When it comes to foot problems, it can often be a case of ‘out of sight, out of mind’, as it is easy to neglect feet when they spend months encased in socks and shoes. Yet, when summer arrives those problems can be difficult to ignore. There is a definite increase in the number of patients complaining about problems affecting their foot health in the summer, says Dr Elizabeth Jones, a podiatrist at Total Foot Health: “People present with them more as they are wearing their sandals and they start to become very aware of them, and some of the problems people can suffer with can be very embarrassing.”
So what is it that is causing these issues? Often, there is a combination of factors according to the experts. On the one hand there is heightened awareness of the problem due to feet being more visible in the summer, but there is also the exacerbation of problems caused by heat, sweat and sunlight.
So, what are the problems that pharmacy teams are likely to be asked for advice on? Here’s a run down of some of the common conditions:
Runners and hikers are, for obvious reasons, the most likely to complain about blisters. While blisters are a year-round problem, the increased levels of activity in the warmer weather, coupled with additional chafing due to sweat, can mean that treatment for blisters is more in demand in the summer months.
Treatment: The College of Podiatry suggests that blisters should be covered with foam or felt if they haven’t popped, and should clear up within three to seven days. It does suggest however, stopping exercise when the person first feels friction and avoiding excessive friction in the area when blisters do develop. Blister plasters are also available to protect the area and aid healing.
Avoidance: Ill-fitting or overly stiff footwear can cause friction and therefore blisters, so it is suggested that people ensure their footwear fits correctly.
Corns and calluses, while common, are the subject of a lot of misinformation. It is possible, for example, to mistake a corn for a verruca, and vice versa, so make sure customers are trying to treat the correct complaint. Corns and calluses are areas of hard, thickened skin that develop when the skin is exposed to excessive pressure or friction. They commonly occur on the feet and can cause pain and discomfort when walking. Corns are small circles of thick skin that usually develop on the tops and sides of toes or on the sole of the foot, however, they can occur anywhere. Calluses are hard, rough areas of skin that are often yellowish in colour and can develop around the heel area or on the ball of the foot.
Treatment: “There are corn preparations that pharmacists sell (impregnated corn plasters) but they should only be used for very short times as a one-off. The key to getting rid of the corn is to get rid of the pressure on the top or the side of the shoes,” explains Dr Jones. To treat the cause of the corn or callus, customers should seek advice from a specialist.
Avoidance: As these conditions are in part caused by ill-fitting footwear, changing shoes to something that fits better can help avoid corns and calluses. “A lot of people think corns have a root which they don’t as they are caused by pressure. If they are on the top of the foot then they are often caused by footwear so the way to get rid of a corn is to change your footwear,” says Dr Jones. In addition, customers should try to stop calluses from developing by applying foot cream, and using a pumice stone or foot file to gently remove hard skin.
Bunions are bony lumps that form on the side of the feet by the big toe. They can cause the big toe to point towards the other toes and hard, red or swollen skin may appear over the lump.
Treatment: Bunions can only be corrected with surgery, though podiatrists may suggest patients try certain exercises, special devices on the foot, and shoe alterations or night splints to relieve the pain. Customers can also ensure they wear wider-fitting shoes with a low heel and soft sole, and if painful, hold an ice pack to the bunion for up to five minutes at a time, try bunion pads or take a painkiller.
Avoidance: Bunions are generally genetic in cause though women are more prone to them than men, with about 15 per cent of women having them. This is thought to be due to looser ligaments in general and wearing narrower and more restrictive footwear that can exacerbate the problem. Customers with bunions should be advised to consider changing their footwear.
We spend a lot of time on our feet and general aches and pains are common, though not ‘normal’, and should not be ignored. Arch and heel pain is generally caused by repetitive use of the foot, and may get worse in the summer as people tend to go on more walks or take part in more activity and sports. One common issue is known as plantar fasciitis, which can cause chronic pain in the heel and arch.
Treatment: “Patients may come to you with general aches and pains. I know pharmacies have arched support-type orthotics for things like plantar fasciitis, it is always worth trying something like that first,” says Dr Jones. “However if it doesn’t settle down within a few weeks then they need to see a podiatrist as there are other things it could be other than plantar fasciitis.” The NHS also suggests resting the foot and using ice packs to relieve the pain, as well as painkillers, heel pads and gentle stretching exercises.
Avoidance: Having a properly supported foot will help avoid pain, so remind customers to consider the thickness of their shoes’ soles and how supportive they are. If taking part in sports, customers should use appropriate footwear.
With their feet on display this summer, customers may be more bothered than usual about cracked heels. This condition is caused by untreated dry skin being exposed to pressure. As there is little moisture in the skin, it is less flexible, which means that when pressure is applied when walking, the skin can crack. If untreated, the fissures that form can become so deep they can bleed and become painful or infected.
Treatment: A urea-based heel balm is arguably the best product to use for cracked heels. Customers should be recommended to apply a heel repair cream twice a day to clean, dry skin, and to use a foot file to gently remove dry skin.
Avoidance: Dehydrated skin is the leading cause of cracked heels, and should be avoided by keeping the skin as moist as possible.
A common problem in summer months, athlete’s foot, is caused by the fungus tinea pedis. “If they have a fungal infection in their feet then that is athlete’s foot, which is probably going to be seen more in the summer because if it is a fungus it likes warm dark moist conditions which is rife in a closed shoe,” says Dr Jones. Athlete’s foot can lead to intense itching, blistering and peeling skin, redness and scaling. It can be caught by coming into contact with infected flakes of skin, often in communal areas such as at a gym or swimming pool.
Treatment: Feet should be washed daily with soap and thoroughly dried. The College of Podiatry suggests customers use an antifungal cream with a steroid cream (or a combined product) for instances where inflammation is present. Instructions should be stuck to rigorously to ensure the infection has cleared and stop it returning. Hands should always be thoroughly washed after treatment to avoid spreading the infection further on the foot or to other areas of the body.
Avoidance: Feet should be cleaned daily and dried thoroughly, particularly between the toes. Advise customers to use a separate towel to dry their feet and to wash it regularly, to wear clean socks every day and rotate the shoes that they wear. Customers should avoid walking around barefoot and opt to wear flip-flops in places like changing rooms and showers.
The College of Podiatry has nine tips to help keep yours, and your customers’, feet in good condition:
Arch and heel pain is generally caused by repetitive use of the foot, and may get worse in the summer