Foot Care for Summer

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Summer Foot Care

WebMD Live Events Transcript

It's time for those tootsies to step out in sandals. Are your feet ready? Before you walk the boardwalk, stroll along the sands, or play in the park, talk with podiatrist Oliver Zong, DPM, about the best way to care for your feet in the summer heat. He joined us on June 23, 2005.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live, Dr. Zong. Thank you for joining us today. It's that time of year -- everyone wants pretty feet.

ZONG:
It's good to be here. Thank you for having me.

MODERATOR:
What are the most common complaints you get this time of year?

ZONG:
This time of year our most common complaints come mainly from women and it has to do with wearing open toes, sandals, and going to the beach and showing off their feet. Most complaints are cosmetic rather than medical at this point. They range anywhere from fungal nails to corns and calluses and include cracked heels; they can range also to deformities such as bunions and hammertoes.

MODERATOR:
Let's start with corns and calluses -- what do you suggest to deal with these?

ZONG:
You'll have your garden-variety corns and calluses that are relatively minor that women will complain about, and for that you can visit your local nail salon to have a pedicure and that will usually take care of minor corns and calluses.

For thicker, more severe corns and calluses you can visit your local foot doctor who will be able to address these more severe problems appropriately. But at home, you can try different types of moisturizers and creams. One can also utilize pumice stones after a shower, bath or after soaking your feet in a foot spa, which tends to feel very good in the summer.

"A nice trick is to take a heavy cream such as Vaseline, and I've even heard of people using Vick's VapoRub, on their heels. The way you would use this is to apply a thick coat of the cream on the heels and wear a pair of socks over the cream while you sleep."

MEMBER QUESTION:
I heard that there is an infection you can get from a nail salon, so I haven't gone for a pedicure for a while. My cousin in California told me about it. What can you tell me about this infection?

ZONG:
The most common infection you can get from visiting the nail salon is fungal nails. This often will arise from salons that do not adequately sterilize their instruments.

One way you can protect yourself is to try to find a salon that is reputable and does sterilize their instruments. If you cannot assure this, you can also purchase your own instruments and bring them to the salon and have them perform their services with your instruments. That should help reduce your risk of catching a fungal infection of the nails.

MEMBER QUESTION:
Is it OK to use a callus shaver? My heels get so callused that a pumice stone won't help and neither do creams. My heels get dry and sometimes even crack. How can I avoid this?

ZONG:
Generally it's probably not a good idea to use a sharp instrument on your feet because it's difficult to control the instrument on yourself as opposed to when a professional is performing a service on your feet.

If you're a diabetic or have systemic medical conditions, you should definitely avoid sharp instruments, such as a callous shaver, whereas a pumice stone is much safer to use.

You'll find you get the best results when the skin is soft and supple, for instance after taking a shower or a bath, or after soaking your feet in a foot spa. There are other things you can do to help reduce cracked heels, such as utilizing moisturizers and creams on your heels and avoiding backless shoes. For severe cracked heels, there are prescription creams with acids in them which will help eat away at the dead skin. And of course, a podiatrist can debride the heel as well.

A nice trick is to take a heavy cream such as Vaseline, and I've even heard of people using Vick's VapoRub, on their heels. The way you would use this is to apply a thick coat of the cream on the heels and wear a pair of socks over the cream while you sleep. After a few days, you should see a great improvement in the heel calluses.

MODERATOR:
You said to avoid backless shoes. One of the joys of summer is going barefoot -- is that something we should avoid?

Quick GuideCommon Causes of Foot Pain

Common Causes of Foot Pain

ZONG:
It's generally good advice to avoid going barefoot especially if you're diabetic or have any neuropathy in your feet. You want to avoid the risk of stepping on things such as broken glass or rusty nails, etc., but you also open yourself up to being exposed to things such as viruses which cause warts and can occur frequently on the soles of the feet. If you want to let your feet breathe, it's more advisable to try a sandal or even a pair of flip-flops.

MEMBER QUESTION:
Will your suggestions for heels work for other foot calluses as well?

ZONG:
Yes.

MEMBER QUESTION:
How do I avoid the yellow, thick toe nails that my mother had? Is this caused by fungus? Also, I've been told that nail polish on the toe nails isn't beneficial.

ZONG:
Generally thick yellow nails are caused by fungus, but they can be caused by other things. The only way to know for sure is to visit a doctor who can have the nail examined under a microscope to confirm they are, indeed, fungal.

If they are fungal, there are nail lacquer preparations and also oral preparations which can address the fungus. If you are a person whose feet sweat a lot you may be more prone to getting a fungal infection. You will want to try to apply antiperspirant to your feet to keep them dry, and try to change shoes on a daily basis. That is, don't wear the same pair of shoes day after day. Fungus thrives in a warm, moist, humid climate, which describes your foot inside of your shoe. So if you can avoid keeping your feet from sweating a lot and airing out your shoes, you will be at less risk for fungal nails.

"Soaking your feet is probably one of the most soothing things you can do. It's something a lot of women will do when they get a pedicure and probably something most men do not do enough of."

Generally there isn't a big problem with using nail polish. Nail polish will, however, discolor the nail when you remove it. You're more apt to getting nail damage when you use something like the fake nails or nail tips, but that's more fingers than toes. Generally nail polish is OK.

MEMBER QUESTION:
How do you avoid getting ingrown toe nails? My big toe nails seem to curl under on the sides and I am constantly digging them out to stop the
pain. Sometimes I get an infection before I can get them out. I soak my feet in Epson Salts. What else can I do? Any suggestions?

ZONG:
To answer your question specifically, it sounds like you have a chronic ingrown toenail problem, especially if your nails recurled. If this happens on a regular basis, you may want to consider having a permanent nail procedure performed so that the edge of the nail never grows back, thus eliminating the ingrown nail problem. This can be performed at any podiatry office in the country.

But in general, for most people, you should try to clip your toenails straight across and not try to dig into the corners as that can cause an ingrown toenail. Also, excessively pointy shoes should be avoided as the excess pressure can cause an ingrown toenail, as well.

Soaking your feet is probably one of the most soothing things you can do. It's something a lot of women will do when they get a pedicure and probably something most men do not do enough of. You can get a bucket or a foot bath and use Epson salts or if you'd like, you can go to the local department store and purchase an inexpensive foot spa. They run about 20, $30 at the local Target, and they do a great job, as well.

MEMBER QUESTION:
The bottom of one of my feet is really scaly and itchy -- so itchy that I scratch it every night to the point of bleeding. I have tried EVERY athlete's foot remedy/ointment around, and nothing works. What else could it be?

ZONG:
This is most likely an aggressive form of athlete's foot. If the over-the-counter preparations have not worked, you should visit a medical professional who can take a sample of your skin and send it to a laboratory for a diagnosis. Most of the time it is just athlete's foot and if it is not and it is something else, it can then be treated accordingly.

Severe cases of athlete's foot sometimes are resistant to the over-the-counter topical creams. In which case, an oral preparation may be better, but this should be discussed with your local medical professional.

MODERATOR:
What are some of the things we should do to avoid athlete's foot?

ZONG:
Athlete's foot is caused by a fungus. In fact, it is the same fungus that causes fungal nails. So if you have fungal nails, it is very likely that you will get athlete's foot. The reverse is also true. If you have athlete's foot, it's very likely you can infect your nails, as well.

Some of the things to avoid athlete's foot are the same as for avoiding fungal nails. That is to say, to keep your feet dry and clean, avoid walking around barefoot -- especially in communal areas, such as showers at the gym and other community type situations. If you have a cut or abrasion on the bottom of your feet, you should definitely not walk around barefoot, as this is often a way for the fungal spores to spread into the skin and cause an infection. This is where during the summer wearing sandals or flip-flops is more advisable than going barefoot.

"There are several types of procedures that are available today for correcting bunions."

MEMBER QUESTION:
I would like to know how I can relieve myself of foot pain caused by a big bump on the side of my foot by my big toe. My toes are curled also, causing me pain in certain shoes. I don't really like having to wear sneakers.

ZONG:
It sounds like you have a bunion and several hammer toes. Oftentimes, some arthritic changes can occur with these foot deformities. Even if there are not arthritic changes, it may be very painful to fit into "normal or stylish" shoes. With these foot deformities, in general, conservative treatment would include wearing proper shoe gear, that is to say, a wide toe box and avoiding pointy-toed shoes, but does not necessarily mean wearing ugly shoes.

However, as is the trend in many big cities, the trend is towards wearing "limo" shoes, which are shoes you wear to parties and functions, which only allow you to walk from the limo to the party. In those cases, one may opt for cosmetic foot surgery in which the bunion is shaved off and hammertoes are straightened and the foot is narrowed to allow you to fit into a normal and in more extreme cases, stylish pointy shoes. This, of course, is a personal decision and should be taken up with your local medical professional.

Quick GuideCommon Causes of Foot Pain

Common Causes of Foot Pain

MEMBER QUESTION:
But I want to wear pointy-toe shoes. How can we do this?

ZONG:
Of course, when it comes to fashion, everything is a personal decision. The decision for surgery is not one that you should take lightly; however, if you do want to have surgery, you should discuss this matter with your local medical professional.

MEMBER QUESTION:
I have a painful bump on the side of my big toe. I'm told it's a bunion. Is surgery going to keep me out of work a long time?

ZONG:
There are several types of procedures that are available today for correcting bunions. In the past, bunion surgery often required extensive time off, up to two months in fact. However, bunion surgery techniques have improved and generally most people are able to return to work within a few weeks after bunion surgery, some people in as little as one week, depending on patients' personal pain tolerance.

MEMBER QUESTION:
I had bunion surgery on my left big toe about 12 years ago and a pin was put in at this time. The result was great and I've had no problems until a few weeks ago. I've developed a painful swelling over the area of the surgery and was concerned that the pin might be causing it. Is this likely the cause? I've been scheduled to have the foot X-rayed. Do you often see problems with bones containing pins in the feet?

ZONG:
If you do have a pin in your big toe, it is possible that it may be the cause of the swelling. Sometimes, after years have gone by, implants such as pins or screws can come loose, or in the worst cases, become infected.

What you are doing is very good. An X-ray will help to see if it is, indeed, the pin that is causing the swelling.

MEMBER QUESTION:
My little toe is shaped so strangely, like it is flattened on its side instead of being shaped like my other toes (it almost seems like it has three sides instead of four sides). It has very little toenail too. What if anything can be done? Is there cosmetic surgery for feet?

ZONG:
There absolutely is cosmetic surgery for the feet. These days, many people, mostly women, do opt for some sort of toe procedure, such as reshaping of fifth toes, or pinky toes, toe shortening and toe lengthening, even. However, there is not too much that can be done about the toenail. But the toe definitely can be reshaped.

"Most patients who complain of plantar fascitis, experience the pain more acutely when they are wearing flats, so commonly we will advise our patients with plantar fascitis to wear a low-heeled shoe."

MEMBER QUESTION:
If the toe was the right shape, I wouldn't care so much about the nail. What is involved in changing the shape of the toe?

ZONG:
This is a hard question to answer without being able to see your toe. However, it would likely involve a plastic surgery type of skin procedure combined with minor bony procedures to realign and reshape the toe. In general, these types of procedures are done on an outpatient basis and are available across the country.

MODERATOR:
What is recovery time like for a procedure like this?

ZONG:
The recovery time for a toe procedure is relatively short. Most patients can return to a sneaker in approximately three to four weeks. And will be able to return to their shoes by the fifth or sixth week. Patients will be able to walk immediately following surgery, in the standard postop surgical shoe, until they are able to wear their sneakers.

MEMBER QUESTION:
Last summer I was having horrible foot pain that was diagnosed as plantar fascitis. My podiatrist had orthotics made for me, but they look unsightly in open summer shoes. Do you have any other suggestions for some arch support that I might be able to place in a slip-on type shoe for added support and to alleviate the pain?

ZONG:
Orthotics were not designed to be used in backless shoes or strappy sandal type shoes. For those type of shoes, they do make specialized Birkenstock type of sandals with orthotics built into the sandal, however not everybody has access to those.

Most patients who complain of plantar fascitis, experience the pain more acutely when they are wearing flats, so commonly we will advise our patients with plantar fascitis to wear a low-heeled shoe. The heel will take the pressure off the plantar fascitis and thus feels better.

There are other treatments for plantar fascitis, such as cortisone injections, and more aggressive therapies, such as shock-wave therapy, cryo surgery and traditional open surgeries. All of these options can be discussed with you by your local medical professional.

MODERATOR:
Let's talk about foot care on the beach. What should we be doing to take care of our feet on the beach?

ZONG:
One of the things people generally forget to do when they are at the beach is to apply sunscreen to their feet. Skin cancer such as melanoma can occur anywhere on the body, even on the feet. When it occurs in the feet, it generally has a worse prognosis, because it often goes undetected for a long period of time simply because people do not look at their feet. So when you're at the beach, be sure to apply sunscreen to your feet.

It would also be a very good time to examine your feet to see if there are any skin lesions or moles that are present. You should examine your feet for any skin lesions at least twice a year.

Also while you're at the beach, although it may be very tempting to go barefoot in the sand, there are things you'll want to avoid, such as sharp shells and other dangers to the feet. If you can, it is better to wear flip-flops or sandals rather than go barefoot. This is especially true if you're diabetic or have a neuropathy. If you have cuts or open sores on your feet, you should definitely avoid going barefoot or entering into the water for that matter as you can pick up a bad marine infection which can be difficult to treat.

"If your shoes aren't comfortable, they don't fit. When you purchase new shoes they should be comfortable the moment you put them on. There is no such thing as a break-in period."

Quick GuideCommon Causes of Foot Pain

Common Causes of Foot Pain

MEMBER QUESTION:
What kind of moisturizer do you suggest for feet?

ZONG:
In general, if you do not have terribly callused feet, any type of moisturizer will do. What tends to work better are the thicker preparations such as creams, which can be purchased at the local drugstore.

More problematic feet may require prescription medications from your foot doctor. However, the previous tip about using Vaseline under occlusion, that is to sleep with your socks on with the Vaseline, should work very well for most people.

MODERATOR:
People have care routines for their faces but forget to care for their feet. What are your top five recommendations for daily foot care?

ZONG:

  1. If your shoes aren't comfortable, they don't fit. When you purchase new shoes they should be comfortable the moment you put them on. There is no such thing as a break-in period.
  2. Keep your feet dry and clean. Things such as foot odor, fungal nails, or athlete's foot arise from having sweaty feet. The drier your feet the less you are at risk for these problems. And your partner will thank you, too.
  3. Cut your toenails straight across to avoid ingrown nails.
  4. Avoid going barefoot, as this often leads to most foot problems.
  5. Every once in awhile, treat yourself to a nice foot soak or pedicure.

MODERATOR:
Dr. Zong, we are almost out of time. Before we wrap things up for today, do you have any final comments for us?

ZONG:
I enjoyed answering your questions, and I hope everybody keeps their feet healthy.

MODERATOR:
Pretty feet are healthy feet.

MODERATOR:
Our thanks to Oliver Zong, DPM, for joining us today.



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Reviewed on 7/8/2005 2:04:39 PM

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