Getting To Know Your Feet

One million years ago, humans began walking upright. This freed their hands for other tasks, and civilization was born. Initially, simple sandals were designed to protect the feet from cold and injury. Gradually, shoes became a fashion statement that was more important than the feet they were designed to protect. The result is that almost everyone, male and female, experiences a foot problem at some point in their life. Unfortunately, these problems are often neglected until they are very painful or complicated. Get to know your feet, and learn to take care of them. You will be relying on them to take you where you want to go for the rest of your life!

THE ABC'S OF COMMON FOOT PROBLEMS

Athlete's Foot (also called tinea pedis) is one of many fungal infections that affect human skin. It can spread from the feet to the inguinal folds at the top of the legs, and is then called "jock itch" or tinea cruris. It can also spread from the feet to the hands. Prolonged or chronic infection often affects the nails as well.

Your feet may become infected when they are bare and exposed to the floor in a public changing room or bathroom. The fungus thrives in warm, moist conditions. Not everyone who is exposed will be infected, and the infection does not look exactly the same on everyone who gets it.

Most often, the space between the fourth and fifth toes looks wet, white, and cracked. It may be itchy or painful, and it often spreads to the spaces between other toes. In another form, the skin on the bottom and sides of the foot looks red, and thick, and has fine white scales in the areas normally covered by a moccasin. Less commonly, there may be inflammation with blisters and pustules which break and leave open sores.

Athlete's foot tends to be a chronic infection that flares in warm weather, or whenever the feet are warm and damp, as in sneakers or heavy sports socks. It can increase the risk of other foot infections through breaks in the skin. Eventually the fungus can infect the nails, making them thick, yellow, and separated from the nail bed.

Prevention includes wearing shower shoes in public places to avoid exposure, washing feet daily with soap and water, and drying thoroughly. Soaps containing benzoyl peroxide can be helpful. Keeping your feet clean and dry makes them less susceptible to fungal infections.

Treatment includes applying an antifungal cream or powder twice a day, after washing and drying the feet. (A hair dryer can help you thoroughly dry the spaces between the toes.) Wear open sandals as much as possible, and never wear the same shoes two days in a row. Socks should be made of cotton to absorb perspiration. Be sure your socks are clean and dry, and that you change them at least daily. Initially, expect to treat the infection twice a day for two to four weeks. You may then need to use a daily maintenance antifungal to control symptoms.
Effective topical antifungals include: clotrimazole (Lotrimin, Mycelex), miconazole (Micatin), ketaconazole (Nizoral), and terbinafine (Lamisil).

If you have:

• impaired immune function or diabetes, or
• an infection that worsens or persists more than 7 days after treatment is begun, or
• a rash on your legs, hands, or near your genitals,

Blisters are the skin's response to friction and irritation. They are filled with sterile fluid, and should be protected until they heal. Apply a piece of moleskin or a bandage. Keep the area clean and dry. Cushion it with socks or a pad to protect it from further contact with shoes. Never open a blister, but if it breaks, wash it, dry it, apply a small amount of antiseptic ointment (like bacitracin), and keep it clean and covered until it heals.

Bunions are a deformity most commonly affecting the joint where the big toe joins the foot. (Bunionettes form at the joint where the small toe joins the foot). This deformity may run in a family, but it is also aggravated by flat feet, and shoes that are too narrow, too high, or too pointed. Over time, the big toe becomes angled toward the other toes, and the joint becomes enlarged, creating a painful bump.
Prevention: avoiding shoes that deform the joint is the best approach. Padding and orthotics (custom-made inserts for shoes) that relieve stress on the joint may help in the early stages. If all else fails, surgery is indicated.

Corns and calluses are thickened layers of dead skin that form over areas that suffer chronic friction and pressure. (The first sign of a problem in these areas is often a blister).
Prevention means responding to the first sign of pain or irritation by removing the irritant and protecting the foot until it returns to normal. Corns usually develop on or between the toes, and calluses develop on the sole of the foot. Their purpose is to protect the skin of the foot, but as they grow thicker, they can become painful. Padding the areas will prevent further irritation. Never attempt to cut or shave corns or calluses; always consult a health care provider before using an over-the-counter chemical treatment to remove them.

Ingrown toenails occur when the nail is cut or picked shorter than the tip of the toe, with the corners shorter than the tip. Pressure, usually on the big toe, forces the sides of the nail into the skin, which becomes red, swollen, and painful. Fungal or bacterial infection can follow. This infection is called a paronychia. Prevention includes good nail care. Toenails should be cut straight across, not shorter than the tip of the toe. Cuticles and skin around the nail should be pushed back gently after bathing, but never cut. If infection occurs, consult a health care professional. Treatment usually includes removing any source of pressure, warm soaks for 15-20 minutes three to four times a day, and elevation. Sometimes antibiotics or surgical incision and drainage are needed.

Warts are caused by a virus called HPV (human papilloma virus). The virus enters the body through minute breaks in the skin. Warts can occur anywhere on the body, but the most common site on the foot is the sole, at weight- bearing areas. They are usually skin colored, but may appear to have tiny brown or red dots. The surface is usually very smooth, without the normal lines and swirls that are seen in adjacent skin. There may be one or several lesions. Warts can persist for several years, but will eventually resolve. The primary reason for treatment is pain relief. Over-the-counter treatments are available, but consult a health care provider before using them. Never attempt to remove a wart yourself. Discuss with your health care provider the variety of treatment options available, which include chemical, surgical and topical medications, to decide which is best for you.

For more information:

• www.feetforlife.org
• www.footcaredirect.com

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