Feet are one of the most hardworking parts of the body, but they often get overlooked and neglected. Pharmacy can help customers keep their feet healthy and pain-free this summer

According to the College of Podiatry, the average person will walk in excess of 150,000 miles in their lifetime – that’s the equivalent of six times around the world – so it’s unsurprising that foot ailments are rife. Some 90 per cent of people in the UK experience some sort of foot problem and as many as 20 per cent suffer from foot pain often or constantly. Despite this, only 30 per cent of people have ever sought professional help, highlighting the potential for pharmacy to step in.

Understanding the problem

So why do people neglect their feet so much? Dr Tariq Khan, consultant podiatrist and director of the Marigold Clinic, puts it down to the simple fact that “feet are at the other end of the body and are masked by shoes. Your hands and face are on show and so you do something about those, but your feet are basically out of sight, out of mind.” While this is certainly a factor, Matthew Fitzpatrick, consultant podiatrist for The College of Podiatry, thinks there’s more to it. He says that it’s not necessarily a conscious decision to ignore them, but rather that people have the mentality that foot problems will heal and they’ll just get over it. In fact, this isn’t the case, as Matthew explains: “The thing with even minor foot problems is that you change the way you walk and that leads to back and neck problems.” 

It’s this connection with general health that makes foot care so important, as not only can foot problems cause pain in other parts of the body, they can also be linked with cardiovascular health, arthritis and diabetes. “In terms of our cardiovascular health in particular, what people want to do is get out and do things,” says Matthew. “We’re told that we should do half an hour of physical activity to increase our heart rate every day and our feet are the starter position for us to do those things.”

As well as potentially leading to more serious issues, foot problems can also impact on quality of life. “It obviously depends on the foot condition. So if it’s bunions or plantar fasciitis, people will be limited in the distance they can walk and limited in the exercise they can take part in due to the pain the conditions cause,” says Dr Khan. “With corns, it can affect the positioning of the foot when walking and cause parts of the feet to be painful. Athlete’s foot causes a burning, stinging and throbbing sensation and so there will be discomfort when sleeping as well as walking.” 

The focus of foot care should therefore be to keep people as comfortable and mobile as possible. This is particularly important in later life when a lack of mobility can lead to wider problems like social isolation.

Summertime, and the livin’ isn’t so easy

Foot problems are prevalent year round, however the summer really puts feet through their paces, as people swap enclosed shoes for unsupportive, slip-on alternatives and strappy, open-toed sandals. This exposure means feet tend to be a lot drier and “you’ll also see a lot more blisters, verrucas, athlete’s foot and the big umbrella term plantar fasciitis which is heel, arch and metatarsal pain,” says Dr Khan.

Many people also become more concerned about the general appearance of their feet when they’re on show in summer and so are perhaps more likely to seek help to banish any unsightly ailments. Yet good news is at hand, as many problems can be tackled with OTC products and self care advice from the pharmacy.

Blisters

Blisters are small pockets of fluid that form in the upper layers of skin after it has been damaged in order to protect the tissue underneath and allow healing. They are usually caused by friction from ill-fitting shoes and occur more often in hot weather. It is important that the skin remains intact to avoid infection. Most blisters will heal naturally and won’t require medical attention, but applying a protective gel dressing can provide instant relief and prevent further damage.

Corns and calluses

Corns and calluses are areas of hard, thickened skin that develop as a result of excessive pressure or friction on the foot, usually from ill-fitting shoes. Corns appear over bony areas such as joints, while calluses are larger and usually occur on the soles of the feet. Using a pumice stone or foot file regularly will gently remove hard skin and prevent it from building up. Many treatments, including corn plasters, contain salicylic acid, which works by removing the layers of hard skin. These should be used with care as they can burn the healthy surrounding skin too. Corns and calluses won’t heal unless the cause is avoided. If corns don’t improve after three weeks of treatment then referral to a podiatrist may be necessary.

Cracked heels

When heels become dry or experience excessive pressure, the skin becomes thickened, hard and less flexible. When walking, especially in open-backed shoes like sandals and flip flops, pressure is put onto the heel, causing the skin to spread out. If the skin is too inflexible it will crack, causing significant pain. In severe cases, the cracks may bleed and can become inflamed or infected. Cracked heels should be moisturised regularly and a pumice stone or non-metal file used in the bath or shower to remove the affected skin. Severe cases can require strapping of the cracks by a podiatrist in order to allow the feet to heal.

Plantar fasciitis

This is the most common type of heel pain. The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot and acts as a shock absorber. It can become damaged and thicken as a result of unsupportive shoes or physical activity such as running or dancing, and this leads to pain known as plantar fasciitis. A combination of rest, stretches and painkillers can be suggested to treat the problem and avoiding flat shoes can also help. Referral to a podiatrist may be necessary for persistent pain.

Foot odour

Feet have 250,000 sweat glands so they tend to sweat more than other parts of the body. Anyone can get sweaty feet, but teenagers and pregnant women are especially prone because hormonal changes increase perspiration. Sweat itself is odourless, but it’s the bacteria that grows in damp, warm conditions that smells, so alternating shoes daily and giving each pair time to dry out helps to prevent odour developing. Everyone should wash and dry their feet thoroughly and change their socks every day.

Athlete’s foot

Athlete’s foot is a contagious condition caused by a fungus called Tinea pedis. It flourishes in the warm, moist environment between the toes and is often picked up from damp changing rooms and swimming pool floors. The affected skin may be red and itchy at first, later becoming white, inflamed and weepy and may also crack and peel. Antifungal creams, sprays, liquids and powders can be used to prevent the fungus from growing and should continue to be used even after symptoms have cleared. Hygiene also needs to be a focus, including washing and drying feet thoroughly and ensuring shoes are clean, dry and aired out.

Verrucas

Verrucas (plantar warts) are flattened, discrete lesions that commonly occur on the heel, ball of te foot or around the toes and are caused by the human papilloma virus. They can develop singly or in clusters and often have a small black spot visible. Verruca treatments containing salicylic acid – including creams, gels, paints and medicated plasters – are available OTC and take up to 12 weeks to work. ‘Freeze’ treatments are also available which treat the verruca in one application – it will usually clear up within 10 to 14 days.

Save our soles

Many foot problems can be prevented or minimised by wearing properly fitting shoes. Dr Khan explains that while there is no such thing as a perfect shoe, there are certain things to look out for. “A one and a half inch heel is optimal. If you were walking barefoot on soft ground then the foot would adapt to the ground, but a flat shoe can’t adapt and it forces the foot into one position. That one and a half inches won’t overstretch the Achilles tendon and will give the right momentum to push off and walk comfortably,” he says. “Shoes should ideally be buckled or laced to hold the foot in the shoe and prevent impact. The toe box should be sufficiently wide and a good enough depth, and the foot shouldn’t touch the front, back or sides of the shoe – this will prevent bunions, ingrown toenails and corns.”

Foot fixes

With so many foot problems causing pain and discomfort, prevention is certainly better than cure and Dr Khan suggests the following daily routine to put people on the right track:

• General hygiene – take a shower or a bath in the morning and dry thoroughly in between the toes, before moisturising
• Alternate footwear
• Soak feet in warm, salt water in the evenings. Not only will this help to clean the feet, it’s also anti-inflammatory and will cool and soothe them. Then moisturise again to improve the barrier of the skin. Feet need twice daily moisturising, just the same as face and hands
• Look out for changes in tone or structure of the skin and nails, and unusual aches or pains that last longer than a week. Dr Khan says that by following this routine and wearing correctly fitting shoes, “foot health should improve 50 to 60 per cent within one month.”

If problems do develop then early recognition as well as early intervention is crucial, says Matthew. This includes understanding what can be done at home and through the pharmacy with OTC products. “The earlier you catch it, the easier it is to fix. Respite, compression, elevation – the things that we’re taught for other foot and ankle problems can help. And if it starts to hurt, go and see a podiatrist. If you get toothache you go to the dentist so why not go to the podiatrist when your feet hurt?”

The thing with even minor foot problems is that you change the way you walk and that leads to back and neck problems