What is Athletes Foot?

Athletes Foot is a fungal infection of the skin also known as tinea pedis. It is caused by the fungus Trichophyton. When the feet, or other areas of the body, stay warm and moist, the fungus thrives and infect the upper layer of the skin. The fungus can also spread to the toenails, which is much harder to treat. Up to 70% of the population will have Athlete's foot at some time during their lives.

What Causes Athletes Foot?

The fungus that causes Athlete's foot can be found on floors and in socks and clothing. It can be spread from person to person by contact with these objects and is highly contagious.

Signs & symptoms of Athlete's foot?

It is common to experience one or more of these signs and symptoms with Athlete's foot:

- Itching and scaling of skin
- Burning sensation
- Dry peeling skin, particularly around the inside arch of the foot
- Soggy peeling skin, particularly between the toes
- In severe cases, cracking skin with bleeding & pain
- Secondary infection by bacteria, particularly between the toes
- Spreading to the toenails which is much harder to treat.

Treatment of Athlete's foot.

In most cases, Athlete's foot can be simply treated with the application of over the counter anti-fungal preparations. These are available in powder form, emollient (cream) or sprays. Once the signs and symptoms have disappeared, it is important to follow the prevention advice below to avoid re-infection.

Prevention of Athlete's foot.

Without proper growing conditions (a warm, moist environment), the fungus will not infect the skin. Avoid keeping your feet in warm, dark, airless places for long periods of time (such as trainers).

Avoid footwear and hosiery made of synthetic materials. Leather shoes and cotton socks both allow your feet to breathe. Also, change socks daily and try and alternate footwear daily, particularly trainers.

If you wear trainers for sport or at the gym, make sure they get a good airing after use and are not left to fester in your sports bag!

When in communal areas (such as changing rooms or around a swimming pool) avoid walking barefoot. Wear flip flops and make sure you dry them after use!

Don't share towels with others and use a separate towel for your feet to avoid spreading the fungus around your body.

Keep feet clean! Wash them daily with a mild soap and take care to dry them properly paying particular attention to the spaces between the toes.

Apply cream to your feet after bathing and drying. Spread liberally over the feet with particular attention to the heels but avoid applying cream between the toes - this creates a moist environment for the fungus.

How do they happen?

TWhen we put pressure on our feet the skin thickens to withstand it. This pressure may then become intense and a corn or callus can appear.

What are Corns?

Corns are the most common skin problem for your feet and appear as small concentrated areas of hard skin. There are two main types of corns, hard & soft.

Hard Corns are a plug of hard skin usually found on the tops of the toes and underneath toes nails.

Soft Corns develop in a similar way to hard corns but are whitish and rubbery in texture. They appear between toes where the skin is moist from sweat or when insufficient drying occurs. Although the skin can be dried out with the daily application of surgical spirit, the corn will need to be removed by a Foot Health Professional. Vascular and Neurovascular Corns can be extremely painful and must be treated by a specialist. They usually occur through trying to remove a hard corn by yourself. The skin becomes damaged allowing blood vessels and nerve endings to push through to the corn.

Always see a specialist!

If you have a corn you should consult a Foot Health Professional for advice and to arrange the removal of a corn. I may also be able to recommend protective pads and/or orthosis to relieve painful corns.

If you are elderly or have diabetes you must not use corn plasters or products as they can burn healthy skin tissue around the corn.

What are calluses?

A callus is a small area of hard skin, caused by pressure or friction. A callus can appear anywhere on the foot where the skin rubs against the bone, shoes or the ground. Most calluses are a symptom of an underlying problem such as bone deformity, a particular style of walking or ill-fitting footwear. By seeking advice from a Foot Health Professional these factors can be improved or cured.

The best treatment

Small areas of callus can be controlled by regularly using one of our foot files or pumice stones. I strongly advise against the use of blades or metal files. Using a deep moisturiser will also help improve the skins natural elasticity. If the callus becomes painful, consult a foot Health Professional who can remove hard skin, relieve pain and redistribute pressure with soft padding or corrective appliances.

What are cracked heels?

The skin around the heel area of the feet can become excessively dry causing it to crack and fissure.

What causes cracked heels?

The skin around the heel is naturally thicker than other areas of the foot and so requires more moisture to keep it supple. If the skin becomes too dry and lacking in moisture, the upper layers start to lose their flexibility causing the skin to split and crack.

Anyone can develop cracked heels though certain factors can make some people more prone to the condition:

- Increasing age - skin naturally loses moisture as it ages.
- Being overweight.
- Wearing shoes with open backs that expose the heels.
- Skin conditions such as psoriasis and eczema.
- Diabetes can cause dry skin.
- Athlete's foot causes drying of the skin and can affect the heels.
- Shoes that are too loose or tight around the heel can shear and rub the skin.

What are the signs & symptoms of cracked heels?

It is common to experience one or more of these signs and symptoms with cracked heels:

- Dry, peeling, flaking skin developing around one or both heels.
- Vertical cracks known as fissures. The pressure placed on the heels when walking can cause fissures to split open and bleed. They can become very painful and susceptible to infection.
- Hard skin can develop around the heels and the edges of the fissures preventing the skin from 'knitting' together and healing.

Treatment of cracked heels

The skin around the heel is naturally thicker than other areas of the foot and so requires more moisture to keep it supple. If the skin becomes too dry and lacking in moisture, the upper layers start to lose their flexibility causing the skin to split and crack.

Anyone can develop cracked heels though certain factors can make some people more prone to the condition:

- Remove dry skin safely and gently with a foot file or by using a pumice stone in the bath or shower. Use twice a week.
- Do not attempt to try and remove hard skin with scissors, blades or other sharp instruments.
- Apply moisturising cream daily to the heels. Creams and balms developed specifically for dry and cracked heels can be obtained.
- For a more intense moisturise, apply moisturising cream at bedtime and wear bed socks during the night.
- If the skin is bleeding or infected, cover with a dry dressing and keep dry until healed.
See a Foot Health Professional, Podiatrist or your GP.

If open cracks fail to heal a Foot Health Professional can reduce the build-up of hard skin around the edges of the fissure, dress the area and advise on home foot care regimes.

- Treat Athlete's foot as it can contribute to dry and flaking skin.
- Avoid wearing loose or tight footwear that can rub the heels.

What can a Foot Health Professional do?

- Reduce dry and flaking skin

- Reduce hard skin build up, particularly around the edges of a fissure in order to encourage the skin to 'knit' together and heal

- Check for open wounds and infection and treat accordingly

- Advise on suitable moisturising products

- Advise on footwear

- Check for signs of Athlete's foot and advise on suitable treatment

Prevention of cracked heels

The two most important steps to follow in order to prevent heels from cracking are:

- File away dry and flaking skin gently twice a week
- Moisturise daily (or twice daily if feet are very dry)

Other simple steps to follow are:

- Wear good shoes that fit properly and don't rub the heel area.
- Treat Athlete's foot.
- See a Foot Health Professional for regular foot checks and foot care.

What is a fungal nail infection?

Fungal nail infections are also known as onychomycosis. It is usually a painless condition when the fungus infects the toenail causing it to become discoloured and unsightly. It can also affect the finger nails, though is less common.

What causes fungal nail infections?

The fungus that causes nail infections can be found on floors and in socks and clothing. It can be spread from person to person by contact with these objects and is highly contagious. The fungus can enter the nail and nail bed if the nail has become damaged or broken.

What are the signs and symptoms of a fungal nail infection?

You are unlikely to experience any pain or discomfort from a fungal nail infection, though you may see one or more of the following signs:

- Discolouration of the nail (dense white to yellow to brown).
- Thickening and distortion of the nail.
- Crumbling, splitting or pitting of the nail.
- A soft layer of debris under the nail.
- Unpleasant odour.
- Lifting of the nail away from the nail bed.
- Spreading of fungus to the skin causing itching, peeling or burning skin, known as Athlete's Foot.

Treatment of fungal nail infection

Since fungal nail infections rarely resolve unaided, it is essential to treat them, particularly to prevent spreading to the other toenails, finger nails and skin. Many of the treatments available are in the form of a nail lacquer or paint that is applied to the surface of the nail. In some cases the nail bed can become infected and your GP may wish to prescribe a course of oral antifungal tablets which can be used in combination with a nail lacquer. Creams, sprays and powders used to treat Athlete's foot are not suitable for fungal nail infections as they are unable to penetrate the layers of the nail.

Be prepared to be patient! It takes 9 to 12 months for a toenail to grow its length so you are advised to continue applying the nail surface treatments until all traces of infection have grown out.

It is also important that fungal skin infections are treated to prevent cross infection to the nails.

What can a Foot Health Professional do?

- Recognise the signs of a fungal nail infection.

- Cut and thin thickened and distorted nails.

- Smooth nail edges to prevent any loose pieces catching on hosiery.

- Check for signs of spreading to other nails and skin.

- Discuss treatment regimes and advise on the most suitable treatment for you.

Prevention of Fungal nail infections

Without proper growing conditions (a warm, moist environment), the fungus will not infect the nails. Avoid keeping your feet in warm, dark, airless places for long periods of time (such as trainers).

Avoid footwear and hosiery made of synthetic materials. Leather shoes and cotton socks both allow your feet to breathe. Also, change socks daily and try and alternate footwear daily, particularly trainers.

If you wear trainers for sport or at the gym, make sure they get a good airing after use and are not left to fester in your sports bag!

When in communal areas (such as changing rooms or around a swimming pool) avoid walking barefoot. Wear flip flops and make sure you dry them after use!

Don't share towels with others and use a separate towel for your feet to avoid spreading the fungus around your body.

Keep feet clean! Wash them daily with a mild soap and take care to dry them properly paying particular attention to the spaces between the toes.

Apply cream to your feet after bathing and drying. Spread liberally over the feet with particular attention to the heels but avoid applying cream on and between the toes - this creates a moist environment for the fungus.

What is an Ingrowing Toe Nail?

An ingrown toenail develops when the side of the toenail grows into the surrounding skin.

The nail pierces the skin, which becomes red, swollen and tender. The toe can also feel painful when pressure is placed on it. The big toe is most likely to be affected, either on one or on both sides.

The medical name for an ingrown toenail is onychocryptosis.

What causes ingrown toenails?

There are several possible causes of an ingrown toenail, including:

- Incorrectly cut toenails .
- Tight-fitting shoes, socks or tights.
- Excessive sweating or poor foot hygiene.
- Injury.
- Nail infections.
- Natural shape of the toenail.

A Foot Health Professional can treat an ingrowing toenail in several ways. In mild cases it may be possible to lift the nail by packing cotton wool under the nail to stop it piercing the skin. Another method is to remove the edge of the nail which is piercing the skin thereby relieving pressure and the pain caused.

Left untreated, an ingrown toenail can cause the toes to become infected and a course of antibiotics prescribed by your GP may be required. In severe cases surgery by a podiatrist may be recommended. This may involve either removing a section of the affected toenail or removing the whole nail.

Preventing ingrown toenails

There are several measures you can take to keep your feet healthy and prevent problems developing.

For example, cut your toenails straight across, not at an angle or down the edges. Always maintain good standards of foot hygiene, including washing your feet regularly and drying them thoroughly. It is also important that your footwear fits properly and is comfortable.

What are sweaty feet?

Sweaty feet is a common condition occurring when feet sweat excessively and inappropriately, sometimes causing an unpleasant odour. The medical term for this is Hyperhidrosis.

What causes hyperhidrosis, or sweaty feet?

It is a natural process for the body to sweat. The body is covered with over 5 million sweat glands and the foot contains 250,000 sweat glands alone. Each sweat gland secretes moisture and salts onto the surface of the skin to cool it down. This explains why we sweat more during hot weather and exercise.

Sometimes the sweat glands of the feet are overactive and produce more sweat than is necessary to cool the feet at that time, this is known as excessive sweating. It may occur simply in response to feelings of anxiety or stress or as part of a medical condition such as diabetes, hyperthyroidism, menopause or obesity. These medical conditions are likely to produce excessive sweating in other areas of the body as well as the feet.

What are the signs and symptoms of hyperhidrosis?

- Moist and wet feet

- Continually damp or wet socks

- Excess moisture on the feet creates a breeding ground for bacteria and fungi which break down to give off an unpleasant odour

- Excessive fungi can cause peeling and sogginess between the toes, Fungi can also spread to the nails

- Excessive bacteria can colonise the skin leading to conditions such as pitted keratolysis where the skin has a pitted, punched out appearance

- Soft corns may develop between the toes

- Ingrown toenails are more likely to develop in sweaty feet, especially in teenagers

- An inability to wear loose sandals and a tendency to slip on tiled or polished floors

- Other areas of the body may be affected - most commonly are the hands, armpits, hands and scalp

- Embarrassment and distress

Treatment & Prevention of sweaty feet

The symptoms of sweaty feet can be minimised by following a simple daily hygiene routine:

- Wash or shower feet daily; more often in hot weather or following exercise
- Use an antibacterial soap to help reduce build up of bacteria on the skin
- Dry feet thoroughly with a towel paying particular attention to the spaces between the toes
- Use specialised sprays and creams to keep the feet dry and conditioned. Your foot health professional, podiatrist, pharmacist or GP can advise which product is best for you
- Dab surgical spirit between the toes to reduce any sogginess
- Avoid footwear and hosiery made of synthetic materials. Leather shoes and cotton socks both allow your feet to breathe
- Change socks daily and try and alternate footwear daily, particularly trainers

Insert removable medicated insoles into your shoes and remember to replace them regularly Your Foot Health Professional, Podiatrist or GP can advise on the most suitable treatment for you.

What can a Foot Health Professional do?

A foot health professional can advise on foot hygiene, footwear and sprays and creams most suitable for your feet.

They are able to spot any signs of infection that may have developed.

A foot health professional can treat soft corns and ingrown toenails that may have developed as a result of sweaty feet.

What are Verrucas?

Verrucas start as a small speckled lesion and can grow quite rapidly. They have a rough surface, often covered by hard skin and may vary in size. They may also spread to other areas of the foot. Although anyone can get them, verrucas mainly affect children and young adults.

How it is caused.

A Verruca is a viral infection of the foot. Injuries and cuts to the foot can also increase the risk of infection. Although verrucas are often confused with corns or callus, they are usually more painful when pinched and may appear anywhere on the foot

Prevention

To help prevent verrucas, wash feet daily and dry thoroughly. Take extra care in communal changing areas. Hosiery should be washed at 60˚C to avoid cross-infection.

Advice

Verrucas have been known to disappear with the help of the body's natural immunity. However, if they are growing in size, spreading or becoming painful, treatment will be necessary. Consult a Foot Health Professional for advice on the best treatment for you.

Treatment

A number of treatments are available. Applying adhesive plasters, lotions and ointments are widely available, these often contain strong acids or natural oils to kill the virus. However, freezing is by far the quickest and most effective method. I am fully trained to use a freezing method called cryotherapy, which has an excellent success rate.

All treatments aim to kill the virus by destroying the affected cells. There is no guarantee they may not reoccur but to reduce the risks, take care of your feet.