourfoot it just kind of takes hold
and never goes away, like I havecertain I'm not, maybe not
fungal infections, but I havecertain things on my feet that
just they don't go away, likealices that develop and and
scars from things, and they juststick there forever well,
calluses and fungus is twodifferent things, totally
(06:37):
different stuff out from this,from pressure, from the shape of
your foot related to the shoe.
Speaker 3 (06:43):
But fuck, yes, the reason why it's so stubborn is
because it kind of they breed inthe moisture.
So if your feet are sweatywithout socks, you're walking
around all day well and it's hotas all hell down here and
you're walking outside it hangsout.
Your feet are moist and ithangs out there and continues to
(07:04):
grow and you have to kill it.
It's not going to go awayunless you kill the fungus.
You got to kill it.
Speaker 2 (07:11):
Be nice doctor.
We don't want to kill things onthe show here, Come on.
Speaker 1 (07:14):
No.
Speaker 2 (07:16):
Okay, so warts another fun one, I think people,
people have heard of planterwarts and those can be really
painful.
What, what's?
Talk a little bit about planterwarts.
What are they, what causes themand why can they be so tricky
to throw?
It's a virus of the skin okay,virus of the skin, I'm right
(07:39):
that we have bacteria, fungusand virus.
Speaker 3 (07:43):
So let's say COVID was a virus, it was a
respiratory virus.
So you can have a virus of theskin.
Viruses act differently.
They live off the host cells.
So if you don't get rid of thewarts or do things to burn the
warts I'll talk about that in asecond.
So what's going to happen isthat virus, or the it's called
(08:07):
Verruca plantaris.
That's like Verruca, that'sthat's what the proper name for
it.
When you have that in your footor really anywhere in your body
, people get them in their hands, People I've seen them in
people's legs and and they'revery painful in the foot and
I'll tell you in a second why.
But what happens is the viruseslive off the host cells and
(08:31):
then if you don't do anything toget rid of the virus, and it's
going to continue living andthriving on your skin and lives
during the way a long time itdoesn't do anything.
Speaker 2 (08:42):
So the reason why the ones on the bottom of your foot
are very, very painful skin andlives there.
Speaker 3 (08:44):
It's tearing away, it doesn't do anything.
So the reason why the ones onthe bottom of your foot are very
, very painful is because itlives on your skin and then, as
you walk, you develop a callusover the wart and that makes the
callus more and more painfuland you're walking on the virus
and you're walking on the wartand you're walking on it.
Walking on it develops thecallus and that's why it becomes
(09:06):
so painful.
Where do you get them?
It's a virus.
It was contagious.
You know a lot of kids get thembecause they walk barefoot in
public pools, public showers,public pools.
Anytime you walk barefootanywhere you can contract like
you could get a skin virus.
Speaker 2 (09:30):
So effective methods of treatment.
You alluded to this earlier.
You talked about burning offwarts.
When is it appropriate to dothat?
Is that something that soundslike it could be pretty
aggressive and maybe not thebest way to get started, like if
you have one developing?
Maybe not the the the best wayto get started, like if you have
one developing.
Maybe there's some othertreatments you'd go to first, or
you consider burning off.
What are your thoughts on that?
Speaker 3 (09:49):
So me and the, either a podiatrist or a dermatologist
, can do this.
But basically to get the virusto die I know you don't like the
word killing and death but I'mjoking to your country to get
the, you know, to kill off the,the wart, you have to kill the
virus and a couple of verysimple ways to do.
(10:10):
That is to use over the carbonacid.
Me or the dermatologist canfreeze it.
You know, like the, the freezecans uh, to to freeze, burn.
That's another way to kill it,to make it die.
Speaker 2 (10:25):
I think I've used that before.
It seems familiar Like anover-the-counter.
Is that over-the-counter orprescription?
Speaker 3 (10:31):
There are like over-the-counter acids like
salicylic acid is very commonfor people to buy.
You get the four patches whichhave acid on them that help kill
the wart and burn it.
But in office I'd go a littlebit more aggressive.
Spray on there.
You can freeze, burn it.
You could burn it with achemical.
There's also like other thingsthat makes the wart blister off.
(10:53):
Uh, very strong pink chemicalsthat do that.
Chemical burns, things likethat.
Those help kill the wart ordestroy it.
Chemical it's a, it's a type ofdestruction.
So we want to destroy.
Like the freeze burning orcryogenic freezing,
cauterization they all kind ofcauterize the wart.
Now the reason why I recommendseeing a podiatrist for the
(11:17):
warts of your feet, mostlybecause the callus that you
develop over the wart is sothick that it doesn't matter
what kind of cautery you use.
You really need to trim thecallus down really deep enough
so that you can expose the wartto the medicine or to the
cautery, if that makes sensereally get in there, good, and
(11:41):
yeah because, the callus blocksthe.
It's going to be a barrier.
So I find if you have one onyour hand, go to the
dermatologist, burn it whatever.
But if you have one on the foot, chances are you have a nice
thick callus over it and that'spreventing the medicine from
penetrating If over-the-counterstuff has not worked.
Speaker 2 (12:04):
Let's talk about prevention.
I find myself more and moregoing back to this idea of
preventative care and prevention.
I think the older I get, thewiser I get and the more I'm
talking about taking care ofyourself.
So a lot of the preventativemeasures that people could take
(12:25):
in most things in life areusually pretty, pretty obvious,
but so many of us avoid that forwhatever reason.
So let's just raise someawareness around prevention.
What, what are some things,some go-to things people can do
to avoid these issues in thefirst place?
And again, I know some of thisis obvious, but it's like wart
and fungus.
Yeah, let's go.
Speaker 3 (12:44):
I mean for the warts it's really the warts, it's
really just don't walk barefoot,don't walk barefoot.
Speaker 2 (12:51):
Isn't it good, though , to go out and walk barefoot,
like I heard that it's good togo out and walk on the earth on
the sand, on some grass great,not, but not like around a pool.
Okay, over pools there's a lotof a lot of how do you not walk
with?
Oh, you guys can wear the watershoes or whatever.
Speaker 3 (13:07):
You can wear your flip flops and water shoes.
Those are fine, Okay, and Imean a lot of kids get it
because you know they'rechanging in the gym and school
and things like that, and thoselocker, those gym gym, the gyms
(13:27):
in the school?
Speaker 2 (13:28):
that's where all the viruses live over there, so you
just got to keep it clean.
Is it good, then, to like I mixbetween some days I wear socks
and sneakers, some days I wearsandals?
Is it good to rotate, like?
I'd imagine, too much ofanything is not good all the
time right.
What's your thoughts on that?
Am I on a good path withrotating my footwear day-to-day
or even changing my socksthroughout the day?
Not good all the time right.
What's your thoughts on that is?
Am I on a good path with, like,rotating my footwear day to day
or even changing?
my socks throughout the day ifif they get a little wet or
(13:48):
musky that that's myrecommendation, typically okay.
Speaker 3 (13:51):
So for people with sweaty feet or people that tend
to have like the athlete's foot,that comes back again and again
, again, it's all aboutmaintaining a dry environment in
your shoe.
So the way, the way, you dothat is you have to alternate
shoes, like if you wear the sameshoe every day.
Speaker 2 (14:09):
Give it a break, wear this shoe today and another
shoe tomorrow, and then that'llgive it, or maybe one of each
one day, if you want to go crazy, right, I mean, if you have
enough shoes, go for it.
Speaker 3 (14:23):
another thing you could do is switch your socks.
So a lot of people love cottonsocks, but they're not great for
athletes Because cotton socks,when they get wet, they stay wet
.
Speaker 2 (14:34):
What's the alternative?
I've never thought aboutanything but cotton socks.
What else do they make socksout?
Speaker 3 (14:41):
of Right.
So now I mean we'll talk forthe best.
But it's florida, it's hot, soyou want any type of sock with a
wicking technology, so you wantsomething that wicks the
moisture.
You could buy special sockslike that if you do truly have
sweaty feet or you're a marathonrunner or one of those things.
But there's as long as you havesome type, some type of like
(15:03):
synthetic fiber on your socks,then it should absorb most of
the moisture so would that belike?
Speaker 2 (15:09):
I bought some socks for running there was, I think
the brand was called sock andsock and knee.
Is that the right?
Am I saying that right?
Oh, those are good.
Are those?
Yeah, those type of socks thathave that lining?
Yeah, because I, I use thosewhen I run and they definitely
feel more comfortable.
Speaker 3 (15:25):
See, those are wicking socks.
I think they have also.
What do you keep saying?
Wicking, w-i-c-k-i-n-g, itwicks Wicking.
Speaker 2 (15:34):
They were talking about witches here Wicking,
wicking, it wicks moisture, itwicks the moisture.
It makes sense why somebodyrecommended to me to get those
socks for running.
So all the pieces of the puzzleare starting to come together
here.
You see.
Good, I'm glad I could bring ithome for you.
What are we missing?
You talked about fungus, wetalked about warts, you were
(15:57):
talking about dry skin.
What are some of the othercommon issues that you see?
Okay, sometimes I see somedermatitis, dermatitis, derma
being skin and pitis being Idon't know what it is.
Speaker 3 (16:10):
Inflammation.
Speaker 2 (16:12):
Dermatitis is inflammation of the skin.
Speaker 3 (16:14):
Yeah, okay, so a lot of people can get that from.
I see it all the time whenpatients wear Crocs without
socks.
Speaker 2 (16:24):
Croc Don't wear Crocs without socks.
People Don't wear Crocs.
Run a 5K race in Crocs withoutsocks.
Croc Don't wear Crocs withoutsocks.
People Don't wear Crocs.
Run a 5K race in Crocs or amarathon in Crocs.
I've seen some videos like that.
No good.
Speaker 3 (16:31):
No, you could get it from like the plastic or the
rubber shoes, like a lot oftimes patients get it on the top
of their foot.
Really, you just have to stopthat.
And if it's very, very painfulor itchy, then any type of
cortisone over-the-counterhydrocortisone cream should help
.
And if it doesn't go away, yousee me for a strong cream.
(16:52):
So that's kind of like anotherthing I see.
So we did athlete's footplantar's warts.
If they're very bad and verypainful, I actually cut out
plantar's warts.
So that's another procedure.
Yeah, I just cut it out, cut itout, burn the remnant burn it,
burn the wicking, burn it.
(17:14):
Oh man, I'm too much and thenfor toenail fungus, I will say
this those are stubborn ones.
There are pills that just helpclear the toenail fungus, but if
you're against pills eventhough the pill that I
prescribed is amazing you need avery strong topical antifungal
to kill toenail fungus.
Why?
Because the toenails are about15 times harder than your skin.
(17:38):
So most of the over-the-counterstuff, even though it has the
antifungal ingredient in it, itdoesn't have the vehicle to
penetrate into the nail.
So that's why there's like moreprescription.
And then I also sell some fancystuff here that helps that
barrier.
Speaker 2 (17:56):
Well, what is what is this magic pill that you speak?
Turbinophene.
Speaker 3 (18:01):
Turbinophene.
Speaker 2 (18:02):
Yeah.
Speaker 3 (18:03):
Or Lamisil.
That's what everybody knows.
That, okay, and what did that?
So that's just it.
Speaker 2 (18:06):
Lamisil, that's what everybody knows.
That is Okay, and what is that?
So that's just.
It was like an anise, what'sthat it?
Speaker 3 (18:10):
kills the fungus from the inside.
Speaker 1 (18:12):
Hmm.
Speaker 3 (18:14):
Okay, yeah, so the new nail will come out
fungus-free when you take thispill.
It takes a couple months.
Toenails take about six to ninemonths to grow out, if you're
young.
So you take the pill over thecourse of three months.
I prescribe it, I monitor you,and then we wait for the noun to
grow out and everybody's veryhappy.
That doesn't mean the funguscan't come back, because unless
(18:34):
you do all those tips and trickskeep your feet dry, keep the
environment of your shoes dry,alternate your shoes and do that
stuff it can always come back.
Right, you can buy like a shoetree, like a UV shoe tree or
shoe zapper.
You hang your shoe on it everyday.
It kills the.
Speaker 2 (18:53):
A UV shoe tree?
Yeah, they have them on Amazon.
I've not seen that.
That's interesting.
Just hang the shoes up and hitthem with that UV light.
Speaker 3 (19:02):
My tip, my favorite tip, is taking one of those
cheap Lipton tea bags, the blacktea, the cheapest ones you have
.
Throw one dry tea bag into eachshoe every night.
The tea that we drink actuallyhas formalin in it.
It actually absorbs the smelland the moisture in your shoe.
Speaker 2 (19:25):
Dry tea bag.
In each shoe Black tea.
In each shoe Black tea.
It has to be black tea, that'sgoing to help freshen up the
situation.
I like that.
Speaker 3 (19:36):
And then other skin conditions.
Those are the most common ones.
I do have some random like.
There are a lot of times I do alot of foot biopsies, like
lower leg or foot biopsies.
I have I've done some biopsiesof weird things that people have
on their feet, just like thedermatologist, and a few people
over the years had some type ofskin cancer.
(19:56):
So it's always important to getyour skin checked and sometimes
I coordinate with thedermatologist and it's funny the
dermatologist that I refer back.
We refer back and forth to eachother.
She doesn't like to do footstuff so she sends me all the
the stubborn stuff and then Ialso, when there's something a
little bit too complicated likeskin cancer, I send back to her.
(20:17):
So you know things like that.
Ulcers are a big one for thediabetic population.
If you want to keep talkingabout skin conditions,
ulcerscers are very, very common.
Speaker 2 (20:29):
Ulcers on skin.
I thought ulcers.
I think of ulcers as like astomach condition.
Speaker 3 (20:34):
No, so ulcer just means hole, so you can get a
diabetic foot ulcer Shows what Iknow here.
I've seen non-diabetics also getfoot ulcers, like patients with
very bad calluses they don'ttake care of and then they just
keep walking and walking andwalking on their calluses and
then they develop a little ulcerwhich is basically a divot in
the skin.
That doesn't close over timeand I have all the tips and
(20:58):
tricks to get it to get it toclose.
But yeah, there are ulcers.
Patients have diabetic footulcers because diabetics don't
have enough sensation in theirfeet and then they keep walking
on pressure points and they haveno idea and then they ulcerate.
So that's another very commonskin condition.
Speaker 2 (21:18):
Fascinating, fascinating.
What would be.
Before we wrap up here, onepiece of advice that you'd like
to give to someone dealing witha stubborn foot condition.
Maybe it's that, that wart thatkeeps popping up, or just dry
feet.
Whatever it is, what's onepiece of advice you can leave
them with Moisturize, moisturizelike moisturizing cream on the
(21:41):
feet, just daily.
Speaker 3 (21:42):
You know, if you, yeah, and so the if you live in
Florida especially.
But we live in Florida.
A lot of people here wearsandals and that's too much air
to the foot.
Speaker 2 (21:55):
Too much air.
I want it.
I want my feet to be aired out.
Come on.
Speaker 3 (21:58):
But it's too much.
And then everybody has theselike dried packed heels, and
then they come.
Speaker 2 (22:03):
That's why you do one day sandals and one day shoes.
Speaker 3 (22:06):
But everybody's not you, everybody's not you.
I'm sorry for them then.
No, it's all good, you're thebest, but you have to moisturize
at least at night before you goto bed.
A little cream on your feet atnight goes a long way.
Monitor your foot.
(22:34):
If you have any sore spot of acallus or you think you might
possibly have a wart, come inand get checked.
If you have dry skin that, nomatter what cream you put on it,
doesn't go away.
It's probably athlete's foot.
You should come in for that.
But really it's very importantto wear shoes with socks and if
you you're wearing those lowprofile shoes, you gotta wear
the, the what's it called thosehidden socks you get out.
(22:57):
Friction is what's going tocause pain and blisters and
calluses and sores anddermatitis.
So just wear.
If you're going to wear theshoe, wear it right.
And there's also different likepads, paddings and things put
inside your shoes.
Just like you got those specialsocks, it's the same thing you
got to just protect your feet inevery shoe that you wear and
(23:19):
that way you'll prevent wartsand funguses and calluses and
things like that.
So, those are a couple of tricks, tips that I recommend, love it
.
Speaker 2 (23:29):
My wife has been trying to get me to moisturize
her on my face, for my skin fora while now.
She, you know.
Unfortunately, I don't do itregularly.
This is why you get what yousee here in this, in this still
video here.
Speaker 3 (23:40):
You look like you have a beautiful supple face.
Speaker 2 (23:43):
I'm being very self self-deprecating today, but very
cool, all right.
Well, that was informative.
Thanks everyone for tuning in.
If you've had your own footproblems, tell us about it in
the comments.
Tell us what you, the strugglesthat you've gone through.
Go see Dr Tabakarov.
Go see Dr Lauren.
She promises it will not hurt abit unless she has to burn it
(24:03):
off.
Will not hurt a bit unless shehas to burn it off.
Okay, correct, there you go.
All right, cool, we will leaveit at that.
We will catch everyone nexttime on the next episode of the
LMD podiatry podcast.
Everyone, take care, stay happy, stay healthy.
Remember we only have this onelife to live, so let's take care
of ourselves and live it withpurpose and love and happiness.
(24:24):
Take care, and love andhappiness.
Take care everyone.
Speaker 1 (24:33):
Stay blessed.
Thank you for listening to theLMD Podiatry Podcast.
For more information, visitLMDPodiatrycom.
That's L-M-D-P-O-D-I-A-T-R-Ydot com or call 954-680-7133.
Welcome to the LMD Podiatry Podcast.
Trust us to get back on yourfeet.
Here's your host, Dr LaurenDeBakeroff.
Speaker 2 (00:15):
Well, hello, hello everyone, and welcome back to
another episode of the LMDPodiatry Podcast.
Your co-host here, jeremy Wolf,as always, joined by your host,
dr Lauren.
Speaker 1 (00:26):
DeBaccarat Dr.
Speaker 2 (00:28):
Lauren.
It's always a pleasure.
Truly, truly is All right.
So well guys, thanks everyonefor tuning in.
We got a fun one today.
We're going to talk a littlebit about skin conditions.
I'm going to demystify skinconditions, so why don't we
(00:48):
start with some basics here,From your lens as a podiatrist,
what are some of the most commonskin conditions that you see?
Walk on into your office, Seethe little arcades there.
Speaker 3 (01:00):
Number one Pun intended.
Yeah so number one skincondition, toenail fungus.
Toenail fungus.
There's a fungus among intended.
Speaker 2 (01:05):
Yeah so number one skin condition toenail fungus.
Toenail fungus there's a fungusamong us.
Speaker 3 (01:09):
Yes, Toenail fungus number one.
The next most popular one isprobably warts.
That's a big one.
And probably number three wouldbe dry skin and calluses of all
sorts.
Speaker 2 (01:27):
So fungus warts, okay , why are conditions like fungus
and warts so prevalent when itcomes to the feet?
Speaker 3 (01:37):
So when it comes to fungus, first of all, it's
easily contagious, so you canjust like bread gets moldy when
you see it in a bag, becausefungus grows from moisture.
So, too, the same thing happensif you wear shoes without socks.
You can actually develop funguson your skin, on the skin of
the foot leading to athlete'sfoot or on your toenails, just
(02:00):
by having too much moisture inyour foot.
Just by having too muchmoisture in your foot, if you
perspire a lot, if you sweat alot in your feet and you're not
using things to dry up your feet, for example, and that moisture
can help you lead into a fungusin your skin or on your
toenails, for example.
Another reason why toenailfungus is very common is because
(02:21):
when people share showers withother people and they don't know
where they went, if you usepublic showers and in south
florida, the number one is thenail flaws because, even though
they have the sterile packs,it's the, it's the what's it
called brush, the nail polishbrush.
That's what everybody gets itfrom, because it's the only
(02:43):
thing that doesn't getsterilized.
And even though people thinkthat the nail polish is so
strong and it has a lot ofchemicals in it, those chemicals
are not strong enough to killthe actual fungal spores that
are on the brush.
So, even though they give you apedicure and everything's great
, the second, they use the samepolish that they use on
(03:05):
thousands of other people.
You're going to get tons offungus Sounds lovely, that's
always great.
Speaker 2 (03:11):
If you go to get a pedicure, you spend a hundred by
whatever it costs to get apedicure, and then you end up
getting some kind of fungalinfection.
That's lovely, oh boy.
So talking about fungalinfections, what exactly is a
fungal infection?
Speaker 3 (03:28):
Elaborate, okay, infections.
What exactly is a fungalinfection like?
What's what we're elaborate?
Okay, so there are differenttypes of microorganisms, right?
So you can get a bacterialinfection, like if someone has
pus in their foot, that'sbacteria husk pus pus.
Speaker 2 (03:40):
Oh, pus, pus.
Okay, I think you said a husk.
No, no, I said what is anelephant husk?
Oh, that's a tusk.
I'm sorry, what is that doingin the feet, jesus, I digress.
Speaker 3 (03:50):
Continue.
There's different types, so youknow you have different.
You have viruses, bacteria andfungi, right?
So there's different types offungi, all Fungi all over the
world.
They grow in different places.
Your average mushroom that youeat, that's a fungus.
But there are types of fungithat they grow on bread, so
(04:13):
there's yeast mold.
Those are all types ofdifferent funguses and there's
different species and thingslike that.
And the same thing is bacteria.
You can have like a staphinfection, you can have a strep
(04:34):
infection.
Speaker 2 (04:35):
You can have pseudomonas infection.
So fungus itself.
It's a type of microorganism.
It just acts differently thanbacteria and a virus.
So here's a term that manypeople have probably heard
before Athlete's foot.
That is a form of fungus,correct?
Yeah?
Speaker 3 (04:45):
it's fungus of the skin.
Speaker 2 (04:57):
Fungus of the skin, of the skin of the foot.
So for somebody that is havingsome issues with the feet, what
are some typical signs somebodyshould look for and how can they
treat that?
When would it require youactually going to see a doctor
like yourself, or a home remedy?
What should people look out for?
Some signs?
Speaker 3 (05:10):
and so for a fractured foot or fungus of the
skin of your foot.
The most common sign is itching.
If your feet start itching.
The other thing is you get likethis scaly, flaky skin on the
bottom of your foot.
Speaker 2 (05:23):
Should I be getting my foot out now to do an
inspection?
Speaker 1 (05:25):
No, no, no.
We don't want to scareeverybody away.
Speaker 2 (05:28):
My face is scary enough looking A lot of people
confuse dry skin with athlete'sfoot.
Speaker 3 (05:35):
Okay, so dry skin your skin is just kind of like
ashy and then athlete's foot.
You can actually see it's amoccasin type, moccasin-like
distribution.
Basically it's a moccasin-type,moccasin-like distribution.
Basically it's like theselittle circular scales on your
foot and they flake off and insome cases they can be red and
sometimes they can cause someitching in your foot and that's
how you know it's athlete's foot.
(05:55):
Home remedies vinegar soakslike half vinegar, half water.
That'll help kill the fungus.
You can try over-the-countercreams, but if that doesn't
resolve on its own, then youprobably need a stronger
prescription that you can geteither from me or a primary
doctor why are fungal infectionsso dang stubborn to get rid of?
Speaker 2 (06:16):
like what?
What is it that that they justkind of it seems that when you
get something cooking on yourfoot it just kind of takes hold
and never goes away, like I havecertain I'm not, maybe not
fungal infections, but I havecertain things on my feet that
just they don't go away, likealices that develop and and
scars from things, and they juststick there forever well,
calluses and fungus is twodifferent things, totally
(06:37):
different stuff out from this,from pressure, from the shape of
your foot related to the shoe.
Speaker 3 (06:43):
But fuck, yes, the reason why it's so stubborn is
because it kind of they breed inthe moisture.
So if your feet are sweatywithout socks, you're walking
around all day well and it's hotas all hell down here and
you're walking outside it hangsout.
Your feet are moist and ithangs out there and continues to
(07:04):
grow and you have to kill it.
It's not going to go awayunless you kill the fungus.
You got to kill it.
Speaker 2 (07:11):
Be nice doctor.
We don't want to kill things onthe show here, Come on.
Speaker 1 (07:14):
No.
Speaker 2 (07:16):
Okay, so warts another fun one, I think people,
people have heard of planterwarts and those can be really
painful.
What, what's?
Talk a little bit about planterwarts.
What are they, what causes themand why can they be so tricky
to throw?
It's a virus of the skin okay,virus of the skin, I'm right
(07:39):
that we have bacteria, fungusand virus.
Speaker 3 (07:43):
So let's say COVID was a virus, it was a
respiratory virus.
So you can have a virus of theskin.
Viruses act differently.
They live off the host cells.
So if you don't get rid of thewarts or do things to burn the
warts I'll talk about that in asecond.
So what's going to happen isthat virus, or the it's called
(08:07):
Verruca plantaris.
That's like Verruca, that'sthat's what the proper name for
it.
When you have that in your footor really anywhere in your body
, people get them in their hands, People I've seen them in
people's legs and and they'revery painful in the foot and
I'll tell you in a second why.
But what happens is the viruseslive off the host cells and
(08:31):
then if you don't do anything toget rid of the virus, and it's
going to continue living andthriving on your skin and lives
during the way a long time itdoesn't do anything.
Speaker 2 (08:42):
So the reason why the ones on the bottom of your foot
are very, very painful skin andlives there.
Speaker 3 (08:44):
It's tearing away, it doesn't do anything.
So the reason why the ones onthe bottom of your foot are very
, very painful is because itlives on your skin and then, as
you walk, you develop a callusover the wart and that makes the
callus more and more painfuland you're walking on the virus
and you're walking on the wartand you're walking on it.
Walking on it develops thecallus and that's why it becomes
(09:06):
so painful.
Where do you get them?
It's a virus.
It was contagious.
You know a lot of kids get thembecause they walk barefoot in
public pools, public showers,public pools.
Anytime you walk barefootanywhere you can contract like
you could get a skin virus.
Speaker 2 (09:30):
So effective methods of treatment.
You alluded to this earlier.
You talked about burning offwarts.
When is it appropriate to dothat?
Is that something that soundslike it could be pretty
aggressive and maybe not thebest way to get started, like if
you have one developing?
Maybe not the the the best wayto get started, like if you have
one developing.
Maybe there's some othertreatments you'd go to first, or
you consider burning off.
What are your thoughts on that?
Speaker 3 (09:49):
So me and the, either a podiatrist or a dermatologist
, can do this.
But basically to get the virusto die I know you don't like the
word killing and death but I'mjoking to your country to get
the, you know, to kill off the,the wart, you have to kill the
virus and a couple of verysimple ways to do.
(10:10):
That is to use over the carbonacid.
Me or the dermatologist canfreeze it.
You know, like the, the freezecans uh, to to freeze, burn.
That's another way to kill it,to make it die.
Speaker 2 (10:25):
I think I've used that before.
It seems familiar Like anover-the-counter.
Is that over-the-counter orprescription?
Speaker 3 (10:31):
There are like over-the-counter acids like
salicylic acid is very commonfor people to buy.
You get the four patches whichhave acid on them that help kill
the wart and burn it.
But in office I'd go a littlebit more aggressive.
Spray on there.
You can freeze, burn it.
You could burn it with achemical.
There's also like other thingsthat makes the wart blister off.
(10:53):
Uh, very strong pink chemicalsthat do that.
Chemical burns, things likethat.
Those help kill the wart ordestroy it.
Chemical it's a, it's a type ofdestruction.
So we want to destroy.
Like the freeze burning orcryogenic freezing,
cauterization they all kind ofcauterize the wart.
Now the reason why I recommendseeing a podiatrist for the
(11:17):
warts of your feet, mostlybecause the callus that you
develop over the wart is sothick that it doesn't matter
what kind of cautery you use.
You really need to trim thecallus down really deep enough
so that you can expose the wartto the medicine or to the
cautery, if that makes sensereally get in there, good, and
(11:41):
yeah because, the callus blocksthe.
It's going to be a barrier.
So I find if you have one onyour hand, go to the
dermatologist, burn it whatever.
But if you have one on the foot, chances are you have a nice
thick callus over it and that'spreventing the medicine from
penetrating If over-the-counterstuff has not worked.
Speaker 2 (12:04):
Let's talk about prevention.
I find myself more and moregoing back to this idea of
preventative care and prevention.
I think the older I get, thewiser I get and the more I'm
talking about taking care ofyourself.
So a lot of the preventativemeasures that people could take
(12:25):
in most things in life areusually pretty, pretty obvious,
but so many of us avoid that forwhatever reason.
So let's just raise someawareness around prevention.
What, what are some things,some go-to things people can do
to avoid these issues in thefirst place?
And again, I know some of thisis obvious, but it's like wart
and fungus.
Yeah, let's go.
Speaker 3 (12:44):
I mean for the warts it's really the warts, it's
really just don't walk barefoot,don't walk barefoot.
Speaker 2 (12:51):
Isn't it good, though , to go out and walk barefoot,
like I heard that it's good togo out and walk on the earth on
the sand, on some grass great,not, but not like around a pool.
Okay, over pools there's a lotof a lot of how do you not walk
with?
Oh, you guys can wear the watershoes or whatever.
Speaker 3 (13:07):
You can wear your flip flops and water shoes.
Those are fine, Okay, and Imean a lot of kids get it
because you know they'rechanging in the gym and school
and things like that, and thoselocker, those gym gym, the gyms
(13:27):
in the school?
Speaker 2 (13:28):
that's where all the viruses live over there, so you
just got to keep it clean.
Is it good, then, to like I mixbetween some days I wear socks
and sneakers, some days I wearsandals?
Is it good to rotate, like?
I'd imagine, too much ofanything is not good all the
time right.
What's your thoughts on that?
Am I on a good path withrotating my footwear day-to-day
or even changing my socksthroughout the day?
Not good all the time right.
What's your thoughts on that is?
Am I on a good path with, like,rotating my footwear day to day
or even changing?
my socks throughout the day ifif they get a little wet or
(13:48):
musky that that's myrecommendation, typically okay.
Speaker 3 (13:51):
So for people with sweaty feet or people that tend
to have like the athlete's foot,that comes back again and again
, again, it's all aboutmaintaining a dry environment in
your shoe.
So the way, the way, you dothat is you have to alternate
shoes, like if you wear the sameshoe every day.
Speaker 2 (14:09):
Give it a break, wear this shoe today and another
shoe tomorrow, and then that'llgive it, or maybe one of each
one day, if you want to go crazy, right, I mean, if you have
enough shoes, go for it.
Speaker 3 (14:23):
another thing you could do is switch your socks.
So a lot of people love cottonsocks, but they're not great for
athletes Because cotton socks,when they get wet, they stay wet
.
Speaker 2 (14:34):
What's the alternative?
I've never thought aboutanything but cotton socks.
What else do they make socksout?
Speaker 3 (14:41):
of Right.
So now I mean we'll talk forthe best.
But it's florida, it's hot, soyou want any type of sock with a
wicking technology, so you wantsomething that wicks the
moisture.
You could buy special sockslike that if you do truly have
sweaty feet or you're a marathonrunner or one of those things.
But there's as long as you havesome type, some type of like
(15:03):
synthetic fiber on your socks,then it should absorb most of
the moisture so would that belike?
Speaker 2 (15:09):
I bought some socks for running there was, I think
the brand was called sock andsock and knee.
Is that the right?
Am I saying that right?
Oh, those are good.
Are those?
Yeah, those type of socks thathave that lining?
Yeah, because I, I use thosewhen I run and they definitely
feel more comfortable.
Speaker 3 (15:25):
See, those are wicking socks.
I think they have also.
What do you keep saying?
Wicking, w-i-c-k-i-n-g, itwicks Wicking.
Speaker 2 (15:34):
They were talking about witches here Wicking,
wicking, it wicks moisture, itwicks the moisture.
It makes sense why somebodyrecommended to me to get those
socks for running.
So all the pieces of the puzzleare starting to come together
here.
You see.
Good, I'm glad I could bring ithome for you.
What are we missing?
You talked about fungus, wetalked about warts, you were
(15:57):
talking about dry skin.
What are some of the othercommon issues that you see?
Okay, sometimes I see somedermatitis, dermatitis, derma
being skin and pitis being Idon't know what it is.
Speaker 3 (16:10):
Inflammation.
Speaker 2 (16:12):
Dermatitis is inflammation of the skin.
Speaker 3 (16:14):
Yeah, okay, so a lot of people can get that from.
I see it all the time whenpatients wear Crocs without
socks.
Speaker 2 (16:24):
Croc Don't wear Crocs without socks.
People Don't wear Crocs.
Run a 5K race in Crocs withoutsocks.
Croc Don't wear Crocs withoutsocks.
People Don't wear Crocs.
Run a 5K race in Crocs or amarathon in Crocs.
I've seen some videos like that.
No good.
Speaker 3 (16:31):
No, you could get it from like the plastic or the
rubber shoes, like a lot oftimes patients get it on the top
of their foot.
Really, you just have to stopthat.
And if it's very, very painfulor itchy, then any type of
cortisone over-the-counterhydrocortisone cream should help
.
And if it doesn't go away, yousee me for a strong cream.
(16:52):
So that's kind of like anotherthing I see.
So we did athlete's footplantar's warts.
If they're very bad and verypainful, I actually cut out
plantar's warts.
So that's another procedure.
Yeah, I just cut it out, cut itout, burn the remnant burn it,
burn the wicking, burn it.
(17:14):
Oh man, I'm too much and thenfor toenail fungus, I will say
this those are stubborn ones.
There are pills that just helpclear the toenail fungus, but if
you're against pills eventhough the pill that I
prescribed is amazing you need avery strong topical antifungal
to kill toenail fungus.
Why?
Because the toenails are about15 times harder than your skin.
(17:38):
So most of the over-the-counterstuff, even though it has the
antifungal ingredient in it, itdoesn't have the vehicle to
penetrate into the nail.
So that's why there's like moreprescription.
And then I also sell some fancystuff here that helps that
barrier.
Speaker 2 (17:56):
Well, what is what is this magic pill that you speak?
Turbinophene.
Speaker 3 (18:01):
Turbinophene.
Speaker 2 (18:02):
Yeah.
Speaker 3 (18:03):
Or Lamisil.
That's what everybody knows.
That, okay, and what did that?
So that's just it.
Speaker 2 (18:06):
Lamisil, that's what everybody knows.
That is Okay, and what is that?
So that's just.
It was like an anise, what'sthat it?
Speaker 3 (18:10):
kills the fungus from the inside.
Speaker 1 (18:12):
Hmm.
Speaker 3 (18:14):
Okay, yeah, so the new nail will come out
fungus-free when you take thispill.
It takes a couple months.
Toenails take about six to ninemonths to grow out, if you're
young.
So you take the pill over thecourse of three months.
I prescribe it, I monitor you,and then we wait for the noun to
grow out and everybody's veryhappy.
That doesn't mean the funguscan't come back, because unless
(18:34):
you do all those tips and trickskeep your feet dry, keep the
environment of your shoes dry,alternate your shoes and do that
stuff it can always come back.
Right, you can buy like a shoetree, like a UV shoe tree or
shoe zapper.
You hang your shoe on it everyday.
It kills the.
Speaker 2 (18:53):
A UV shoe tree?
Yeah, they have them on Amazon.
I've not seen that.
That's interesting.
Just hang the shoes up and hitthem with that UV light.
Speaker 3 (19:02):
My tip, my favorite tip, is taking one of those
cheap Lipton tea bags, the blacktea, the cheapest ones you have
.
Throw one dry tea bag into eachshoe every night.
The tea that we drink actuallyhas formalin in it.
It actually absorbs the smelland the moisture in your shoe.
Speaker 2 (19:25):
Dry tea bag.
In each shoe Black tea.
In each shoe Black tea.
It has to be black tea, that'sgoing to help freshen up the
situation.
I like that.
Speaker 3 (19:36):
And then other skin conditions.
Those are the most common ones.
I do have some random like.
There are a lot of times I do alot of foot biopsies, like
lower leg or foot biopsies.
I have I've done some biopsiesof weird things that people have
on their feet, just like thedermatologist, and a few people
over the years had some type ofskin cancer.
(19:56):
So it's always important to getyour skin checked and sometimes
I coordinate with thedermatologist and it's funny the
dermatologist that I refer back.
We refer back and forth to eachother.
She doesn't like to do footstuff so she sends me all the
the stubborn stuff and then Ialso, when there's something a
little bit too complicated likeskin cancer, I send back to her.
(20:17):
So you know things like that.
Ulcers are a big one for thediabetic population.
If you want to keep talkingabout skin conditions,
ulcerscers are very, very common.
Speaker 2 (20:29):
Ulcers on skin.
I thought ulcers.
I think of ulcers as like astomach condition.
Speaker 3 (20:34):
No, so ulcer just means hole, so you can get a
diabetic foot ulcer Shows what Iknow here.
I've seen non-diabetics also getfoot ulcers, like patients with
very bad calluses they don'ttake care of and then they just
keep walking and walking andwalking on their calluses and
then they develop a little ulcerwhich is basically a divot in
the skin.
That doesn't close over timeand I have all the tips and
(20:58):
tricks to get it to get it toclose.
But yeah, there are ulcers.
Patients have diabetic footulcers because diabetics don't
have enough sensation in theirfeet and then they keep walking
on pressure points and they haveno idea and then they ulcerate.
So that's another very commonskin condition.
Speaker 2 (21:18):
Fascinating, fascinating.
What would be.
Before we wrap up here, onepiece of advice that you'd like
to give to someone dealing witha stubborn foot condition.
Maybe it's that, that wart thatkeeps popping up, or just dry
feet.
Whatever it is, what's onepiece of advice you can leave
them with Moisturize, moisturizelike moisturizing cream on the
(21:41):
feet, just daily.
Speaker 3 (21:42):
You know, if you, yeah, and so the if you live in
Florida especially.
But we live in Florida.
A lot of people here wearsandals and that's too much air
to the foot.
Speaker 2 (21:55):
Too much air.
I want it.
I want my feet to be aired out.
Come on.
Speaker 3 (21:58):
But it's too much.
And then everybody has theselike dried packed heels, and
then they come.
Speaker 2 (22:03):
That's why you do one day sandals and one day shoes.
Speaker 3 (22:06):
But everybody's not you, everybody's not you.
I'm sorry for them then.
No, it's all good, you're thebest, but you have to moisturize
at least at night before you goto bed.
A little cream on your feet atnight goes a long way.
Monitor your foot.
(22:34):
If you have any sore spot of acallus or you think you might
possibly have a wart, come inand get checked.
If you have dry skin that, nomatter what cream you put on it,
doesn't go away.
It's probably athlete's foot.
You should come in for that.
But really it's very importantto wear shoes with socks and if
you you're wearing those lowprofile shoes, you gotta wear
the, the what's it called thosehidden socks you get out.
(22:57):
Friction is what's going tocause pain and blisters and
calluses and sores anddermatitis.
So just wear.
If you're going to wear theshoe, wear it right.
And there's also different likepads, paddings and things put
inside your shoes.
Just like you got those specialsocks, it's the same thing you
got to just protect your feet inevery shoe that you wear and
(23:19):
that way you'll prevent wartsand funguses and calluses and
things like that.
So, those are a couple of tricks, tips that I recommend, love it
.
Speaker 2 (23:29):
My wife has been trying to get me to moisturize
her on my face, for my skin fora while now.
She, you know.
Unfortunately, I don't do itregularly.
This is why you get what yousee here in this, in this still
video here.
Speaker 3 (23:40):
You look like you have a beautiful supple face.
Speaker 2 (23:43):
I'm being very self self-deprecating today, but very
cool, all right.
Well, that was informative.
Thanks everyone for tuning in.
If you've had your own footproblems, tell us about it in
the comments.
Tell us what you, the strugglesthat you've gone through.
Go see Dr Tabakarov.
Go see Dr Lauren.
She promises it will not hurt abit unless she has to burn it
(24:03):
off.
Will not hurt a bit unless shehas to burn it off.
Okay, correct, there you go.
All right, cool, we will leaveit at that.
We will catch everyone nexttime on the next episode of the
LMD podiatry podcast.
Everyone, take care, stay happy, stay healthy.
Remember we only have this onelife to live, so let's take care
of ourselves and live it withpurpose and love and happiness.
(24:24):
Take care, and love andhappiness.
Take care everyone.
Speaker 1 (24:33):
Stay blessed.
Thank you for listening to theLMD Podiatry Podcast.
For more information, visitLMDPodiatrycom.
That's L-M-D-P-O-D-I-A-T-R-Ydot com or call 954-680-7133.
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