Common foot conditions

Athletes Foot is an infection caused by fungal spores, which grow in warm, dark, moist places and can spread. It is an itchy red rash which may cause your skin to tear and can be a cause of smelly feet. It usually grows in-between your toes but can grow anywhere on your foot, including the nails.

To help prevent athletes foot:

• wash your feet and change socks daily
• alternate footwear when possible
• dry properly in between your toes
• do not share towels or footwear as infection can be passed on to others.

Treating athletes foot

If you experience athletes foot, treatments are available from your local pharmacy who can also provide advice.

Your foot supports your weight, acts as a shock absorber, serves as a lever and helps to maintain your balance. If treated incorrectly callus can form on the skin.

A callus is a protective response to pressure or friction when you walk or stand. An area of thickened hard skin forms anywhere your skin rubs against bone, shoes or the ground. Excessive callus build-up can be uncomfortable or painful.

To prevent a callus wear footwear that is wide and deep across the front of your foot and has a low heel and cushioned, shock absorbing insoles. Ensure your footwear can be adjusted with laces, a buckle or Velcro.

To treat a callus:

• never use knives, blades or scissors on hard skin
• don’t pick skin away as you can cause pain and infection
• gently rub the areas of your hard or thickened skin with a file or pumice
• apply moisturising cream daily (but not between your toes as athletes foot can develop)
• if you are diabetic or elderly, do not use corn plasters.

Chilblains are an abnormal response to the cold, causing small, itchy, red, painful, burning swellings on your skin, which may become infected if the skin on the swelling breaks.

Chilblains usually occur on toes, fingers, nose or ears due to cold weather. Other causes include quick changes in temperature from cold to hot if you warm your hands or feet too quickly, damp environments and some medications.

People most at risk of chilblains are the elderly, those with poor circulation or who are diabetic or have anaemia. Smoking can also be a factor.

To prevent a chilblain:

• keep your feet warm by wearing warm or thermal socks and not walking barefoot
• stop smoking
• don’t warm feet with direct heat such as in front of a fire, a hot water bottle, or in a hot bath as this makes chillblains worse
• warm feet slowly with blankets or warm clothing
• dry feet thoroughly after washing.

Treating a chillblain

If you have a chilblain, apply a soothing lotion such as calamine or witch hazel to the affected area. Your GP can check your medications and prescribe creams or tablets if needed.

There are three types of corns:

• soft corns – occur between the toes and are rubbery in texture and whitish-yellow in colour
• hard corns – are the most common type of corn. They occur over a joint, on the balls of the feet or tops of the toes as small areas of concentrated hard skin.
• seed corns – are tiny corns associated with dry skin, which
  can be loosened out in the bath. They resemble a seed and are found in a cluster.

Soft and hard corns can form when toes press or rub together due to toe or foot deformities, or tight fitting footwear. Seed corns are caused by friction rather than pressure.

To help prevent corns wear footwear that is wide and deep across the front of your foot and has a low heel and cushioned, shock absorbing insoles. Ensure your footwear can be adjusted with laces, a buckle or Velcro.

Treating a corn:

• never use knives, blades, scissors or pick skin away as you can cause pain and infection
• gently rub areas of hard or thickened skin with a file or pumice
• apply moisturising cream daily (but not between your toes as athletes foot can develop)
• for soft corns – use an astringent between the toes, such as surgical spirit, to help dry your skin
• if you are diabetic or elderly, do not use corn plasters.

Diabetes can affect your feet in two key ways:

• • nerve damage or neuropathy – if nerves are damaged by diabetes you may experience a change in sensation, numbness or tingling
  • poor circulation or ischaemia – diabetes can reduce the blood supply to your legs and feet. Occasionally foot ulcers may develop if the blood supply to your feet is very poor. If foot ulcers fail to heal this can potentially lead to an amputation.

To prevent foot problems if you have diabetes:

• keep yourself healthy
• maintain control of your diabetes
• stop smoking
• attend your annual diabetes foot check appointment where your feet will be examined for signs of nerve or circulation damage
• protect your feet and check them each day for injury
• don’t walk barefoot, as you can injure your feet
• wear footwear that fits correctly
• be careful of direct heat, such as hot water bottles or a hot bath – you may not feel the heat
• use moisturiser daily on your feet (but not between your toes as the moisture can cause athletes foot).

If you are concerned about your feet seek immediate advice from your GP or podiatrist.

Fungal nails are caused by a fungus that lives in the nails, slowly destroying them. Your nails usually appear thick, brittle, discoloured and deformed.

The fungus thrives on moist warm areas of your skin and nails and will spread your toe nails are damaged or you:

• do not dry your feet thoroughly
• wear dirty socks
• share your towels
• wash your feet too much
• have damp, warm feet.

To prevent fungal nails:

• wash your feet every day using mild soaps
• dry your feet well, especially between your toes
• change your socks or tights daily and alternate your footwear
• allow your skin to breathe by wearing socks made from natural materials like cotton or wool.

Treating fungal nails

Your pharmacist or GP can provide medication to treat the fungus. Remember – poor hygiene can lead to re-infection.

Involuted nails have a very pronounced curve so the edge digs sharply into the groove down the side of your toe. Pressure on your nail will cause pain. Redness may be present round your nail and if pressure continues, your skin will become hard forming a callus or corns.

Ingrowing nails have a rough edge or spike of nail which pierces into your flesh. Swelling and redness may be present around the nail and it will be painful. Discharge and pus may also be seen, especially if your skin is infected.

Ingrowing nails can be caused by:

• excess sweating
• heredity – there may be a family history
• cutting your nails incorrectly
• tight fitting shoes – see our Footwear page.

To prevent ingrowing nails:

• avoid wearing tight shoes or socks
• don’t cut down the sides/corners of your nails
• follow the shape of the end of your toe when cutting your toe nails
• file any rough edges
• don’t pick at your toenails.

Treating ingrowing nails and involuted nails

Involuted nails – a podiatrist will cut away the problem edge and any corns or callus will be removed and the edge of your nail smoothed. Any redness should settle down.

Ingrowing nails – minor surgery can be performed to remove all or part of your problem toenail if conservative treatments are unsuccessful. You will be advised of your treatment options during your consultation.

Neuropathy is damage to your nerves. It means your nerves do not carry messages to your brain. Neuropathy can be present in a number of medical conditions such as diabetes, rheumatoid arthritis and alcoholism. The cause may never be known. Symptoms can include numbness, tingling, burning, pins and needles and sharp pain, worse at night. You may have no symptoms. You may have severe pain.

Neuropathy can be a problem for your feet as your nerves help protect you from injury. Neuropathy can cause deformity or loss of feeling. Deformity can change your foot shape and your shoes may not fit you properly leading to injury. Injury to your feet can go unnoticed with loss of feeling. Neuropathy can also cause complications such as trauma, ulceration and infection. Some types of neuropathy cannot be reversed.

If you are diabetic:

• maintain good blood glucose control
• have a healthy diet, regular exercise and stopping smoking
• check your feet daily for damage to skin or infection
• test the temperature of your bath water before putting your feet in – feet can be burned
• check inside your shoes before putting them on for any objects, eg: stones or small toys
• turn your socks inside out so seams do not rub your toes
• take a template of your feet or get feet measured when buying new shoes as you may not be able to feel if they fit – see our Footwear, measuring your feet and fitting your shoes pages.
• don’t walk barefoot – protect your feet at all times
• don’t use corn plasters, products that contain acid or anything sharp on your feet
• don’t use direct heat to warm feet such as fires or hot water bottles.

If you develop any foot problems, seek immediate advice from your doctor or podiatrist.

Poor circulation is when blood vessels in your legs become hard or narrow. It can cause blood flow to your feet and legs to be reduced or prevent the nutrients and oxygen needed for function from reaching your soft tissues. Poor circulation can also occur when waste products build up in your soft tissues.

If you have poor circulation the skin on your feet and legs becomes thin and dry and you may lose the hair on your legs. Your feet may feel cold and maybe white, blue or red in colour. Blocked or narrow arteries can cause pain in the calf muscles on walking short distances.

Poor circulation makes the skin on your feet and legs more prone to injury, infection and ulceration. Healing of skin that has been injured is slow and infection may spread. Pain in your legs may reduce your mobility.

What can I do?

• if you are diabetic it is important to maintain good blood glucose control
• eat healthily, take regular exercise and stop smoking
• inspect your feet regularly to check for redness, cuts or injuries
• wash your feet daily and dry thoroughly, especially between your toes
• try to keep your feet warm during cold weather, wearing thick socks of cotton or wool turned inside out so seams do not rub
• make sure your shoes fit correctly and comfortably.

What should I avoid?

• don’t soak your feet as this will dry and harden your skin
• don’t put moisturiser between your toes it makes your skin moist and weak
• don’t use corn plasters, products containing acid or anything sharp on your skin, as injury to your skin may become infected and take a long time to heal
  use corn plasters or products that contain acid, injury to your skin may not heal well.

If you are concerned about your feet, especially if they are painful, seek immediate advice from your doctor or podiatrist.

What is a verruca?

A verrucae is the name given to a wart that is on your foot, it is caused by the same virus that causes hand warts. A verrucae may be painful when gently squeezed.

Verrucae are brownish in colour with rough crumbly surface. They can be small or quite large, single or in a group. When magnified the skin lines appear broken around the verruca. Small pink or black dots can be seen in the wart.

You can catch or pass on a varruca anywhere you come into contact with other people’s skin, damp conditions in changing rooms, swimming baths, or at home from a bathmat.

To prevent catching or passing on a verruca:

• wear footwear in communal areas
• do not share towels
• check feet for small cracks and cuts and cover before doing an activity in bare feet.

Treating a verruca
If the verruca is small and not painful, leave it untreated, the body’s own immune system will deal with it over time.

If it persists longer than eight months, becomes painful or spreads, you can obtain medication from your pharmacist. If it does not respond to treatment then consult your doctor who can refer to the podiatrist for further advice.