Typical Problems and their Treatments
Typical Problems and their Treatments
Click any of the links below to jump to a specific problem.
Callus
Corns
Hard or Dry Skin
Blisters
Burning or Itchy Feet
Verrucae
Fungal Nails
Althlete's Foot
Thickened Toenails
Ingrowing Toenails
Callus
This is the thickened skin that the body produces in response to high pressure or friction. It typically occurs only in areas where the shoes rub or where body weight is concentrated during standing, walking or running.
Treatment involves removal by debridement, offering footwear advice and supplying pressure relieving devices where applicable.
Corns
Corns are areas of callus that are more deeply situated in the layer of dermal tissue that lies beneath the skin. These tend to be painful because they press against the underlying fleshy tissue.
Treatment involves removal by debridement, offering footwear advice and supplying pressure relieving devices where applicable.
Hard or Dry Skin
What may start as simply hard and dry skin may develop into callus if it is situated in an area of high pressure during walking or sitting. Hard or dry skin may also become cracked skin if not regularly filed when dry and then moisturized.
People with sensitive skin or eczema may find that dry skin build-up happens despite regular moisturizing. Moisturizing is still beneficial and worth keeping up with.
Cracked Heels
Continual build-up of callus in areas of high pressure, for example on the heels, means that the skin becomes dry, brittle and thickened. The problem is that foot pressures can cause this type of skin to quite easily crease and split. These splits, known as fissures, can deepen and develop into open tear-wounds on the area. Such wounds have problems healing because of a lack of respite from foot pressures.
Treatment involves reduction by debridement to ease the skin tension around the area of the fissure, offering footwear and home-care advice and supplying pressure relieving devices where applicable.
Blisters
The usual, but not the only cause is an out-of-the-ordinary period of excessive foot pressure, for example, after a change to new footwear, the sudden trauma from rubbing can detach and burn the skin. The gap created under the skin then fills with fluid and a blister is formed.
Treatment consists of applying a dressing to cushion and maintain a clean wound, and, after establishing the cause, offering footwear and other advice.
Burning or Itchy Feet
This general symptom may have many possible causes. The skin may have become irritated by a rash due to a bacterial or fungal infection. Alternatively, these sensations may relate to deeper tissues which may have become traumatized by areas of high foot pressure.
After diagnosis of the cause, treatments will be various, but will aim to restore the feet to a pain-free state, and general advise will be offered to prevent a recurrence.
Verrucae
A verruca is a form of wart caused by the Human Papilloma virus. The virus establishes a presence on and under he skin of the foot. Verrucas tend to be cratered and spongy in consistency and can sometimes occur in clusters. They tend to sting when the surrounding skin is stretched rather than when pressed.
Whilst there is no known way of killing the virus, treatment consists of ways of making the foot an inhospitable place for the virus to continue to live. Methods of doing this are intensely localized freezing or burning. This virus is contagious, but not everyone will develop a verruca.
Fungal Nails
Inside a closed shoe is an ideal place for a fungus to grow (just think of how mushrooms are grown!). It's warm, moist and dark. So, it is advisable to give your shoes a few days off to air out, and if your feet perspire a lot, use an absorbent anti-fungal powder in your socks and shoes at the start of the day.
If your nails are fungally affected, they are likely to be brittle, flaky and discoloured with a grey or orange tint. There are topical agents that are effective in gradually removing the fungus, if applied regularly for a period of months while the affected nail area grows out.
Athlete's Foot
This is a fungal presence affecting the skin of the feet rather than the nails. It tends to affect the sheltered areas, typically between the toes and the inner arch. The same principles for its cause and prevention apply, as above (see fungal nails).
The skin tends to become rashed and itchy, and sometimes breaks and bleeds. Once again, there are topical agents that are effective in gradually removing the fungus, if applied regularly.
Thickened Toenails
This is a common condition, and the degree of nail thickening can vary from slight to extreme. To some extent, everyone’s nails thicken with age. This is because the act of walking while wearing shoes causes varying degrees of trauma to the nail cells within the toes. This means that the blueprint cells that program the growth of new nail gradually become damaged causing them to be spaced out and less organized.
As a result, the affected nails grow out as enlarged but less dense, causing them to be flakier, yellower, and perhaps more conspicuous to the eye.
Ingrowing Toenails
The leftmost diagram below shows a normal versus an ingrown toenail. Looking at the toe end-on, you can see that the ingrown nail almost curves back on itself and tends to pinch the toe on each edge. Sometimes this curvature may only occur on one side of the nail.
With this kind of nail curvature, there is an increased likelihood that the skin along the side of the nail can become irritated and inflamed.
The most common causes of this inflammation are:
- Pressure from ill-fitting footwear
- Leaving behind a ragged edge when trimming. It is easy to do this without realizing it because the ragged edge is hidden. As the nail continues to grow, the ragged edge gradually causes a wound in the toe tissue.
- Pressure from accidental trauma
Once the traumatized tissue swells, the pressure between the nail and the surrounding toe tissue is increased and a painful condition will develop and continue indefinitely until the nail is trimmed professionally. Once the pressure is relieved, the flare-up can subside and heal. If left, however, the wound is likely to become infected and more painful.