Pedi-Cures: Protecting the Skin You Walk In

Walk a mile in his patients' shoes, and you, too, might be running to the doctor's office in search of fast fixes for corns on your feet, says Beverly Hills dermatologist David Rish, M.D.

Rish's rich and famous patients put their shoes on one foot at a time like everyone else, and they pay the common price for wearing shoes that put fashion before function. Says Rish: "It's very common to have corns on the feet because those pretty, pointy shoes just don't fit."

All told, one out of six Americans — about 43 million — have foot problems, according to the American Academy of Orthopaedic Surgeons. While corns are largely man-made — owing to bad habits like squeezing into undersized footwear — some other common foot problems, such as athlete's foot and so-called plantar warts, can be harder to avoid.

Uncomfortable and sometimes extremefully painful as they are, foot problems can usually be treated, if not prevented, either by taking simple foot-care steps at home or with a doctor's care.

Foot Care Facts

With each step, the pressure on your foot is equivalent to 1.5 times your body weight. It's no wonder, then, that when the toes are positioned particularly tightly against each other or against a shoe, the constant friction can cause the skin on top of the toes and underneath them to thicken and irritate the tissues underneath. The corns or calluses that form from the pressure develop on the big toe or the "pinky" toe.

Many calluses can be easily prevented by making sure shoes fit properly. Women, more often than men, crush their toes into shoes whose shape is far different from that of their feet, says Rish. And high-heeled shoes can push women's toes into the front of their shoes, compounding the pressure.

Whether brought on by improperly fitting shoes or another cause (such as certain foot deformities called hammer toe or claw toe), the pain from these calluses can sometimes be reduced at home, by soaking your feet regularly and wearing drug store-bought pads, carefully positioned on the toe to relieve the pressure.

And as soon as you see a corn developing, Rish suggests, gently rub the callus with a pumice stone to remove the thick skin — "the key word is gently," he emphasizes — and then moisturize your feet to avoid drying and cracking.

Alternatively, Rish can easily rid a woman of her corn by shaving the dead layers of thickened skin off with a scalpel. So what's the problem? Seems that women don't want to give up their high-fashion footwear, he says: "I shave [the corn] off and fix it up, and they put those pointy, pretty shoes back on and they're back in a month."

Warts & Athlete's Foot

Wart's the Matter

If it's painful to walk — as if there's a stone in your shoe — you might be suffering from plantar warts. These erupt on the sole of the foot after a virus enters the body through a break in the skin. With the pressure of standing and walking, the warts begin to grow inward into the foot. Plantar warts look much like calluses, but are sometimes distinguishable by the tiny black dots on their surface (the ends of capillary blood vessels).

The viruses that cause plantar warts thrive in warm, moist environments. To lessen the opportunity for the virus to penetrate its way into your foot, dermatologist Rish recommends wearing slippers whenever possible, such as when you're walking in the gym locker room or around the house.

To treat a plantar wart, a doctor can trim the wart and apply a chemical dressing. Often, the doctor will instruct you to continue care at home by applying salicylic acid patches daily.

Plantar warts can sometimes become a chronic problem. "They can be cut off, burned off, frozen off, treated with over-the-counter acid solutions," Rish says, but still, 50 percent of the time they come back. Pursuing effective treatment is important because otherwise warts can multiply and "one wart becomes two, three and four."

Athlete's Foot Facts

While myth has it that walking barefoot in the locker room is a sure-fire way to catch so-called athlete's foot, scientific studies show that fungal infections of the feet don't seem to be contagious at all. In fact, because it is moisture, sweating, and lack of ventilation that cause the fungi to proliferate, people who tend to go barefoot are actually less likely than others to develop athlete's foot.

Technically known as tinea pedis, athlete's foot infections are caused by living germs that grow on all people, but for unknown reasons only develop into athlete's foot in some. The condition most often affects men, and only rarely women and young children.

Symptoms of athlete's foot can include peeling, cracking and scaling between the toes; redness, scaling and blisters on the soles and sides of the feet; and often accompanying itchiness.

To avoid getting athlete's foot:

  • Wash your feet daily, and dry them thoroughly, including between your toes.
  • Avoid tight shoes, especially in the summer, when sandals are the best choice.
  • Wear socks made of cotton rather than synthetic material, and change your socks at least daily and more often if they become damp.
  • Go barefoot when possible, such as at home.
  • In the summertime, dust an anti-fungal powder in your shoes.

Athlete's foot can usually be treated "very effectively" with over-the-counter anti-fungal creams, though prescription pills may be needed for resistant cases, according to Norman Levine, M.D., professor and chief of dermatology at the University of Arizona.

Healthy Nails and Footcare

Treatment Tough as Nails

When fungal infections affect the nails of the foot, they can cause the toenail to separate from the nail bed, allowing white, green, yellow or black debris to build up under the nail.

Fungal infections in the nail can be difficult to treat. Oral anti-fungal medications are only "fairly effective," according to Levine, working between 50 and 75 percent of the time.

With another common nail disorder, an ingrown toenail, the nail grows into the toe's skin, causing the toe to become infected and sore.

To treat an ingrown toenail at home, you can soak your foot in warm, soapy water several times a day. In some cases, you may have to gently lift the edge of the nail from its embedded position and put some cotton or waxed dental floss between the nail and skin, changing the packing daily.

In more severe cases, a doctor may prescribe antibiotics or perform a surgical procedure to permanently remove part of the toenail.

You can prevent ingrown toenails in the first place by not cutting your toenails too short, especially on the sides of the big toes. And of course, avoid wearing shoes that are too small.

Extra Foot Caution for Diabetics

Small wounds, as minor as a blister from a too-tight shoe, can cause diabetics to develop serious health problems, in some cases even requiring amputation. Even if a foot problem wouldn't be cause for alarm in nondiabetics, those with the disease should see a doctor right away if they notice even a slight injury to their foot.

For everyone else, most foot problems can be easily treated, and in many cases even avoided in the first place with common-sense steps that don't require someone to, in Levine's words, "tiptoe through life."