Don’t Be Embarrassed About Feet Urge Podiatrists

Feet are one of the hardest working parts of the body and in a lifetime you will walk in excess of 150,000 miles which is about five times around the world. As a result, foot problems are common and if untreated can cause discomfort and wider health problems.

As part of its annual Feet for Life month in June 2013, The College of Podiatry ilooked to raise awareness of common foot complaints. The College is encouraging people to become more foot aware and not be embarrassed about seeking help where needed.

Some of the most common foot problems that can cause embarrassment include foot odour, verrucae, corns and callus, fungal infections, ingrowing toenails, bunions and cracked heels.

“Our feet are one of the most neglected parts of our body, but it’s important to keep an eye on them and to know what’s normal for you so you can spot any problems. Feet are not supposed to hurt so if you do experience ongoing pain then you need to have this investigated. Don’t be embarrassed about seeking professional help, it’s a podiatrist’s job to treat feet so there will be nothing we haven’t seen before. Follow our tips to spot some of the symptoms of common foot problems so you don’t have to suffer in silence or hide your feet away in the summer!”

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Common foot problems

- Foot odour: to keep foot odour at bay, wash feet at least once a day and dry carefully between the toes. Wear clean socks made from at least 70% cotton or wool. Alternate shoes daily to allow them to dry out. If odour persists try an antibacterial soap.

- Verrucae: a verruca is a type of wart that looks like a small, dark puncture mark in the early stages but later turns grey or brown. It’s contagious through direct contact. You can buy over-the-counter remedies from your pharmacy; ask for products with salicylic acid. If at any stage your verruca becomes painful and the surrounding skin goes red, stop treating immediately and see a podiatrist.

- Corns and calluses: corns and calluses occur as a result of pressure on the foot. Corns appear over a bony prominence such as a joint and a callus usually occurs on the sole of the foot. Do not cut corns yourself and don’t use corn plasters or paints which can burn the healthy tissue around the corns. Commercially available cures should only be used following professional advice. Calluses can usually be kept at bay by using a pumice stone or non metal foot file gently in the bath.

- Fungal infections: fungal infections such as athletes foot can lead to intense itching, cracked, blistered or peeling areas of the skin. If left untreated it can spread to the toenails causing thickening and yellowing of the nail. Fungal infections are highly contagious so avoid handling and do not use the same towel for your feet as the rest of your body. You can buy over the counter remedies but nail infections do not often respond to topical treatments so you may need oral medication. See a podiatrist if your infection persists.

- Ingrowing toenails: ingrowing toenails pierce the flesh of the toe and can be extremely painful and lead to further infection. They most commonly affect the big toenail but can affect other toes too. To reduce risk use nail cutters and cut nails straight across and don’t cut too low at the edge or down the side.  If you have an ingrowing toenail, see a podiatrist who can remove the offending spike of nail and cover with an antiseptic dressing. If you have bleeding or discharge, you may require antibiotics.

- Bunions: a bunion is a condition where the big toe is angled excessively towards the second toe and a bony prominence develops on the side of the big toe. Contrary to popular belief, bunions are not solely caused by shoes. They are caused by a defective mechanical structure of the foot which is genetic, although footwear can contribute to a bunion developing. Some treatments can ease the pain of bunions such as padding in the shoes, but only surgery can correct the defect. To avoid exacerbating a bunion, try not to wear narrow shoes with pointed toes. If you experience frequent pain, see a podiatrist.

- Cracked heels: cracked heels can be extremely painful and occur where the skin has become dry or has experienced excessive pressure. To prevent them moisturise regularly and use a pumice stone or non-metal file in the bath or shower. If the problem worsens see a podiatrist as some severe cases can require strapping of the cracks in order to allow the feet to heal.

Diabetes - brace yourself for the diabetes tsunami!

A busy week at the clinic!

We see our fair share of diabetic patients at the clinic most weeks. Sometimes the patients we see are not so sure about just how diabetes affects their feet or just how important it is to have regular foot checks.

So we've put together a few points that everyone should know about diabetes, in plain english so that everyone reading it can understand.

The first thing to note is that diabetes is generally split into two groups called type 1 and type 2 diabetes. Treatment guidelines have changed of late and many people who would have been considered type 2 diabetic now use insulin as part of their treatment plan.

Diabetes is a condition resulting from either, the absence of insulin in the body to help break down and use glucose from the blood, or having some insulin but having too little or poor quality.

Diabetes can have serious implications for your feet and legs. If you have poorly controlled blood glucose particularly over a long period of time changes can happen to the nerve and blood vessel tissues in your lower limbs. So what! you might say.

Well, if the nerve tissue changes and becomes less conductive, this is called peripheral neuropathy. Having peripheral neuropathy increases the risk of injury. Because the feeling can be absent in the foot injuries are common, although often the sufferer is unaware of injury to the foot. The result of this can lead to breakdown of the tissue, or as we call it, ulceration.

Ulceration is complicated because of the hardening of the arteries which is also caused by prolonged poor glucose control. Sufferers will lack the ability to supply damaged tissue with a sufficient blood supply. This prolongs healing, increasing the risk of infection and ultimately leads to gangrene and amputation.

Now heres the scary part...statistically, the mortality rate (chances of death related to the disease) is greatly increased if an amputation has been required. What we find is that, in general, because diabetes is a 'silent' disease', often without any outward signs, people either dismiss it, deny it, or just don't understand enough about it. It is that serious. Diabetes, if poorly controlled or neglected for periods of time can seriously impact on your foot health and ultimately lead to your premature departure.

Finally, the best way that you can prevent these changes happening for as long as possible is to maintain good blood glucose levels. What we mean by that is your average blood sugar levels. Daily readings will fluctuate, this is normal even in a person who doesn't have diabetes. The average blood sugar is measured by HbA1c. Because the recommended level can change sometimes there's little point in writing it down here, but we would encourage all patients we come across in the clinic to discuss their blood glucose levels with the GP. Ask the GP for your HbA1c levels, learn about getting it to the best levels you can, and finally, own your disease, take control of it, don't allow diabetes to control you, or to destroy your quality of life.

If you have diabetes and are worried about your feet, or if you have any other questions about your feet please contact the clinic to arrange your assessment today. We will be happy to advise you and to carry out your diabetic foot check.

For more information about diabetes visit http://www.diabetes.org.uk/

Using Salicylic Acid to treat Veruccae - get the most from your treatment

Application of salicylic acid will leave the site white and macerated

Salicylic applications are widely available from shops and pharmacies. It has been used as a traditional treatment for veruccae for years. The packs which are available to buy are typically about 12% in strength. This includes brands like bazooka etc.

Podiatrists use formulations which are much more potent that this, sometimes more than 5 times stronger. These preparations are not available to buy and can only be given to you by a suitably qualified person such as a podiatrist in this instance.

Before applying any acid or caustic based treatment the podiatrist will remove the thick layer of skin which covers the actual verucca using a scalpel. This is called sharp debridment. It is common for the verucca to bleed during sharp debridment so you shouldn’t be alarmed if this is the case. By debriding the verucca the podiatrist can treat the seat of the growth, at the capillary bed level.

All verucca treatments will, in one way or another, destroy tissue locally. There is no single treatment which has shown to be more effective over another. That's why we will explain each of the available treatments to you and elect the one most suitable for your lifestyle.

Here are a few tips to help you get the most from your salicylic acid treatment.

• Keep the site dry. If you get the site or the dressing wet you will not get the desired effect from the treatment. Use plastic shower seals if you need to but it is important to keep it dry. 

• Ensure to follow up with your podiatrist if they have asked you to, and if a review appointment has been made for you it is important that you attend. This is because we have applied acid to your foot, it’s important that we check to ensure you are not having any unexpected side effects or burn.
   
• If applying a home treatment on the advice of the podiatrist it is a good idea to review at 2 or 3 weekly intervals to check your progress.
   
• Remember, your veruccae are caused by a virus. Even if the podiatrist can get rid of your verucca this time doesn’t mean that you won’t get another in the future.
   
• If you experience pain associated with your treatment call us for an appointment.
   
• Lastly, remember veruccae are self limiting and harmless. They are annoying but you will not come to any harm as the result of a veruccae. They are not linked to hygiene but can be passed on from one person to another, so it’s a good idea to cover your veruccae with veruccae socks when swimming or using communal facilities.