Welcome to the personal website of

Dr. Michael A. Zapf, DPM, MPH, FACFAS, FACFAOM

Thank you for visiting the web site of Dr. Michael Zapf. He is a member of the Agoura-Los Robles Podiatry Centers

The "real" practice web site, the one that contains registration forms, doctor information for all the office and directions to the office is located at:

www.conejofeet.com   ç Click here

I am Dr. Michael Zapf. I have been offering a full range of podiatric medical services, from ingrown nails to heel pain and foot surgery, to my friends and neighbors in the Las Virgenes, Conejo and Simi Valleys since 1985. This is my personal web site. It has been up since 1990 and has received more than 2 million visits. The entire site is my responsibility only and nearly everything on the site was written by me. You are welcome to peruse this site and learn what you can about me, your feet and the problems your feet can develop. Things happen fast in medicine so whatever you read could well be outdated, especially if it was written many years ago. On this site you will read historic articles that I wrote for a lay audience as long as 25 years ago, so please do not take anything on this site as definitive or as applying directly to your condition. You may wonder why I have my own site even though there is also an official practice site. Well, my partners are of a younger generation raised on tweets, e-mails and iPhones. They want a professional site that they believe better represents the professional nature of our practice. They also believe that people no longer take the time to read anything of length. I, on the other foot, think there is still a world out there full of people who still read lengthy descriptions of problems and solutions. if you are one of those old fashioned readers, then this site if for you. Let me know what you think. Let me know you are out there.

Please note that all information and photographs on this site are copyrighted by me, Michael Zapf, DPM, and cannot be used for any private or commercial purposes. I work with two other podiatrists in my practice who may or may not share any of my ideas and philosophy. Do not expect them to practice the way I do or even believe in any of the speculation I present here. If you appreciate what I have written and want me to be your treating doctor, you will have to ask for me specifically. Even if my office says at first, " He is booked until next month",  I still want to see you as long as you are a little flexible with your schedule. If your visit is an emergency, I know that  you will be happy with either of my associates, Dr. Darren Payne or Dr. Steve Benson. They are exceedingly well trained and capable in any foot emergency.

 

Michael Zapf, DPM, MPH, FACFAS, FACFAOM     (If you want to know what all those initials mean, click here   è  

Our office phone number is (818) 707-3668 and my e-mail address is zfootdoc [at] doctor [dot] com

Agoura Hills Office: 28240 Agoura Road, Suite 101, Agoura Hills, CA 91301

Thousand Oaks Office: 555 Marin Street, Suite 290, Thousand Oaks, CA 91360

For the address, hours and registration forms please see the practice web site: www.conejofeet.com


07/24/2010HomeNews+FAQShock Wave

 

To Order Foot Supplies è ç click

For Information about Laser Treatment for Fungal Nails Click hereè
 

For information about Shockwave Therapy for heel pain          click here è

Exciting news!!! New Thousand Oaks Location  è

 

 

 

 

Family Life -JULY 1997

A TALE OF TWO WARTS

By: Michael Zapf, D.P.M., M.P.H., F.A.C.F.O.

 

Breeann and Jessica are sisters in name only. Jessica is older and is very athletic. She is one of those teenagers who is always on the soccer or softball fields. As an athlete she is used to a little pain now and then. When she has an injury or a problem she wants it taken as soon as her busy schedule would allow. Breeann is her younger sister and definitely not into sports. Breeann is also not into pain. She will do almost anything, as a matter of fact, to avoid anything painful, including athletics. With two sisters so different it is no wonder that when they recently developed plantar warts they developed two distinctly different types.

Viruses cause warts. There are more than 50 different types of wart viruses. Usually a patient gets infected with a single type. Some wart viruses like the hands, some the skin of the face, some the genital area and four or five types love the bottom of the feet.

The wart virus enters the skin through a small, imperceptible crack in the skin. The virus works its way down to the living layer of skin cells and attaches to one of the cells. Then a mysterious thing happens. The wart virus, like all viruses, injects its DNA or RNA into a living cell. The invading DNA or RNA takes over the reproductive machinery of the cell. The cell, in this case a skin cell, tries to reproduce itself. Instead of dividing into two new cells, it can only make new viruses. When the cell is chock full of new viruses it ruptures, freeing the newly minted virus particles that go on to invade neighboring cells. The cycle continues until there are millions of skin cells with wart virus. At this point the lump of cells is visible to the eye as a wart. The whole process is akin to a microscopic science fiction movie.

Back to our sisters. Jessica had one very large wart lesion under her heel. It is about a third of an inch in diameter and nearly as deep. It hurt when she walked, let alone played goalie. Her pediatrician tried a couple of times to freeze it with liquid nitrogen. Liquid nitrogen treatments are painful and with thick warts fail more often than they succeed. Because of this wart’s thickness, topical acids are also bound to fail. The quickest and surest way to get rid of such a lesion is to gently remove it. The wart is simply scooped out after first preparing the area with local anesthesia. The local anesthesia hurts for a few seconds and then there is no more pain. What is left is a void that will fill in with regular skin in a week or two. Done properly the wart comes out as a single, firm mass and the deep layer of the skin is left completely intact. Only if the deep layer is accidentally penetrated during removal can there be a painful scar. Make sure your doctor has plenty of experience in removing plantar warts before he or she attempts this. Jessica’s wart was removed in this very manner and it went well. She gritted her teeth and uttered nary a word. I expect her to be back on the soccer field in a little over a week.

Breeann probably is infected with a different type of wart virus. She has multiple, thin warts scattered all over the bottom of her toes and the ball of her foot. Thin warts frequently respond to topical treatment with one of the many acid preparations available at the pharmacy. The trick to making it work is soaking the feet in hot water prior to the application of the acid. I recommend 15 minutes in water between 105° -109° F. This temperature is slightly warmer than hot tub temperature and should be monitored by a hot tub thermometer available at any pool store. The soaking is followed by the application of a drop of the acid onto each wart. After allowing it to dry, a second drop is applied. I also suggest supplementing the diet with extra vitamin A. As the days go by here is an accumulation of debris on top of the warts. Every week the warts should have the top layers of this debris shaved off. I do this in the office with a scalpel blade. I know some doctors give parents a disposable scalpel blade, but I think this is a bit risky. The shaving should be done down to the level where there is painless, pinpoint bleeding from the little blood vessels that grow in the warts. I stress to patients like Breeann that this method looks like it should hurt but it is, indeed, painless. After the first session their confidence is restored. With this method the warts can be eliminated in as few as three weeks, but they can often take longer. While Breeann has a different wart, a different temperament and a different treatment, I expect that she will soon share a trait with her sister…being a former wart patient.

   

 

 

 

 

 

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Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: July 24, 2010