You are in the right place. Dr. Tom Biernacki, DPM, FACFAS — board-certified foot & ankle surgeon with 3,000+ surgeries — explains exactly what foot hygiene & infection prevention means and what actually works. Call (810) 206-1402 for a same-day appointment at our Howell or Bloomfield Hills office.
Quick answer: Foot Hygiene Infection Prevention Athletes Foot Fungal Nails Warts is a common nail condition with multiple causes including trauma, fungal infection, biomechanical pressure, and underlying medical conditions. Treatment depends on the cause: trauma resolves as the nail grows out (6-12 months), fungus needs antifungal therapy, and biomechanical issues need shoe and orthotic correction. Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Why Foot Hygiene Matters More Than Most People Realize
The feet are among the most infection-prone areas of the body, yet foot hygiene receives far less attention than hand hygiene in both public health messaging and individual daily routines. This neglect has consequences: athlete’s foot affects approximately 15–25% of the population at any given time; onychomycosis (fungal toenail infection) affects 10–12% of all adults and up to 50% of adults over age 70; plantar warts (verruca plantaris) are among the most common dermatological conditions seen in children and young adults. All three conditions share a critical characteristic: they are largely preventable with consistent, evidence-based foot hygiene practices.
Beyond these common infections, inadequate foot hygiene in patients with diabetes or peripheral vascular disease can directly contribute to wound complications that have life-altering consequences. Establishing good foot hygiene habits is a high-use health behavior with disproportionate benefits for foot health across the lifespan.
Daily Foot Washing Protocol
The feet should be washed daily with soap and warm water, with particular attention to the interdigital spaces (between the toes) — the warm, moist environment between the toes is the primary incubation site for tinea pedis (athlete’s foot). Many people wash their feet by allowing shower water to run over them without direct washing; this is insufficient to remove the skin scale, sweat residue, and microbial load that accumulates with daily activity. Use a washcloth or soft brush to actively clean the entire foot surface including the heel, arch, and all toe spaces.
Thorough drying is equally important. Pat — do not rub — the entire foot dry, paying careful attention to the interdigital spaces. Moisture left between the toes creates the ideal environment for dermatophyte fungal growth. A hairdryer on a low setting can assist with drying in patients who have difficulty toweling between toes due to toe deformity or limited flexibility.
Preventing Athlete’s Foot (Tinea Pedis)
Tinea pedis is a highly contagious superficial fungal infection caused primarily by Trichophyton rubrum and Trichophyton mentagrophytes. The fungi thrive in warm, moist environments and spread through direct contact with contaminated surfaces. Prevention focuses on disrupting transmission at these surfaces:
- Never walk barefoot in public areas where fungal contamination is likely: locker rooms, pool decks, gym showers, hotel bathrooms. Flip-flops or shower sandals are essential in these environments.
- Change socks daily — more frequently if feet perspire heavily. Moisture-wicking synthetic or wool socks reduce the duration of foot moisture exposure compared to cotton, which retains moisture.
- Alternate footwear to allow drying. Shoes worn daily accumulate significant moisture; rotating between two pairs of shoes allows each to dry thoroughly between uses.
- Apply antifungal powder (miconazole, clotrimazole, or tolnaftate) to shoes and socks if prone to recurrent tinea pedis.
- Treat active tinea pedis promptly — both to relieve symptoms and to prevent spread to toenails (onychomycosis). Over-the-counter topical antifungals (clotrimazole, terbinafine, miconazole) applied twice daily for 4 weeks resolve most cases. Persistent or extensive infections require prescription-strength topical or oral antifungals.
Preventing Fungal Toenail Infection (Onychomycosis)
Onychomycosis — fungal infection of the toenail plate — typically begins from adjacent tinea pedis spreading to the nail, or from direct nail trauma that allows fungal access to the subungual space. Prevention strategies include aggressive treatment of any tinea pedis (eliminating the primary source of infection), keeping toenails trimmed straight across at appropriate length (long nails accumulate debris and moisture that encourage fungal growth), and ensuring footwear provides adequate toe box room to prevent nail trauma.
Once established, onychomycosis requires months of treatment. Prevention is far preferable to treatment. Patients who have had onychomycosis previously should apply topical antifungal lacquer (ciclopirox) or efinaconazole to affected nails prophylactically after completing a successful treatment course to reduce recurrence risk.
Preventing Plantar Warts (Verruca Plantaris)
Plantar warts are caused by human papillomavirus (HPV) — specifically types 1, 2, 4, and 63 — that enters through microabrasions in the plantar skin. Transmission occurs through contaminated surfaces: pool decks, gym floors, locker rooms, and shared footwear. Prevention focuses on the same barefoot avoidance strategies used for tinea pedis prevention — consistent use of sandals in public wet areas. Prompt treatment of any plantar wart prevents satellite spread that creates large, multi-wart mosaic clusters difficult to eradicate. Any thickened, painful plantar lesion that does not resolve as expected for a callus should be evaluated by a podiatrist, as warts are frequently mistaken for calluses by patients.
Moisturization for Dry and Cracked Skin
Dry heel skin — particularly the thickened, fissured skin that develops over the heel with aging, diabetes, and prolonged standing — represents a portal for bacterial entry if fissures deepen. Daily moisturization with urea-based creams (10–20% urea is most effective), ammonium lactate lotion, or petroleum-based emollients maintains skin hydration and supple texture. Apply immediately after bathing while skin is still slightly moist for maximum absorption. Avoid applying between the toes as this encourages fungal growth.
Footwear Hygiene
Shoes and socks are significant vectors for fungal and bacterial contamination. Wash socks in hot water (above 140°F) to kill fungal spores — cold-water washing is insufficient. Use UV shoe sanitizers or antifungal shoe sprays inside footwear between uses. Replace athletic shoes every 300–500 miles or approximately every 6–12 months of regular use — old shoes accumulate microbial load and lose structural support simultaneously. Never share footwear, including flip-flops, sandals, or athletic shoes.
When to See a Podiatrist
Despite consistent hygiene practices, foot infections sometimes develop and require professional treatment. Seek podiatric evaluation for: tinea pedis that does not respond to 4 weeks of over-the-counter treatment, any signs of bacterial superinfection (increased redness, warmth, swelling, pain, or discharge), toenail changes including thickening, discoloration, or separation from the nail bed, plantar lesions that are painful or growing despite home treatment attempts, or any foot infection in the context of diabetes or circulatory compromise — where seemingly minor infections can escalate to serious complications rapidly. Balance Foot & Ankle provides prompt, effective treatment for all common foot infections in patients of all ages across Southeast Michigan.
Relief Starts With One Appointment
Board-certified podiatrists serving Southeast Michigan — same-week appointments available.
Foot Infection Treatment in Michigan
From athlete’s foot to fungal nails and plantar warts, foot infections are common but treatable. Dr. Tom Biernacki provides comprehensive infection treatment including topical and oral medications, laser therapy, and Swift microwave treatment at Balance Foot & Ankle.
Learn About Our Nail & Skin Treatments | Book Your Appointment | Call (810) 206-1402
Clinical References
- Havlickova B, et al. “Epidemiological trends in skin mycoses worldwide.” Mycoses. 2008;51(Suppl 4):2-15.
- Gupta AK, et al. “Optimal management of fungal infections of the skin, hair, and nails.” Am J Clin Dermatol. 2004;5(4):225-237.
- Al Hasan M, et al. “Dermatology for the practicing allergist: tinea pedis and its complications.” Clin Mol Allergy. 2004;2(1):5.
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, Suite 208
Bloomfield Hills, MI 48302
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Book Your AppointmentMore Podiatrist-Recommended Fungus Essentials
Breathable Diabetic Shoe
Orthofeet Sprint — deep, breathable design reduces fungal growth.
Moisture-Wicking Sock
Watch: Plantar Wart Removal: How to Get Rid of a Foot Wart with No PAIN! — MichiganFootDoctors YouTube
OS1st FS4 — keeps feet dry, eliminating the warm-wet environment fungus needs.
Breathable Recovery Slide
HOKA Ora 3 — lets feet air out after closed-shoe exposure.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
Topicals only penetrate the top 30% of the nail plate — if the fungus is near the cuticle or under 50% of the nail, oral terbinafine or laser is usually required for full clearance. Balance Foot & Ankle offers in-office fungal nail diagnostics and laser treatment that reaches the nail matrix where topicals can’t. We’ll examine the nail and recommend the fastest path to clear, healthy regrowth.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
In Our Clinic
In our clinic, the toenail fungus patient has usually already tried OTC topical antifungals for months with no improvement. We confirm the diagnosis with a PAS stain or fungal culture — because about 30 % of thickened, discolored nails are actually NOT fungal (they’re trauma, nail psoriasis, or keratin granulation from polish). For true dermatophyte onychomycosis, oral terbinafine (Lamisil) remains the most effective treatment with ~70 % cure rate and manageable safety monitoring. Nail laser and topical efinaconazole are options for patients who can’t take oral medication. The nail grows back clear over 9–12 months, not overnight.
In-Office Treatment at Balance Foot & Ankle
When conservative care isn’t enough, Dr. Tom Biernacki and the team at Balance Foot & Ankle offer advanced, same-day options — including Foot Fungus Treatment Michigan at our Howell and Bloomfield Hills clinics.
Same-day appointments available. Call (810) 206-1402 or book online.
When Shoes Aren’t Enough — Dr. Tom’s Top 9 Orthotics
About 30% of patients I see for foot pain need MORE than a great shoe — they need a structured insole. Below: my complete 2026 orthotic ranking with pros, cons, and the specific patient I’d give each one to.
★ DR. TOM’S COMPLETE 2026 ORTHOTIC RANKING
9 Best Prefab Orthotics by Use Case
PowerStep, Currex, Spenco, Vionic, and Superfeet — every orthotic I’ve fitted to thousands of patients across both Michigan offices. Each card includes pros, cons, and the specific patient I’d give it to. Real Amazon ratings, review counts, and prices below.
Best All-Purpose Orthotic for Most Patients
Semi-rigid arch shell + dual-layer cushion + deep heel cup. The orthotic I’ve fitted to more patients than any other for 15 years. APMA-accepted. Trim-to-fit design works in athletic shoes, casual shoes, and most work boots.
✓ Pros
- Semi-rigid arch shell provides true biomechanical correction
- Deep heel cup centers the heel and reduces lateral instability
- Dual-layer cushion (top + bottom) lasts 9-12 months daily wear
- Available in 8 sizes for precise fit
- APMA-accepted and clinically validated
- Lower price than Superfeet Green for equivalent function
✗ Cons
- Too thick for most dress shoes (use ProTech Slim instead)
- Some break-in period required (3-7 days for arch tolerance)
- Not enough correction for severe pes planus or rigid pes cavus
Dr. Tom’s Recommendation: If a patient has run-of-the-mill plantar fasciitis, mild flat feet, or arch fatigue, this is the first orthotic I try. Better value than Superfeet for 90% of patients, which is why I swapped it into our clinic kits three years ago. Sub-$50 typically.
Maximum Motion Control · Flat Feet & Severe Over-Pronation
PowerStep’s most aggressive stability orthotic. Adds a 2°-7° medial heel post on top of the standard PowerStep platform — designed specifically for flat-footed patients and severe pronators who need real corrective force.
✓ Pros
- 2°-7° medial heel post adds aggressive pronation control
- Same trusted PowerStep arch shell, more correction
- Built specifically for flat-foot biomechanics
- Excellent for posterior tibial tendon dysfunction (PTTD)
- Removable top cover for cleaning
✗ Cons
- Too aggressive for neutral-arch patients
- Needs longer break-in (10-14 days) due to stronger correction
- Adds 2-3 mm of stack height — won’t fit slim dress shoes
Dr. Tom’s Recommendation: When a patient comes in with significant flat feet AND symptoms (heel pain, arch pain, knee pain), the Original PowerStep isn’t aggressive enough. The Maxx is what gets prescribed. About 25% of my flat-footed patients end up here.
Low-Profile · Fits Dress Shoes & Narrow Casuals
3 mm slim profile with podiatrist-designed tri-planar arch technology. Engineered specifically to fit inside dress shoes, oxfords, loafers, and women’s flats without crowding the toe box. Vionic was founded by an Australian podiatrist.
✓ Pros
- 3 mm slim profile (vs 7-10 mm for standard orthotics)
- Tri-planar arch technology adds support without bulk
- Built-in deep heel cup despite slim design
- Fits dress shoes WITHOUT having to remove the factory insole
- Trim-to-fit · APMA-accepted
✗ Cons
- Less arch support than full-volume orthotics
- Top cover wears faster than thicker alternatives
- Not enough correction for severe foot deformities
Dr. Tom’s Recommendation: My default when a patient says ‘I need orthotics but I have to wear dress shoes for work.’ Slim enough to fit in oxfords and pumps without the heel sliding out. The single highest-impact change you can make for office workers with foot pain.
Built-In Metatarsal Pad · Morton’s Neuroma · Ball-of-Foot Pain
Standard Pinnacle orthotic with a built-in metatarsal pad positioned proximal to the metatarsal heads — the exact location that offloads neuromas and metatarsalgia. No need for separate met pads or pad placement guesswork.
✓ Pros
- Built-in met pad eliminates DIY pad placement errors
- Specifically designed for Morton’s neuroma + metatarsalgia
- Same trusted PowerStep arch + heel cup platform
- Top cover protects sensitive forefoot skin
- Faster relief than orthotics + add-on met pads
✗ Cons
- Met pad position is fixed (can’t fine-tune individual placement)
- Some patients with very small or very large feet need custom
- Slightly thicker than the standard Pinnacle
Dr. Tom’s Recommendation: If a patient has Morton’s neuroma, sesamoiditis, or generalized ball-of-foot pain (metatarsalgia), this saves a clinic visit and a prescription. The built-in pad placement is anatomically correct for 80% of feet. Way better than DIY met pads.
Adaptive Dynamic Arch · Athletic & Daily Wear
Currex’s flagship adaptive arch technology — the orthotic flexes with your gait instead of fighting it. Different stiffness zones along the length give you targeted support at the heel, midfoot, and forefoot. Available in three arch heights (low/medium/high).
✓ Pros
- Dynamic flex zones adapt to natural gait cycle
- Three arch heights ensure precise fit
- Lighter than rigid orthotics (no ‘heavy foot’ feel)
- Excellent for runners and athletic walkers
- European podiatric design (German engineering)
✗ Cons
- More expensive than PowerStep Original ($55-65 typically)
- Less aggressive correction than Pinnacle Maxx for severe cases
- Three arch heights means you must self-select correctly
Dr. Tom’s Recommendation: I started recommending Currex three years ago for runners who said PowerStep felt ‘too rigid.’ The dynamic flex zones respect natural gait. Best for active patients who walk 8K+ steps daily and don’t need maximum motion control.
Running-Specific · Heel Strike + Forefoot Strike Compatible
Currex’s purpose-built running orthotic. The midfoot flex zone is positioned for runner’s gait mechanics, with a flared heel cushion for heel strikers and a forefoot rocker for midfoot/forefoot strikers. Tested on 1000+ runners during product development.
✓ Pros
- Designed by German biomechanics lab specifically for runners
- Dynamic arch flexes with running gait (not static like PowerStep)
- Three arch heights (low/medium/high)
- Reduces overuse injury risk in mid-distance runners
- Lightweight (no impact on cadence)
✗ Cons
- Premium price ($60-75)
- Not aggressive enough for severe over-pronators (use Pinnacle Maxx)
- Runner-specific design = less ideal for daily walking shoes
Dr. Tom’s Recommendation: If a patient runs 20+ miles per week and has plantar fasciitis or shin splints, this is the orthotic I prescribe. The dynamic flex zones respect running biomechanics in a way that no rigid PowerStep can match. Pricier but worth it for serious runners.
Cavus Foot & High-Arch Patients
Polyurethane base with a deeper heel cup and higher arch profile than PowerStep — built for cavus (high-arched) feet that need maximum cushion and support. The 5-zone cushioning system addresses the unique pressure points of high-arch feet.
✓ Pros
- Deeper heel cup centers the heel for cavus foot stability
- Higher arch profile fills the void under high arches
- 5-zone cushioning addresses cavus foot pressure points
- Polyurethane base lasts 12+ months
- Available in Wide width
✗ Cons
- Too tall/aggressive for normal or low arches
- Won’t fit slim dress shoes
- Pricier than PowerStep Original
- Some patients find the arch height uncomfortable initially
Dr. Tom’s Recommendation: Cavus foot patients are often misdiagnosed and given low-arch orthotics — that makes everything worse. Spenco’s Total Support has the arch profile that high-arch feet actually need. About 15% of my patients have cavus feet; this is what they wear.
Cushion Layer · Standing All Day · Gel Pressure Relief
NOT a true biomechanical orthotic — this is a cushion insole. But for patients who want gel pressure relief instead of arch correction (or to add ON TOP of factory insoles in work boots), this is the best gel option on Amazon.
✓ Pros
- Genuine gel cushioning (not foam pretending to be gel)
- Targeted gel waves under heel and ball of foot
- Trim-to-fit · works in most shoe types
- Sub-$15 price (most affordable option in this list)
- Massaging texture is genuinely soothing
✗ Cons
- ZERO arch support — this is cushion only
- Won’t fix plantar fasciitis or flat-foot issues
- Compresses faster than PowerStep (4-6 months)
- Top cover wears through in high-mileage applications
Dr. Tom’s Recommendation: I recommend these to patients who tell me ‘I just want my feet to stop hurting at the end of my shift’ and who don’t have a biomechanical issue. Construction workers, factory workers, retail. Pure cushion does the job for them.
Tight-Fitting Shoes · Cycling Shoes · Hockey Skates
Superfeet’s slim version of their famous Green insole. The trademark stabilizer cap is preserved but the overall thickness is reduced — works in cycling shoes, hockey skates, ski boots, and other tight-fitting footwear that the standard Superfeet Green can’t fit into.
✓ Pros
- Stabilizer cap centers the heel (Superfeet’s signature feature)
- Slim profile fits tight athletic footwear
- Lasts 12+ months daily wear
- Excellent for cycling shoes specifically
- Built-in odor-control treatment
✗ Cons
- Premium price ($45-55)
- Less cushion than PowerStep equivalents
- Not as aggressive correction as Pinnacle Maxx for flat feet
- The signature ‘heel cup feel’ takes 1-2 weeks to adapt to
Dr. Tom’s Recommendation: If you’re a cyclist with foot numbness, hot spots, or knee pain — this is the orthotic. The stabilizer cap solves cycling-specific biomechanical issues that no other orthotic addresses. Worth the premium for athletes.
None of these solving your foot pain?
Some patients (about 30%) need custom-molded prescription orthotics. We make 3D-scanned custom orthotics in our Howell and Bloomfield Hills offices — specifically built for your foot mechanics.
Schedule a Custom Orthotic Fitting →FSA/HSA eligible · Most insurance accepted · (810) 206-1402
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your toenail fungus, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.
Same-day appointments available. (810) 206-1402
Learn about our toenail fungus laser treatment → | Book online →
Doctor Hoy’s Natural Pain Relief Gel
Natural topical pain relief I use in our clinic. Arnica + camphor formula — apply directly to the area 3–4x daily. ($20–25)
Shop Doctor Hoy’s →Frequently Asked Questions
How long does it take a toenail to grow back?
6-12 months for a full big toenail. Smaller toenails 4-6 months. Speed varies with age, circulation, and nutrition.
Will this affect other nails?
Trauma affects only the injured nail. Fungal infection can spread without treatment. Systemic causes affect multiple nails simultaneously.
Should I cover the nail or leave it open?
Cover with a breathable bandage during work or activity. Leave open at night for healing. Keep dry and clean.
What is Plantar wart?
Plantar wart is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.
Symptoms and warning signs
Common signs of plantar wart include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.
Conservative treatment options
Most cases of plantar wart respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.
When is surgery considered?
Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.
Recovery timeline and prevention
Recovery from plantar wart varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.
Ready to feel better?
Same-week appointments available in Howell and Bloomfield Hills, Michigan.
Book Your VisitReady to fix this for good?
Reading goes only so far. The fastest path to relief is a 30-minute office visit with Dr. Biernacki — same-day Howell or Bloomfield Hills. Call (810) 206-1402 or use our online booking.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.