heathcare professional site

common foot problems

Few foot problems are hereditary – most arise through neglect, abuse and infection. Even diabetics can avoid the foot problems associated with their condition by taking better care of their feet.
 
Here are some of the most common foot problems, and what you, your GP or podiatrist can do about them:
 
Athlete’s Foot
Athlete’s Foot is described in detail in its own section on this website, but here are the facts in brief:
 
It’s a fungus which attacks the spaces between your toes, and usually starts between your fourth and fifth toes. It’s highly infectious, and can also infect your toenails and other parts of your body. Symptoms are itchy, irritating patches of skin between the toes, and may possibly spread elsewhere on the foot. The skin may also crack, flake, and be quite painful, especially when the skin is stretched.
 
To avoid it, wash and dry your feet regularly, especially between the toes. Don’t walk barefoot around swimming pools and in public changing rooms. Don’t spend too long in hot, sweaty trainers, which you should wash, dry and air regularly. Wear cotton socks rather than nylons. Don’t wear the same shoes every day.
 
Lots of treatments are available, but be sure to keep applying them for the recommended period, otherwise the condition could return if you do not apply the treatment long enough. Lamisil Once® however treats Athlete’s Foot in one application.
 
Blisters
Blisters occur when a small area of skin is repeatedly rubbed, perhaps by ill-fitting footwear, and a bubble of fluid forms. You’re particularly vulnerable if you exercise in trainers or boots that don’t fit you well, because of the amount of friction.
 
To avoid them, make sure your shoes fit you well. Wear cotton socks if you have sweaty feet. Put a padded insole in your trainers. Wash and dry your feet well (with talcum powder) after exercising.
 
To treat painful blisters, clean them with water and soap and then apply a bandage. If they're pierced, drain the fluid and apply an antiseptic and then apply a bandage.
 
Bunions
A bunion is an inflammation of the soft tissue at the joint where the big toe is attached to the foot. You’ll notice a swelling around the big toe joint, and redness. You’ll also be in pain and have difficulty walking.
 
The first thing you should try is better-fitting shoes, with lots of space for your toes to move.  If this doesn't do the trick, you may need to have the bunion surgically removed.
A specialist might also recommend exercises and shoe inserts to prevent the condition recurring. But if your bunion has deformed your foot, you may need corrective surgery – so treat it early.
 
Chilblains
Chilblains are small itchy, red, burning swellings on the skin, which can become increasingly painful, swell and then dry out, leaving cracks in the skin which expose the foot to the risk of infection. They typically occur on the toes, fingers and face.

They’re caused by the skin's abnormal reaction to cold, particularly if you expose it to temperature extremes. People who work outdoors and don’t wear appropriate clothes are vulnerable, as well as elderly people with poor circulation.
 
To prevent chilblains, keep your whole body warm in cold weather, especially if your circulation is poor and you don’t take much exercise.
 
If you have chilblains, don't scratch them – use a soothing lotion. If the chilblain has ulcerated, apply an antiseptic dressing. At night, rub an emollient cream on your feet to retain heat.
 
Corns and calluses
These are thickened layers of skin, usually caused by ill-fitting shoes. Corns usually occur on the tops of toes; calluses are the same thing, but on the soles of your feet. To avoid them, wear comfortable shoes.
 
Don't cut corns yourself, especially if you are elderly or diabetic. Try an over-the-counter cream, although this won’t work in every case. You could use a pumice stone to remove the thickened skin a little at a time, but better still, have a podiatrist remove the corns. Use padding or insoles to relieve pressure on your feet.
 
Gout
Gout is a hereditary condition – an inflammation of the joints and tissues in your toes, usually your big toe. It’s very painful.
 
If gout is not treated properly, it will eventually cause permanent damage to the toe joint. You should see your GP as soon as possible.
 
Ingrown toenails
An ingrown toenail is one that cuts into your flesh. It’s very painful and can lead to infection.
 
To avoid them, cut your toenails straight across, rather than shaping them at the sides. This will encourage your nails to grow outwards rather than into your skin. You could also tuck a small piece of cotton wool under the toenail, to force it upwards.
 
If the problem persists, see a podiatrist. In extreme cases, you may need surgery.
 
Onychomycosis (nail fungus, nail ringworm or tinea unguium)
Onychomycosis is a fungal infection that causes toenails to thicken, yellow, and split. It’s often the result of a failure to treat Athlete’s Foot, allowing the fungus to spread to the toenails. The nails can become so thick that they press against the inside of the shoes, which can be very painful.
 
It’s not as easy to treat as interdigital Athlete’s Foot, and normally requires an oral antifungal. Because nails grow very slowly, it typically takes at least six months for the nail to regain a healthy, clear appearance. Always get advice from your doctor to treat nail fungus.
 
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a condition that causes inflammation in many joints of the body, leaving them swollen, painful and stiff.
 
RA affects the smaller joints such as the fingers and toes first. The joints of the toes may enlarge and even freeze in one position, so they can't extend fully. It can then spread to other areas of the foot, causing your arches to collapse and the balls of your feet to slip forward – very painful.
 
The sooner you’re diagnosed and start on a treatment, the better. You will also benefit from using special insoles to minimise pressure on affected joints.
 
Verrucas
A verruca is a viral wart usually on the sole of the foot, although they can also appear around the toes. They can grow to half an inch in diameter and may spread into a cluster of small warts. They can be painful if they’re on a weight-bearing area such as the ball or the heel of the foot.
 
The verruca virus is very contagious, but not dangerous. It thrives in warm, moist environments such as swimming pools, changing room floors and bathrooms. If you have any cuts on your feet, you’re particularly vulnerable. 
 
Don’t touch it, as it may spread. Instead, cover it up with a plaster. In some cases, this may cure it. A number of over-the-counter gels and ointments are available. If these don’t work, have a podiatrist freeze it off or cut it out.

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