Skin problems on your feet

Our skin is amazing, the skin is the largest organ of the body with a total area of about 20 square feet. The skin protects us from microbes and the elements, it helps regulate body temperature, and it permits the sensation of touch, specifically with regards to temperature. We need to look after it, so it can look after us!

Normally during an event or in training for an event it is recommend that the feet are kept dry as blisters are typically formed when the skin is wet. This is primarily due to outside factors, such as the swim section of a triathlon, or from sweating. However, If the skin is kept continually dry it will eventually crack, these cracks are called fissures, and once they s have opened to the lower layers of the skin they are extremely painful.

There are a lot of runners who spend weeks before an event using footbaths to dry the feet out prior to a race but this doesn’t prevent the foot sweating during an activity, event or race. This is because the skin will want to sweat when the temperature is raised either due to body exertion or increased ambient temperature. The sweat is released as the body seeks to cool itself down, sadly this can increases the risk of a blister forming.

To achieve the best results the skin needs to be supple, soft and pliable so it can resist the forces that are placed upon it during exertion. If these requirements are achieved then the skin can move and flex as required, when the skin is either too wet or too dry it fails to achieve that flexibility and resilience.

Preparation is key when trying to achieve the perfect equilibrium between keeping the foot from getting too dry or too wet.

To keep the skin soft and smooth use a foot file to initially get rid of the flaky skin then follow this up weekly with an exfoliant like the Rescue foot mask or daily in the shower or bath with the Scrubby Foot soaps to smooth the skin. Once the skin is suitably prepared, apply an emollient like the Hydrating foot lotion for a daily application and the Intensive foot balm for very dry feet both of which hydrate the skin. If you us this regime every day for a week, you will notice a considerable difference in the texture and tone of the skin.  The skin will now have an increased resilience to the forces applied to it through pressure and friction which are the causes of increased shear. All of this preparation will help prevent the formation of blisters by increasing the quality of the skin (Link to our Optimum skincare kit )

Calluses and Corns – What are they and how are they caused?

Calluses are an over production of skin usually in an area that is receiving too much pressure, most likely on the balls of the feet, the toes or on the heels.

Corns are a nucleus of skin equivalent to the size grain of rice that presents deeper in the skin. Corns cover less surface area than a callus but are caused by a hot spot of pressure from external forces.

Fortunately, in both cases they can be removed. However, the skin regime shown above will not be enough to resolve a thick callus or corns. In these cases we recommend a visit to a Podiatrist as they can be easily removed when in clinic. It is worth noting that this is not a painful treatment, in fact most patients find the treatment pleasant. After having them removed ensure you continue with the skin regime above to help prevent the callus returning. If you have any corns or calluses make sure you get them treated prior to any serious training or an event as they significantly increase the likelihood of blisters forming in that area.

Blisters that present under a callus are excruciatingly painful and are very difficult to treat. Ensure they are seen to quickly by a Podiatrist and this will result in a shorter recovery period. When visiting the Podiatrist make sure you discuss your ambitions and expectations in detail as they will be able to advise how much skin needs removing and how regularly to come in for treatment. We recommend avoiding using over the counter product for the removal of callus and corns as many fail to work and often have acids present within them that damage the healthy skin around the corns and callus. (photo of acid induced maceration of hd)

Fungal Infection and Athlete’s Foot

Athletes foot is a fungal infection of the skin and is a common problem for a lot of feet especially, as the name suggests, in sporting activities.  A fungus thrives in a warm, moist, and dark environment, typically this presents as trainers or walking boots. When using these types of footwear the toes are usually quite snug against each other creating the perfect environment for an infection. This infection initially presents as red itchy skin, which when rubbed can then crack and become quite sore. In this state the skin is fragile and not of great quality, which makes it more prone to blistering.

There are many creams and sprays available that treat a fungal infection of the skin, the preferred one at the moment for Dermatophyte infections are the Terbinafine based products. Fungal infections can be particularly difficult to treat so we recommend that repeat applications are used as this is crucial to the success and maintenance of the skin. Prolonged fungal infections make you more susceptible to them in the future so acting fast for treating them is integral to having happy feet. Simple methods such as washing your socks inside out on the high temperature and spraying the inside of your footwear with an anti-fungal shoe spay will all help prevent the spread of a fungal infection. Continuing with these practices will also help prevent repeat episodes of infection cycle. Podiatrists can take a nail or skin scraping of the fungal infection and can test for a confirmation of an Fungal infection.

Verrucae or warts on feet

Verrucae are also a common problem Podiatrists see on the feet and they can be very uncomfortable. If they are located on a weight-bearing area of the foot they can contributing factor to the formation of a blister.

Verrucae are a virus that invades the skin through a micro cut on the surface of the skin and then establishes itself in the epidermis of the skin. They can look a bit white and cauliflower-like in appearance, and be of superficial depth yet cover a large surface area or appear hardly there on the surface but have considerable depth.

The immune system usually recognises them and responds within a two year period, this is typically faster for younger children through to adolescence. However, as we get older, the immune system can take a little longer to recognise them.

If the verrucae are not painful then leave them alone and eventually the immune system will do its job. If they are painful and stopping you doing your activities then we recommended using a Podiatrist to treat them. Verrucae, similar to corns and calluses, assist in the formation of blisters and are especially painful if a blister forms underneath them.

There are plenty of verrucae treatments available. There are over the counter products that usually contain salicylic acid 12-25%, and also freezing canisters are readily available. However, we recommend going to see a Podiatrist who will help you choose the right treatment plan for you. These can include acids that have a stronger percentage than those over the counter, electro surgery, freezing, needling, surgery or the most recent treatment is the swift microwave.

Cracked and split skin on feet

Fissures are cracks in the skin that are caused by either the skin being too wet (macerated) or too dry. They can be extremely painful especially around the heel area, which as you can imagine, every time you put your foot down the fissure opens up into the lower layers of the skin. Avoiding the extremes of wet and dry conditions will help prevent fissures from occurring. Using emollients for dry skin and drying agents for the macerated skin is recommended for the best results.

Blisters from sweaty feet.

Macerated feet is a condition where the foot is saturated with water, it can be caused by sweating quicker than the skin can naturally evaporate the moisture away. The skin appears whiter, especially in between the toes, similarly to when you have spent too much time in the bath. The environment your feet are in can cause them to sweat more and an increase in humidity is certainly a factor too. Adolescents tend to suffer more from sweaty feet as a result of hormones related to their age. This is nothing to be embarrassed about and will likely pass over time, however, whilst this is present, good foot care should be a priority. There is also a condition where the sympathetic nerve malfunctions, which is a medical problem that causes the sweat glands to over produce sweat. A visit to the GP will help to confirm that condition

There are ways to help reduce sweating mainly by removing factors that encourage sweating. However, please bear in mind that sweating it is often just down to the way you are made. Some people naturally have dry skin and some are sweatier, unfortunately you can only improve on what you are given but not fundamentally change it.

How to stop smelly feet.

Smelly feet are caused when the foot sweats and the sweat can’t evaporate off, as the environment it is in doesn’t allow for it. This is primarily from footwear that is made from a material that isn’t breathable.  After long periods of time the bacteria multiply on the skin and that cause the smell.

Wearing socks which wick the sweat away from the skin help stop the bacteria from thriving. Changing your socks a couple of times a day, especially if you work in a very warm environment, will also help. Taking footbaths with sage or rosemary oil in the water will naturally deodorise the skin. There are also foot and shoe deodorants available, they tend to work for a while by plugging the sweat glands, however, the longer the feet are exposed to a warmer environment the harder it is to keep the foot from sweating.

Dry flaking skin on feet

Dry Skin is a skin type where the fatty (Lipid) layer of the skin is depleted and no longer provides a protection for the moisture layer underneath it. This moisture then evaporates leaving the skin very dry and red. This can then itch and  crack causing a fissure. There are many reasons for this to happen, detergents (soaps), medical conditions and weather can all have a drying effect on the skin.   There are several treatments that help with dry skin: – Luke warm showers and baths, Ph neutral soaps, emollients that are based with urea, and then using Vaseline over the top of  these treatments to behave like a barrier that will lock in the moisture.