What To Buy In The Foot Care Aisle

Choices abound in the foot care aisle.  It’s common to see a perplexed shopper scanning the displays and shelves of foot care products trying to figure out what to buy.  At McDermott Footcare, clients often ask what are the best items to purchase to care for their feet between foot care visits.

Let’s divide the items into categories.

Nail Scissors/Clippers/Files

Admittedly, it’s difficult to judge the quality of scissors/clippers since they often come in packaging.  You may have to decide by trial and error.  In general, buy the best quality stainless steel product you can afford.  It’s advisable to have 2 sizes of clippers:  a smaller one for the fingernails and a larger one for the toenails.

Nail files are available in metal, glass or cardboard.  A cardboard nail file is also known as an emery board.  It is more gentle than metal or glass and is disposable.

A metal nail file’s abrasive surface is usually made of mineral corundum.  It is the most abrasive file and is best for thicker nails.

Glass nail files are more expensive than metal or emery files.  Their abrasive surface is finer and smoother, therefore not suitable for tough jobs.

For personal nail scissors/clippers and nail files, it is advisable not to share with other people.  While it isn’t necessary to sterilize your personal nail tools, they should be regularly disinfected.  A disinfectant wipe will be suitable.

Corn and Callus Products

Many preparations and pads are available for corn and callus home treatment:  medicated pads, liquid drops, moleskin, corn and callus scrapers/shavers.

Medicated pads and drops can be harmful since the acid in the preparation can burn the skin around the corn or callus.  At a recent foot clinic, a client showed me a large, irritated area on the bottom of her foot.  She had been using an over-the-counter medicated pad for a few weeks and now the area around the callus was showing large areas of peeling and redness caused by the medication in the pad.

Non-medicated pads and moleskin are useful.  To avoid undue pressure (and pain) over the corn or callus, use pads with the hole in the middle or cut a hole yourself.  This way, the pad protects the corn or callus without discomfort.

I do not recommend corn and callus scrapers/shavers for in-home use.  These items are very abrasive and can cause bleeding, irritation, infection if used too aggressively.

Because of an increased risk of infection in diabetic feet, it is never recommended that diabetics use medicated pads or corn and callus scrapers/shavers.  Even a slight irritation or scratch can develop into a complicated infection.

Warts and Plantar Warts Medication

Like medicated corn and callus pads, wart preparations can also damage the skin around the wart.  It may take weeks to eradicate warts, especially plantar warts, despite claims on the packaging.  Before purchasing wart medications, try home remedies first.  Often, they are just as good as over-the-counter preparations (read here).

Again, diabetics should stay away from over-the-counter wart preparations.  There is a possibility of damage to surrounding skin which can cause infection.

Toe Spacers, Padding, Toe Props

These are great deals in the foot care aisle.  The purpose of these devices is to realign toes which are crowded together, clawing downwards or in need of some padding for increased comfort inside shoes.

Toe spacers are placed between toes that are crammed together.  They are generally comfortable if the right size is used.  Trial and error may be needed to find a toe spacer which fits and is comfortable.

Padding usually comes as foam tubes or adhesive moleskin.  They may be cut to size.

Foam tubes usually come in 3 different sizes and the one to use depends on the size of the toe.  The tube foam slips on over the entire toe, acting as a cushion and/or toe spacer.

Moleskin pads are adhesive and may be cut to fit the affected area.  There are different thicknesses of moleskin available.  Again trial and error is needed to find the right thickness.

Toe props are placed under the toes, to straighten and realign claw toes.

Insoles

The variety of insoles can be staggering at a well-stocked foot care aisle.  There are insoles for everything from plantar fasciaitis, diabetics, sweaty feet, runners, walkers, high heels, the list goes on.  In general, these are very good buys.  Again, trial and error is needed to find the one that suits you best.  Always get insoles that have a cloth layer on the top.  The cloth helps to absorb sweat.  Many insoles are made only of gel.  These will not absorb sweat and may increase the likelihood of developing athlete’s foot or bromhidrosis (smelly feet).

Heel Creams and Foot Soaks

Many of these preparations contain fragrance which is drying to the skin.  Instead of highly fragranced items, there are other choices that will not promote dryness.

Find a moisturizing body lotion or cream that contains urea.  Urea is a natural substance produced in the body and it serves to retain moisture.  Urea added to moisturizers does the same thing.  Choose a non-fragranced product.

Fragranced foot soaks contain epsom salts as the main ingredient.  For a cost-effective, less drying alternative to fancier products, combine regular, fragrance-free epsom salts with a shallow basin  of warm water.

White vinegar is very good for the feet.  Make a solution of 1/4 cup white vinegar and a shallow basin of warm water for a skin-smoothing, fungus-inhibiting, inexpensive foot soak.

Other Items

Pumice stones are handy and effective for gently scrubbing away dry skin on heels.  They are also good for sloughing calluses and corns.

Athlete’s foot medications come in creams, powders and sprays.  With consistent use and other measures, they can be effective for mild athlete’s foot.  Complicated athlete’s foot should be treated by your doctor.  Diabetics with athlete’s foot should always consult their doctor.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Plantar Warts: How Did I Get Them? What Can I Do About Them?

Plantar warts are caused by a few of the 120 types of human papillomavirus, or HPV.  The virus affects the superficial areas of the skin, especially on the pressure points of the foot such as the heel and the ball of the foot.  Since it is a virus, it is contagious.  It typically enters through small cuts or irritated areas in the skin, or areas  that are constantly exposed to water.

What does a plantar wart look like?

McDermott footcare   plantar wart

A lifeguard/swim instructor developed a plantar wart on the ball of the foot as a result of long hours working in constantly wet, bare feet.

Plantar warts are small, grainy, callus-like lesions on the bottom of the foot.  There may be a single wart measuring about 2 – 3 cm; a large “mother wart” surrounded by several smaller warts; a cluster of warts grouped together, otherwise known as a mosaic wart. The centre of the wart(s) have tiny red or black dots caused by trapped capillaries.  On weight-bearing surfaces, the warts may be flattened.

How do you get plantar warts?

  • the virus enters through tiny cracks in dry skin
  • through cuts, scrapes and other skin irritations
  • through wet, softened skin from prolonged exposure to water

Who usually gets plantar warts?

  • children and teenagers since their immune system is not fully developed and since they are more likely to go barefoot
  • people with weakened immune systems

Home remedies for plantar warts

  • apply a doughnut-shaped pad (available at drugstores) around the plantar wart to reduce pressure on the area when weight-bearing
  • try an over-the-counter medicated wart remover.  Since these preparations may chemically burn the skin, protect the area around the wart with a light coating of petroleum jelly.  This remedy is not recommended for young children or diabetics.
  • gently rub the callused area with a pumice stone after soaking in a vinegar-water solution for 10-15 minutes
  • apply duct tape over the wart.  Change as needed if it becomes wet.  Re-assess the area after 3 – 4 days and leave the tape off overnight if the skin underneath appears wet.  You may apply a drop of tea tree oil before applying the tape.  It may take 6 – 7 weeks to eradicate the wart using this treatment.

When to see your doctor

  • if after 2 weeks of applying home remedies, there is no noticeable change
  • if new growths keep appearing
  • if you are unsure the growth is a wart
  • if you have a previous history of skin cancer or have a close family member with a history of skin cancer
  • if you are diabetic

How to prevent plantar warts

  • avoid walking barefoot in public shower stalls, change rooms, swimming pools, saunas
  • change your socks daily
  • check the bottom of your feet daily.  If needed, use a mirror.

    If needed, use a mirror to check the bottom of the feet.

  • keep feet clean and dry
  • do not touch warts on other people
  • if you touch a wart on yourself or on someone else, wash your hands thoroughly for at least 15 seconds using warm, soapy water
  • don’t scratch warts since this encourages their spread
  • don’t share shoes and socks
  • cover warts with waterproof tape while in swimming pools or shower stalls

Diabetes and plantar warts

If you are diabetic, always have your doctor treat plantar warts. Complications such as poor nerve functioning(neuropathy) and decreased blood circulation (micro/macroangiopathy) make home treatments dangerous for people with diabetes.

Since diabetics have concerns with decreased nerve functioning in their feet (neuropathy), it may not be possible to feel discomfort from a plantar wart.  Daily checking the entire foot to detect new growths or lesions is important.

Over – the – counter wart removers should not be used by diabetics since there is the strong possibility that harsh chemicals in the preparation may irritate healthy skin surrounding the wart.  These irritations may aggravate the area and cause skin infections.  Because of poor circulation, any skin infection in the feet of diabetics must be treated aggressively.

See also:  Lifeguards and Plantar Warts:  A Love Story

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Diabetic Foot Screening

People with diabetes are at a higher risk for foot-related wounds, ulcers and lower limb amputation.  This is because of nerve and circulatory changes (read here) which occur in diabetes.  For this reason, it is important to regularly assess the feet of diabetic clients.

At McDermott Footcare, the tool used for this assessment is Inlow’s 60-Second Diabetic Foot Screen, obtained from the Canadian Association of Wound CareThe screening tool consists of a mono-filament device and accompanying checklist.  The frequency of assessment is determined by the initial and subsequent assessment scores.  The higher the score, the more frequent the assessment.  The quick but thorough assessment covers all important areas.

Visual:

The first part of the assessment involves looking to see the condition of the skin and nails.  Are the skin and nails fungal?  Are there calluses or open ulcers?  Are the nails thickened?  Is footwear appropriate or causing trauma?  Look for Charcot’s Deformity, bunions and previous amputations.

Touch:

Next, the temperature of the foot is recorded.  By touching the feet, a comparison is made of the temperature of both feet.  Are they equal in temperature or is one foot colder/hotter than the other?  Are they colder/hotter in relation to the environment?

The range of motion of the great toe is assessed.  Things to look for include how easily the toe can be moved or is it rigid.  What degree is the rigidity?

Sensation And Other Assessment:

Next comes testing with the mono-filament tool.  10 sites on the foot are touched with the mono-filament and the client’s ability to feel the touch is rated.  The client is also asked whether they feel numbness, tingling, or burning in the feet.  The pedal pulses are felt.  The presence of dependent rubor (redness when the feet are down; pallor when they are elevated) and erythema (reddened areas of the skin) complete the assessment.

Clients respond favourably to Diabetic Foot Screening.  They are advised that it is part of the overall nursing plan of care for keeping their feet healthy.  It is also a good springboard for discussion and health teaching about foot health.  As needed, clients have been advised to see their doctor for further treatment based on the findings of the assessment.

The 60-Second Diabetic Foot Screen is very convenient and quick to complete.  Regular screening gives clients peace of mind that their foot health is monitored appropriately.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author