A major part of our work involves taking care of the skin on your feet. Your skin is the largest organ in your body and serves as the protective barrier between you and the outside world. If your skin is in good condition, it will contribute to your overall health.
A breach in your skin can result in minor issues such as athlete’s foot, or more serious conditions like bacterial infections.
People often ask, “What are the most common skin conditions you see and treat in podiatric practice?” Dry skin and hard skin are the most common and are generally easy to manage, though there are extremes of these conditions as well. When the skin becomes dry and hard, it can become prone to splitting. These splits are known as fissures and can be painful.
We may also see patients with combinations of conditions, such as psoriasis, where the skin sheds at a faster rate than normal and can also be very dry. Eczema on the feet is less common, but we do sometimes see it around the ankles as a result of varicose veins or “leaky veins” (gravitational eczema). And, of course, the classic fungal infections, which usually present as moccasin-type tinea pedis or dry tinea pedis. In European skin, fungal infection appears as a dry, flaky, pink area on the base of the foot with a demarcated border on the upper part of the foot.
If we have skin issues, we must always assess and address the toenails as well, since the skin and nails share a common origin. Skin conditions can directly affect the nails, and we may see this with conditions like psoriasis and sometimes fungal infections. It is believed that painful splits between the toes from athlete’s foot may be caused by a secondary bacterial infection, which rapidly leads to painful fissures between the toes that can also itch terribly.
Most hard skin issues we see typically take the form of calluses on the ball of the foot (plantar metatarsal heads), the heel region, the apex of the toes, and the top of the joints on hammer toes. Corns also commonly develop on joint surfaces or prominences where pressure and friction can be high.
The management depends on the specific needs of the patient. In simple terms, a good foot and skin hygiene regime is essential. There are plenty of gentle, hypoallergenic skin wash products available. Regular use of an emollient (moisturiser) is great for dry skin and can significantly help with corn and callus buildup, although pressure relief is equally important.
For individuals with lower leg and foot eczema, your GP can prescribe specialist creams. If you are prone to fungal infections, you can speak to your pharmacist or GP about the latest topical or oral medication strategies. Over the years, we’ve seen many patients with significant psoriasis who, by working in combination with their consultant dermatologist and receiving regular podiatry treatments, have experienced real improvements in the condition of their feet and their comfort. Consistency is often key, but finding the right treatment method and, in some cases, addressing lifestyle factors, is equally important.
If you are diabetic or have another underlying medical condition that affects your health, it is crucial to maintain regular contact with your medical practitioner. As podiatrists, we recommend that individuals with diabetes have regular foot checks, as well as skin and nail care when needed. And of course, check your feet every day. If you cannot do this, find someone to do it for you.
Our feet were never designed to be enclosed in footwear all day long, which is why our skin and nails can become damaged from long-term use of shoes. Ideally, shoes should be breathable, made of natural materials, have good cushioning and support, and offer plenty of room without compromising performance.
There’s normally no harm in taking your feet out of shoes and socks for a while, as long as it doesn’t compromise your health. Diabetic individuals and those with compromised health or circulation need to take extra care if going barefoot, and in some cases, it’s not advisable. If you’re unsure, speak with your medical practitioner, who should be able to provide you with suitable advice.
At Coastal Podiatry at the Sandbanks Clinic in Poole, we are always happy to help and offer advice and treatments for your feet. In addition to treating conditions of the foot and lower leg, as podiatrists, we also see ourselves as educators. Our job is to provide you with the best information we can to help you maintain optimum foot health. We are always here to help and happy to listen to your foot health needs.