Corns and Calluses

A callus is an area of hard, thickened skin on the foot that forms in response to pressure or friction, usually through poor-fitting shoes. When pressure is concentrated in a small area, a corn, which has a central core, may develop. If the pressure is not relieved, calluses and corns can become painful.

Common sites of corns and calluses are the ball of the foot, under the big toe, tips of toes and any bony prominence. ‘Soft’ corns may develop between the toes, where the skin is moist from sweat or inadequate drying. Sometimes, the pressure of the corn or callus may cause inflammation, which can result in pain, swelling and redness.

Symptoms of corns and calluses

• The symptoms can include:

• Thickened patch of hard skin on the foot

• Hard, small bump of skin that may have a central core

• White and rubbery bumps of skin (‘soft’ corns)

• Pain when pressure or friction is applied to the area.

Treatment for corns and calluses

Treatment of corns require removal of the dead tissue with a scalpel. The treatment of corns varies according to the cause and how long it’s been present.  A follow up visit in 6 weeks after the initial treatment is usually highly recommended to resolve the issue.

Diabetic Foot Care

Prevention is the key to avoid diabetic foot complications.

Diabetics are more vulnerable to foot problems because diabetes can damage nerves and reduce blood flow to the feet. Many Diabetics eventually lose sensation in their feet known as diabetic neuropathy. Neuropathy can also present itself as burning, tingling or numbness in the feet. With the lack of sensation on the bottom of the foot, diabetics are at risk of developing more serious foot complications which can lead to dangerous infections and even amputation. Therefore, proper foot care for diabetics is especially important. Regular foot examinations are necessary.

If you have diabetes but you are unable to properly trim your toenails or you have corns/calluses or unable to see your feet, it is the best to have a foot care professional provide regular foot care for your feet. 

Fungal Toenail

Fungal infection of the toenail is a common foot health problem, causing unsightly, thickened, discoloured nails. Toenail fungus is the most common nail disease in adults, affecting up to 10% of the population.

What causes a fungal toenail infection?

A fungus is a microscopic organism that lives off a protein (keratin) in the nail. Fungus thrives in a dark, warm, moist environment such as within sweaty sports shoes and moist socks. The toenails are especially vulnerable around damp areas where people are likely to be walking barefoot such as swimming pools, change rooms and communal showers. Some people seem to be more susceptible to developing fungal nail infections. These may include people with diabetes, circulation problems and immune-deficiency conditions.

How do I know if I have a Fungal Toenail Infection?

If you have a fungal nail infection you may notice that the toenail has become thicker, yellowish-brown or milky-white in colour, and sometimes malodorous. A build-up of nail and skin may collect beneath the nail plate, and the nail may detach from the skin under the nail.

The infection is capable of spreading to your other toenails, the skin, and even the fingernails and to other members of your household. Fungal nail infections aren’t usually painful, however, if they cause excessive thickening of the nail plate this can result in some tenderness and difficulties in trimming the nail.

Treatment

Nail infections don’t get better without treatment, and may get worse, affecting more of the nails and skin. The affected nail may be trimmed and reduced periodically by your foot specialist with an electric drill, removing diseased nail matter and debris and creating micro holes (Lacuna method) allowing antifungal sprays/lotions to be applied directly to the active edge of the fungus. You may be advised to apply an antifungal spray to your toenail regularly over many months.

Athletes Foot 

Athletes foot is a contagious fungal infection of the skin. It is easy to catch and is often picked up in public areas, such as communal showers. The skin can change in appearance, becoming red, moist and itchy, and sometimes developing small blisters.

Athlete’s foot usually forms between the fourth and fifth (smallest) toes or third and fourth toes, producing skin cracking, white and soggy toes, scaling, and itchiness. The infection can spread to the soles of the feet. It’s made worse by sweaty feet and wearing tight socks or shoes that stay in moisture. If a bacterial infection sets in on top of it, the skin will ooze, burn, and smell.

The best way to prevent athlete’s foot

• Keep your feet clean, dry, and cool.

• Whenever possible, take off your shoes to “air out” your feet.

• Clean your feet daily with soap and water.

• Always dry well between your toes.

• Use an absorbent powder such as talcum powder.

• Wear absorbent socks (e.g., made out of cotton, bamboo or wool).

• Avoid tight-fitting footwear, since sweaty feet provide ideal conditions for fungal growth.

• Change your socks after exercising or after any excess sweating. Bamboo socks are excellent as they allow your feet to breath. Then wash them on a 60 degree wash to kill the spaws.

‍Ingrown toenails

Ingrown toenails are generally caused by poor nail-cutting technique, abnormal nail shape or poorly fitted footwear.

What are the symptoms of an ingrowing toenail?

Early on, the skin around the ingrowing nail may become reddened and feel slightly tender. If it progresses and becomes infected, it may become more swollen, red and painful. If the infection gets worse, there may be some yellow or green fluid (pus) oozing from around the nail. It will become even more painful and there may be an overgrowth of skin around the nail.

What is the treatment for an ingrowing toenail?

In growing toenails are usually treated by a qualified foot specialist.

Prevention of ingrown toenails

Ways of avoiding ingrown toenails include:

• Do not cut nails into the corners – this can leave a spike of nail that can embed itself into or irritate the flesh next to the nail. If you do have to cut your toenails into the corners, make sure that a nail spike is not left behind by using a blacks file to smooth the edge.

• Make sure that you and your children wear shoes that fit properly.

Verruca

Verruca’s are a wart as a result from an infection of the skin caused by the human papillomavirus (HPV). The virus enters the body through a break in the skin (such as a cut) and then forms a rough bump on the surface of the skin. Verruca’s are benign (non-cancerous) growths.

Anyone can get verruca’s but they are more common among children because they frequently have scrapes and cuts. The elderly also get warts more frequently because they have a weaker immune system.

Warts are very contagious. They can easily be transmitted from one person to another by coming into direct contact with a wart or with something – such as a locker room floor or a towel – that has been in contact with a wart.

What are Verruca’s?

A verruca is a wart that occurs on the sole (plantar) of the foot, most often on the parts of the sole that receive pressure when standing or walking. Because of this pressure, plantar warts are often flat or grow inward. Verruca’s can appear alone or in a cluster (mosaic warts). Verruca’s are usually small. They tend to grow slowly and can eventually penetrate deep enough into the skin to cause discomfort or pain.

What are the symptoms of Verruca’s?

People who get verruca’s may feel as if they have a stone in their shoe. Because of their flat appearance and location on the bottom of the foot, verruca’s are frequently mistaken for corns. Like corns, verruca’s have tough, thick skin. However, unlike corn’s, a verruca is painful when squeezed. A verruca may also have black dots on its surface. These dots are from the dilated blood vessels in the wart.

How are verruca treated?

Verrucas’ often go away on their own after a certain amount of time. However, since these warts are frequently painful, the patient may want to have them treated right away. Verruca’s are hard to treat because there is no guarantee it will completely work.  I would always pair back any hard skin with a scalpel that is covering the virus and suggest various treatments.

Bunions

Bunions are a common foot deformity of the big toe. They are often an inherited condition. Footwear does not directly cause bunions but may contribute.

Bunions can occur in adolescence or develop as you get older. The deformity of a bunion tends to worsen over time.

Symptoms

Bunions can cause painful rubbing over the bony prominence in footwear. This makes finding footwear difficult and may limit activities. They can also be associated with pain elsewhere in the foot due to altered weight bearing caused by the big toe deformity.

Prevention

You can try shoe modification with wider shoes to limit the rubbing. Splints and spacers may be helpful when worn to prevent rubbing. They will not correct the deformity permanently or prevent progression.

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