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Posts for category: Dermatology

It is common for your children to have anxiety about having plantar warts on their feet and we would like to lessen your child anxiety as well as your own. Plantar warts are a common virus that children and adults can acquire over time. We typically see plantar warts in children from going barefoot in the grass or around public pools. Adults can acquire plantar warts from showering in public health clubs or going barefoot in hotels while traveling. Typically the wart virus will appear as callus tissue that has red or brown dots in the center. It is usually raised and can be painful.

Our foot specialists have been using Cantharone for many years. Cantharone or Cantharidin comes from the green blister beetle. It has been used in China for more than 2000 years. I have personally been using Cantharone since 2002 and have had excellent results with treating warts in adults and children. The advantages are that it is a painless treatment with minimal down time. The typical treatment would be one to three applications. The procedure is straightforward. You would come to the office our specialists will typically lightly trim the hard callus tissue to make sure it is a wart. An applicator is used and a small amount of Canthrone is applied followed by antibiotic cream and band aid. No needles, no cutting, and most important painless!!! The way the Catharone works is the body reacts by forming a blister on top of the wart, the blister then sepeates the wart from the skin, and by the next office visit healthy skin grows in the place of the wart tissue. It tyically will take one to three treatments.  It is a simple treatment with a high success rate. Children are especially happy and are amazed that the treatment does not hurt and is quick.

I tell my patients to expect some tenderness for a few days while the blister forms. I usually would have my patients not do too much physical activity for one to two days. I really like this treatment for active children that play sports because the downtime is minimal.

I am familiar and utilize other treatment options if necessary for stubborn warts but rarely have to use them especially in children.

For more information please refer to our education videos on our home page:

Spring is right around the corner and that means getting your feet ready for sandals and flip flops. If you haven't looked at your toenails all winter it may be a good time to take a look and see if they are at all discolored. If they are this blog will give you a nice road map on our evaluation and treatment for fungal nail better known as "Onychomycosis."

The first step would be at home if you have nail polish take it off and see if you notice any differences between the toenails. Look for any yellow discoloration in the nails or increased thickness. If you do notice any pain or nail color changes it may be a fungal infection, bleeding under the nail plate, or ingrown toenail.

During your evaluation our Doctors will evaluate if you have a fungal infection is typically diagnosed clinically but a culture of the nails can be sent off for evaluation. Trimming and filing of the nails is a painless approach to clearing some of the fungus. If you have an ingrown toenails we have experienced foot specialists who first and foremost ease any anxiety that our patients have if they need a procedure. Once the toe is anesthetized we consider our nail procedure "virtually painless."

Oral medication such as Lamisil is a good option if the fungus is in the nail root and patients are not take any cholesterol medication or multiple medications. We screen our patients carefully for this medication and obtain a Liver function test before treatment and one month into the three month course of the medication. Typically results are seen within the first thee to four months on using oral Lamisil.

We have a FDA approved topical Medication in our offices called Clear nails which is applied topically once to twice a day to toenails in which Lamisil is contraindicated or our foot specialists believe that topical would be a better option for treatment. Prescription topical Penlac is another option for topical application. The newer topical Medication called Jublia (efinaconazole) is on the market but our foot specialists have limited experience with this medication being so new and are uncertain of the long term results vs topical Clear Nails and topical Penlac. We have written a few prescriptions for this medication but it has been averaging at this point $400 with private pay insurances we will look further into this with local pharmacies. Compounding pharmacies can also make topical antifungal medications as an option as well. We sometimes recommend oral biotin to increase strength of toenails and vicks vapor rub to help soften thick toenails that are difficult to trim.

For more information please refer to our website at



A common condition that we see in our offices are plantar fibromas. If you have a lump on the bottom of the foot typically in the mid portion of the foot it is more than likely a benign growth called a plantar fibroma. Plantar fibromas are a benign nodule that grows on the bottom of the foot along the plantar fasica ligament. Symptoms consist of a painful mass on the bottom of the foot between the heel pad and the forefoot. The cause is unknown but thought to be a genetic component. We are able to visualize the fibroma with Diagnostic Ultrasound in the office. Typically plantar fibromas are asymptomatic and the location is usually in a non-weightbearing part of the foot.

Conservative treatment consist of offloading pads, custom orthotics, cortisone injections to help shrink the size of the fibroma, and topical compounding transdermal Verapamil. The topical medication has shown in certain studies to shrink the size of fibromas without the need of a cortisone injection.

Surgery is the last option and involves removal of a portion of the plantar fascia. The recurrence rate is high so sometimes the entire plantar fascia has to be removed for chronic cases.

Please contact us at our West Ashley or Mt. Pleasant offices if you are experiencing any foot pain. For more information please refer to our website at


As the Spring season approaches it is important to evaluate your toenails for potential fungus infection. Fungal infection of the toenails is often ignored because the infection can be present for years without causing pain.

Discolored toenails are a common complaint of patients that present to our office. Typically a discolored toenail can be a sign of "Onychomycosis." The key to diagnosis and treatment is prompt evaluation of the discolored toenail. Onychomycosis is a fungal infection of the toenail that can be caused from trauma to the toenail, pedicures, damp areas such as swimming pools, locker rooms, and showers. Treatment options consist of topical antifungal treatment, oral antifungal treatment, nail avulsion, and lazer treatment of the toenails.

The majority of cases if caught early enough can be treated with nail trimming and topical antifungal medication.

Carolina Foot Specialists offers a liquid product for toenail fungus called Clear Nails. The active ingrediants consist of liquid Lamisil, ciclopirox, and fluconazole. Clear nails is an inexpensive safe option that assists in clearing of the toenail.

Some preventative measures include proper hygiene, clean and dry feet which will resist disease, washing the feet with soap and water, shower shoes when in a locker rooms setting, disinfecting home pedicure tools, and not applying nail polish to nails suspected of infection.