The foot can be affected by a wide range of skin conditions.
Corns are a deep localised area of hard skin that form at any site that receives repetitive pressure. Although the corn itself does not have nerves as it is dead skin, it may press on nerves in the foot and cause pain.
The most common sites for corns to develop are the toes or any bony prominence. If the corn continues to develop they can ulcerate and become infected. Corns should be manually removed by a podiatrist. They may need to be padded to redistribute the pressure away from the area. Footwear should also be addressed to make sure there are no pressure areas.
Unless the cause of the pressure is addressed the corn will continue to recur. In some cases, surgical correction may be necessary to address hammer toes or bony prominences causing the corns.
Pressure over an area of skin will cause the body to build up more skin as way of protecting itself. This build up of extra layers of hard skin can cause discomfort.
The most common sites of callus are the heel and ball of the foot. It should be removed by a podiatrist and followed by a good self-maintenance program. This will involve regular pumicing or sanding of the hard skin and daily application of a heel or foot balm. This is particularly important around the heel where dry skin is unable to stretch and can split causing deep painful fissures which can become infected.
Orthotics or shoe modifications can be made to redistribute pressure away from painful callused areas. Footwear should also be addressed as long term high heel wear can cause callus over the ball of the foot and backless shoes or jandals can be responsible for heel callus or splits.
A wart that grows on the sole of the foot is called a verruca. Verrucas are caused by the Human Papilloma Virus and are highly contagious. They can spread by direct contact or by walking across a surface barefooted where someone else with a verruca has been. This is particularly common in areas like showers or pools where water is present to soften the skin and make it more susceptible for the virus to get in.
Verrucas can present as one single wart or can spread and have several warts close together like tiles (known as mosaic verrucas). The verruca builds up a hard protective layer around itself and this can be painful to squeeze. It has an irregular surface with black dots and can get quite deep.
Treatment involves breaking down the hard protective layer around the verruca but the method to do this can vary depending on the age of the patient and the site and number of the verrucas. For young children a more conservative approach is generally taken using occlusive dressings. In teenagers and adults either a combination of debriding the dead skin and applying acids as well as occlusive dressings can be used for single verrucas. For long standing mosaic verrucas the most successful treatment involves puncturing the main verruca multiple times (under local anesthetic) and initiating an immune response.
Tinea Pedis (Athletes Foot)
Fungal infections of the feet are very common as being enclosed in footwear creates the perfect warm, dark, moist environment that the fungus likes. The most common sites are between the toes and around the borders of the foot.
Tinea presents as an itcy, red, scaly patch that may be quite soggy looking when between the toes. An anti-fungal cream will be needed to rid the infection. Prevention is however more important and general foot hygiene of drying thoroughly especially between toes, changing socks if getting sweaty andf keeping skin smooth and devoid of splits so the fungal infection does not gain an entry point.
Chilblains usually occur on the extremities of the body such as the fingers, toes, heels, nose and ears. They are very common in winter especially in children and the elderly and people with poor circulation. Chilblains occur when the extremities become cold and the amount of blood travelling to the area becomes restricted. If the body re-warms too quickly, the fluid from expanding blood vessels can leak into the surrounding tissues and cause pain and swelling.
Chilblains can cause
- Burning, itching skin
- Pain or tenderness
- Redness or purple colouration
- Blisters or ulceration
- Possible infection in ulcerated area
Certain conditions can increase the likelihood of getting chilblains
- Family history of poor circulation or chilblains
- Problems that affect circulation like diabetes or smoking
- Connective tissue diseases like Raynauds or Lupus Erythematous
- Taking beta-blocker medication
- Hormonal changes
In most cases chilblains will heal themselves in a couple of weeks. If they are painful then creams can be purchased to help ease the symptoms. If the chilblain breaks open or ulcerates then you should go to your podiatrist.
Prevention of chilblains is extremely important
- Keep the body temperature evenly warm in cold weather
- Wear warm hats, gloves and socks
- Ensure shoes do not rub or have pressure points. Any site of irritation could trigger a chilblain
- If you do become cold then warm the extremities up slowly. Exercise or wriggle the fingers and hands to increase circulation.
- NEVER put cold hands or feet into hot water or shower
- NEVER use a direct source of heat such as hot water bottle, electric blanket or heater close to cold extremities.