Toe Lift

In a world where the “beautiful” are given many advantages, it is easy to understand why appearance is weighted so highly. The old adage, “What is beautiful is good” is very still sadly true today, in fact especially today with the influence of social media, when being perceived as attractive creates a halo effect. Feet are no different then other parts of the anatomy, especially for women who tend to wear more open toed shoes and sandals then men.  Measuring quality of life is an important aspect of delivering holistic dermatological care to feet. The lesions on the tops of toes are trivial to most health professionals and my fellow podiatrists, some individuals adapt to the change in the appearance of their toes, however, others react negatively and have decreased psychosocial performance (functioning of emotional, social, mental well-being).   The management of scars is a challenge for professionals since these lesions can greatly impact quality of life. Although s...

The International Advisory Panel on Scar Management recommended the use of intralesional steroid injections for the treatment of hypertrophic scars (1).    Corticosteroids were proved to induce scar regression through many different mechanisms. Firstly, they suppress inflammation by inhibiting leukocyte and monocyte migration and phagocytosis (2). Second, they are powerful vasoconstrictors, thus reducing the delivery of oxygen and nutrients to the scar bed (2).   Third, they have an antimitotic effect that inhibits keratinocytes and fibroblasts, slowing reepithelialization and new collagen formation. Furthermore, they may reduce plasma protease inhibitors, thus allowing collagenase to degrade collagen.  Corticosteriods also induces a significant plunge in alpha-1-antitrypsin and alpha-2-macroglobulin levels, which tend to be greater in scar tissue and are natural inhibitors of collagenase in human skin (3). Corticosteroids affect fibroblast proliferation and pro...