John Hollander, DPM

Toenail repair- Acrylics vs. Keryflex

Important factors for you to consider before heading to the nail salon!

If you have a bruised or damaged toenail, are experiencing yellow brittle nails, or have nails that just don’t grow “normally”, chances are you have been searching for a cosmetic option to fix them.  If you search for toenail repair, you have probably come across the options of using acrylics at the nail salon or a cosmetic application called Keryflex, which is only available to medical professionals.  While acrylics may seem like a quick and easy solution to your nail concerns, there are some important factors you need to consider before heading to your local nail salon.

Acrylics can seem like a great solution to covering up an ugly toenail, but they could be perpetuating an existing condition. For example, if you have Onychomycosis (toenail fungus), an acrylic nail application could cause further damage to your nail. Acrylics are not flexible and the toenail experiences lots of flexibility during the use of your foot (i.e. walking, running).   This lack of flexibility can cause the acrylic to pull on your nail bed and cause damage to it. In addition, acrylics are applied using harsh chemicals which can further irritate and damage the nail. If you are not seeking medical treatment for your onychomycosis the application of the acrylic could further perpetuate the condition. Acrylics are porous which means water can get under the acrylic and cause even more fugus to grow! Another factor to consider is that often the chemicals used to apply acrylics are in a communal container.  While we would like to think that a salon technician has the training and safety to know not to share containers with those that have a fungal infection, there is still the possibility that the condition could go unnoticed thus, leading to a contaminated jar of polymer!

An alternative to using acrylics is a product called the Keryflex Nail Restoration System. Its application process is similar to that of gel nail polish but without the damaging effects. Keryflex is a medical grade cosmetic resin- not a gel- that is impregnated with Piroctone, a hydroxypyridone antifungal ingredient. Keryflex does not treat onychomycosis, but it can prevent new fungal growth and can conceal the effects of it while your nail is healing. Keryflex was designed specifically for toenails with the need to be durable and flexible. This flexibility makes it an excellent option for runners and athletes that may have experienced black or severely broken toenails.  It is a non-porous resin, thus allowing nail polish to be removed with acetone without affecting the cosmetic nail.  Once applied, it is permanently bonded! No need to worry about lifting or chipping.  Because this product can only be applied by a medical professional, you won’t find it in your local beauty supply store.   You also won’t have to wonder whether your kit was used on someone else. Each person gets a kit specifically for them.

When looking for a cosmetic option to treat your nail condition, please take these points into consideration. Acrylic can be a quick, inexpensive and easy way to hide a problem, but depending upon your situation, it could make things worse.  With that being said, we recommend you speak with your doctor or podiatrist about your nail concerns before visiting your local nail salon.

If you would like more information on the Keryflex Nail Restoration system, you can visit our website, schedule a consultation or read more about Keryflex here.

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Simple Ways to Practice Wellness

January 20th through the 27th is Healthy Weight Week. The idea behind Healthy Weight Week is to not focus on dieting or what the number on the scale says, but rather to practice mindful eating, moving your body in ways that make you feel good during and after the movements and practicing true self care.  These are all things that we can do for ourselves on a regular basis. Here are just a few ways that you can celebrate Healthy Weight Week and continue throughout the year.

Snacking is OK! There is nothing wrong with snacking, but the nutritious values of what you are snacking on, is what counts. Ask yourself, before you snack, “does this provide any nutritional value to me?” If no, opt for something else.

Moving your body! Explore a new trail, try a new sport, tidy up the house.  The CDC is recommending at least 2.5 hours of exercise per week! That’s nothing! 30 minutes a day of actively moving your body is easy to do. Think you don’t have time- read our blog post on how to incorporate more walking into your day.

Take a breath! Stress can prevent you from maintaining or losing weight. Take a few moments to practice mindful breathing.

Drink more water. Water helps the body remove excess waste and helps provide one with a clearer mind.

Sign up for a race! Signing up for a race automatically provides you with a goal and a timeline to reach it. Run, ski, bike, row, chop wood-any kind of race will do.

Talk to loved ones. Having someone that you can talk to about your daily ups and downs has shown to reduce stress levels.  It is also helpful in keeping you accountable in your goals when you have a support group ready to cheer you on.  In addition, face to face or talking on the phone are much more beneficial than sending an email or a few text messages. So, when you have the option to meet in person, video chat or telephone- take it!

Cook a nutritious balanced meal. The tip that says having a colorful plate is a balanced plate, is quite helpful.  A plate full of beige food is likely to be low in nutrients and higher in carbohydrates.

Be thankful. Before you let negative talk get the best of you, practice saying what you are thankful for. Positive talk leads to lower stress levels, higher self esteem and can produce better productivity in yourself.

Make time for sleep. Aim for 7-8 hours of sleep each night.  Turn off your electronics a minimum of 30 minutes before you close your eyes. Rather than watching a YouTube video, opt for reading a book or magazine instead.  And avoid alcohol before bed- while it may help you fall asleep faster, it has been shown to cause restless sleeping patterns.

Make one small change. Rather than grabbing a soda, drink a glass of water instead. Instead of an entire pint of B&J ice cream, only eat half. You don’t have to drop everything you love to eat, cold turkey (no pun intended). One swap here and another swap there, all add up over time and can lead to positive habits and a healthier self.

Cheers to a happier, healthier, more mindful YOU!

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Survival Tips for Keeping your Feet Warm

Whether you’re an avid winter sports enthusiast or one that prefers to stay indoors at any sign of cold or wet weather, it is important to know how to keep your feet warm and dry.  When venturing out into the elements you may need something more than just a rain boot or a fancy knee-high. Here are some easy survival tips to effectively keep your feet warm and dry this winter season.


  1. Wear a warmer shoe. Give your feet a head-start by keeping your shoes indoors where it is warmer.
  2. Wear shoes designed for your activity and weather. Avoid mesh running shoes. Instead, wear a hiking boot or trail shoe and something with a thicker sole, is water resistant or has water-proof features, especially around the toes and lower sides of the shoe.
  3. Wear a thicker sock. Aim for wool or synthetic fiber socks rather than cotton, which can absorb moisture quickly, dry slowly and pull heat away from your skin, making it a fabric to avoid when there might be snow involved.
  4. Waterproof clothing. If you’re going to be in cold conditions for an extended period of time, consider adding a liner between your sock layers, or even using plastic bags.
  5. Move your body. Starting to feel cold, walk faster, ski faster, run faster, do a few jumping jacks.  Physical activity increases body heat and helps to get the blood moving faster to your extremities which alleviates that cold feeling.

‘…On cold days, I grab a paper towel or Starbucks napkin and fold it over the top of my foot, toes, and under the toes. Then I put on my shoe. This provides a thin layer of insulation that is usually just enough for comfort…”

Remember that if you use toe warmers or do warm water soaks, then you’ll want to make sure the toe warmer or water is not too hot as you can easily burn yourself. If you have neuropathy then you need to check the temperature with your hand or forearm first, as you cannot rely on your feet to tell you if it is too hot.

“Don’t let cold feet keep you indoors during the winter. There is more to winter walking than just the treadmill. But your toes can get painfully cold, and you may even risk frostbite in bitter weather. You want to avoid getting sweaty feet, as that puts you at risk of developing a blister. You can protect your feet in cold weather with these tips.”

For further tips on keeping your feet dry and warm while outside in the cold, check out this article.


If you are experiencing cold feet with little to no relief, contact our office for an evaluation.  You may have a more serious condition. (707) 578-1222.

Stay active this winter and have fun enjoying the outdoors!

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How to tell if you have athlete’s foot or psoriasis.

Do you have athlete’s foot or psoriasis? This is a common question, because the signs and symptoms of both conditions are similar.  To help you figure this out we have put together a quick sign and symptom tree to help determine whether you have the fungal infection commonly known as Athlete’s foot, or a genetic condition known as Psoriasis. Answer each question and follow the corresponding path, which will lead you to the corresponding condition.

This sign and symptom tree is not designed to formally diagnosis or treat your skin conditions, but rather break down the common symptoms and differences that these two conditions have. There are other symptoms related to each condition that is not listed here.  If you have a concern about your skin or feet you should contact your health care provider. They will be able to give you a formal diagnosis and treatment plan for your specific needs.  If you have a concern about your feet, please call our office to set up an appointment.  We can be reached at (707) 578-1222.

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An Eco-Friendly Approach to Gift Wrapping

If you’ve been trying to reduce your carbon foot print this year, another method for doing so can be in the way you wrap your gifts.  While it is very temping to take advantage of the cute wrapping papers on sale, stop and think about what you have at home that could work in its place.  If you’re scratching your head, not to worry, we have complied a list of ideas to help you be greener, while also wowing your recipients with a beautiful and thoughtful presentation.

Eco-Friendly Wrapping Paper

Newspaper. If you don’t get the paper, ask your neighbor or snag a free daily paper. Finish off with a lovely ribbon or twine.

Paper Grocery bag. Leave plain or decorate with stamps, doodles or decoupage colorful cutouts from a magazine.

Fabric. Do you have a stash of fabric? Take a beautiful square and use it to cover your gift. Tie the corners together or use a safety pin to secure. You might even add a few colorful beads onto the safety pin for extra pizzazz.

Loner Socks. Depending on the size, have fun by using a colorful sock tied off with ribbon. This is a great option for your loner socks! Maybe hold off on using the ones with dark stains on the foot though 😊.

Shoe box. Don’t spend money on another box for your gift, look in your closet! Your shoe box makes a wonderful container. Just cover with your favorite Eco-friendly wrapping material.

Jars. Do you have a beautiful old (or new) jam jar laying around? This could make a beautiful presentation for a handmade gift of candies, bath salts or just another fun way to gift smaller items like enamel buttons or beads for your crafting friend!

Toilet Paper Rolls. Don’t throw those rolls out just yet! Bend the ends inwards to create an instant jewelry gift box! Finish off with a pretty ribbon.

Reusable Shopping Bags. Have you stocked up on a hefty stash of reusable shopping bags? If one has a pretty pattern on it, use that as your gift bag. Then, your recipient can start using the bag for their shopping! Win-win all around!

Pringle Cans. Reuse your favorite chip can to hold fresh baked cookies or colorful socks. Just wash out the can and then cover it with brown paper.

Reuse your gift bags. Don’t throw away a gift bag or tissue paper. It they are still in good condition, fold them up and store for future use.

Don’t have ribbon? Use an old plastic bag! Stretch the bag thin to create “string” and tie a bow around your gift.

Don’t have a bow?  Use fallen leaves, twigs, an old ornament or make your own bow out of paper.

Don’t have a crafty side?  Purchase wrapping paper that is made from 100% recycled paper and uses natural dyes. Wrappily uses 100% recycled newspaper and Green-Field Paper Company uses soy-based inks. Take a look on Etsy as well, for smaller productions.

We hope these Eco-friendly gift wrap suggestions inspire you in your future gift-giving and have you re-thinking the materials that can be used in place of traditional gift wrap. Not only will you be helping the earth, but you’ll be helping out your wallet as well!

Happy Holidays from all of us at Sonoma County Foot and Ankle Center!

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How to Relieve Dry Skin with Exfoliants Found at Home

Dry skin, it happens to the best of us.  Dry skin can occur for several reasons and often becomes most prevalent during the summer and winter months where the air is most dry.  Removing dead skin cells helps to relieve the appearance of dry skin, encourage new cell production, as well as, prime the skin for moisturizers which help lock in moisture.

Try these simple exfoliants, that are typically found in your kitchen, the next time you experience dry skin on your arms or legs.

Take a Milk Bath.  Milk contains lactic acid which acts as an exfoliant and may also increase your skin’s ability to hold in moisture.  If one specific area is dry, soak a washcloth in cold milk and place the washcloth on the dry area for five minutes. Gently wash off the milk to allow for some of the lactic acid to remain behind.  If you are feeling dry all over, add a quart of milk to your bath. For additional benefits, you could even add a few tablespoons of honey or oatmeal to the water. Don’t have milk, try plain yogurt- though we don’t recommend using it in your bath.

Take a Salt Bath. Yes, you heard that right. Add two cups of Epsom salt to your warm bath and soak.  Take a small handful of additional Epsom salt and use it to scrub the areas of skin that are dry.  For a softening affect, add dried seaweed to your bath.

Make a Sugar Scrub. Perfect for showers, a sugar scrub can be applied quickly to your legs, arms and belly.  Take a cup of sugar and mix in a ¼ cup of coconut oil.  Add your favorite essence if you’d like.  Apply the scrub to your skin in a circular motion and rinse off with warm water.

Baking Soda.  There is nothing easier than mixing baking soda and water to make an exfoliant.  Baking soda is great for sensitive skin and delicate areas such as your face and neck.  Simply mix water into a handful of baking soda to make a paste consistency. Apply with circular motions and rinse off with warm water.

Immediately after exfoliating your skin, be sure to apply your favorite moisturizer.  Coconut oil with lavender and orange essence is a lovely combination but do note that it can leave the skin feeling a tad bit greasy.

If you are not seeing relief in your dry skin after a week or two of self-care, you may need to see a doctor.  Chronic dry skin can be the sign of something more serious.

Happy exfoliating!

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Fall Leaf Porcupine Craft!

 Children enjoy animals and collecting things, so why not take this opportunity to make a fun porcupine from all of the fallen leaves they collect?

Print out our spike-less porcupine on card stock here —-> PorcupineCraftpage then, head outside to collect your favorite leaves.  Attach your leaves to the porcupine with your favorite white glue and let dry. To help keep the leaves flat, try covering them with a magazine and then a book for weight.  You could even add some glitter to the leaves if you wanted to jazz him or her up a bit!

We hope you enjoy this craft time with your kiddo!  Be sure to share your creations with us on our Facebook page or on Twitter!

Happy crafting from all of us at Sonoma County Foot and Ankle Center!


*This image is for personal use only.

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Halloween Safety Tips

Halloween is upon us and in just a few short days the streets will be filled with the familiar sounds of laughter and greetings of “trick or treat”.

Halloween is all about having fun. Getting outside, dressed as your favorite super hero, goblin or ghost or humorous theme.  Let’s keep the holiday fun by following a few safety tips!

  1. STAY ON THE SIDEWALK.  Keep the roads for the cars and utilize the sidewalk whenever possible. This keeps everyone safe and happy.
  2. WALK IN A GROUP. They say there is safety in numbers. And besides, isn’t it always more fun to trick or treat with your best buds.
  3. STAY VISIBLE.  Wear bright colors or reflective tape on your costumes.  Grab a few glow sticks or a flashlight too!  It is dark at night, and having lights can help keep you from tripping and for others to see you.
  4. WEAR COMFORTABLE SHOES. As a podiatrist office, it is our duty to suggest you wear comfortable, well-fitting shoes at all times- especially on Halloween!  Sneakers are a great option! Don’t forget your orthotic inserts if you use them.  And it’s always a good idea to double knot your shoelaces too!
  5. INSPECT YOUR CANDY. Keep an eye open for choking hazards for little trick or treaters.  Don’t eat handmade goodies (you never know their cleaning habits).  And if a candy looks opened, it’s probably best to toss it.
  6. DRIVE SLOWLY. Take this one night to drive a smidgen slower than the speed limit, especially in the neighborhoods.  Kids get so excited, that sometimes they forget to look for cars. Help them, by keeping an eye out for them as you drive.

We wish you all a fun, happy and sppppooooooky Halloween night!

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Lisfranc Injuries- A Common Misdiagnosis

Some say that Lisfranc injuries are rare, but that may be due to the fact that up to 20% of Lisfranc injuries are misdiagnosed as a sprain by physicians. The reason for this may be the methods for determining the type of injury the patient has based on first evaluation. The different types of tests a physician can use, usually all result in some level of discomfort in the foot region which can lead to a misdiagnosis.  That is why further investigation is necessary in the form of medical imaging.  Medical imaging will allow the physician to look for fractures in the metatarsal bones, widening between joints or dislocation of the joints in the mid foot[1].

What exactly is a Lisfranc injury?

Second metatarsal fracture w/ dislocation of third through fifth tarsometatarsal joints.

Lisfranc (midfoot) injury is when the bones of the midfoot become broken or dislocated, or the ligaments that support the midfoot have been torn.

This type of injury can occur from a simple twist and fall, to direct impacts by falling from high elevations or car accidents.

Symptoms of a Lisfranc injury include:

  • Swelling & pain of the midfoot
  • Decreased or inability to bear weight on the foot
  • Bruising on the top of the foot and especially the bottom of foot
  • Pain that worsens with standing, walking or bearing weight on the foot

A proper diagnosis of a Lisfranc injury is crucial.  “When one misdiagnoses Lisfranc injury as a sprain or renders insufficient treatment, complications such as osteoarthritis and midfoot pain result. The outcome of Lisfranc injuries depends on the severity of injury to the cartilaginous joint surface with the most common outcome being midfoot arthritis.[2]” There is also a chance of one developing a flat foot if proper treatment is not taken.

The treatment of Lisfranc injuries depend upon the severity of the injury.  It can vary from applying a compression bandage and ice, to wearing a short leg splint or boot, a brace with compression wrap, or surgery.

If ice and rest do not provide your foot with relief please make an appointment with your podiatrist for an evaluation, the sooner the better!


[1] Weatherford, B. M., MD. (2017, September). Lisfranc (Midfoot) Injury – OrthoInfo – AAOS. Retrieved October 5, 2018, from–conditions/lisfranc-midfoot-injury/

[2] Shah, N. N., MD, & DeMeo, J., DPM. (2016). Keys To Diagnosing And Treating Lisfranc Injuries. Podiatry Today,29(4), 60-67. Retrieved October 5, 2018, from


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