Foot Notes...

A Foot & Ankle Centers, PC Newsletter

Foot & Ankle Centers, PC
4230 Harding Pike
Suite 202
Nashville, TN  37205

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Did you Know...
A 2�-inch high heel can increase the load on the forefoot by 75%!
No wonder they hurt!  Try to limit your wear to only occasions that are necessary.  A better option is a wedge if you need the height.
March , 2014 

It's been a long, cold winter so we know everyone is ready for spring!  Don't forget to take care of your feet as you start to get out and exercise, work in the garden, and even wear sandals.  Treat your feet well with good shoes, moisturizers, and pedicures to keep them in tip-top shape.


We're all looking forward to enjoying the beautiful weather to come!

The Staff of Foot & Ankle Centers

The Nail Spa at FAC 

Spa Health Client of the Month: The Diabetic


Diabetic clients have very specific needs and concerns when it come to having nail service. When giving a diabetic patient a pedicure, the nail technician has to take proper precautions to help a diabetic client enjoy a safe and relaxing service.  Fortunately for all of the clients at the Nail Spa at FAC the sanitary precautions we take are the highest available.   These are some of the considerations for providing diabetic clients with nail care:
  • Susceptibility To Infection
    • Due to the higher risk of infection even a minor skin irritation or injury has the potential of becoming a severe, life threatening condition.  In our spa all instruments are surgically sterilized, the pedicure tubs are disposable and all clients receive a personal nail kit to ensure there is no cross contamination.
  • Poor Circulation/Peripheral Neuropathy
    • Many diabetics lose sensation in their feet and legs so extreme caution must be taken with temperature water.  For this reason, we never use hot towels with our diabetic pedicure to make sure there is never a risk of burning the skin.
  • Thinning of the skin 
    • Caution is taken when performing massage on skin that appears to be thinning.  The nail technician will check and be sure there are no open cuts or wounds because a pedicure should never be done with any open sores.  If an ulcer is noted the client would be referred for immediate medical attention.
If you are diabetic or know someone that is you can rest assured that you don't have to compromise your health when getting nail services at our spa.   So sit back, relax, and enjoy the service! 


*Adapted from Nail Magazine, March 2014

What is Toenail Fungus?

Toenail fungus, or onychomycosis, is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and smells foul. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and results in thicker nails that are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.



Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where you are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete's foot and excessive perspiration.



Toenail fungus is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail's quality and color, which is often ugly and embarrassing


Diagnosis and Treatment:

You should visit Dr. Cohen when you notice any discoloration, thickening, or deformity of your toenails. The earlier you seek professional treatment, the greater your chance at getting your nails to clear.

Treatments may vary, depending on the nature and severity of the infection. Your podiatrist can detect a fungal infection early and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.

Sometimes oral antifungals may be the most effective treatment. They offer a shorter treatment regimen of approximately three months and improved effectiveness. However, often you may get a recurrence once the medication is stopped.  Dr. Cohen has been using topical antifungals for a while but has recently switched brands and has had tremendous success.  Instead of only using the topical antifungal (Clarus Antifungal Solution) it is initially used in conjunction with Kera Nail Gel.  The Nail Gel has ingredients that help make the nail more permeable so the topical antifungal is much more effective.  

In some cases, surgical treatment may be elected. Permanent removal of a chronically painful nail that has not responded to any other treatment permits the fungal infection to be cured and prevents the return of a deformed nail.



Proper hygiene and regular inspection of the feet and toes are the first lines of defense against fungal nails. Clean and dry feet resist disease.

  • Wash your feet with soap and water, remembering to dry thoroughly.
  • Wear shower shoes when possible in public areas.
  • Change shoes, socks, or hosiery more regularly.
  • Clip toenails straight across so that the nail does not extend beyond the tip of the toe.
  • Wear shoes that fit well and are made of materials that breathe.
  • Avoid wearing excessively tight hosiery to decrease moisture.
  • Wear socks that "wick" moisture away from your feet.
  • Disinfect instruments used to cut nails.
  • Disinfect home pedicure tools.
  • Don't apply polish to nails suspected of infection (those that are discolored, for example). 
*Information from 
Make it Last!
$10 Off
  any gel polish manicure or pedicure
Limit one per customer.  Please present coupon at the time of service.
Not valid on prior purchases. Expires 3.31.14