Corns

Q. What is a corn?

A. A corn is a localised pressure point that causes the underlying skin cells to die. As the body replaces the skin cells they gradually get compressed together making a nucleus of tightly compact skin, it is this that is responsible for causing the pain associated with corns. The nucleus usually has an overlying callous.

Q. What is the best way to treat them?

A. The best way is to have them treated professionally by a chiropodist. The overlying callous will be pared down with a scalpel exposing the nucleus beneath. By careful enucleation the nucleus can be successfully removed. As the chiropodist is removing dead skin tissue there is no, or very little discomfort to the patient.

Q. Can they return?

A. If the pressure that caused them in the first place is maintained, once the corns are removed the chances are that they will return. Corns and hard skin are symptoms of an underlying cause, the benefit of visiting a chiropodist is that they will try to establish what the cause is and take steps to correct it.

Q. Where can they appear?

A. Corns appear anywhere pressure may occur. The main areas are: the balls of the feet under the heads of the metatarsal bones; on the top surface of the toes where they rub against the shoes; the end of the toes for the same reason; in between the toes where a bone in one toe will gently rub against a bone in the adjoining toe. They can even occur under toe nails.

Q. Can they cause serious injury?

A. In order to avoid pain when walking people change their gait pattern to take the weight or pressure away from the corn. This action can produce secondary problems such as pain in the lower back, hips, knees, or lower legs. If ignored for a prolonged period corns can cause the underlying tissue to break down and an abscess will form. This will greatly increase the level of pain and discomfort, and increase the need to have it treated.

Verruca

Q. What is a verruca?

A. A verruca is a virus, the human papilloma virus, and the same virus that causes warts on the fingers. There are a few strains of the virus that cause different types of verruca. Verrucas are very vascular and they develop a layer of hard skin tissue over their surface. Sometimes the blood in the small capillaries caught up in the verruca stops flowing and congeals, this give the appearance of a dark coloured spot within the verruca.

Q. How are they transmitted?

A. They are transmitted by direct or indirect contact. All you need is a small micro scratch or breach in the skin’s surface and if it comes into contact with the virus it can take hold. Walking around bare-footed in a communal environment such as changing rooms or swimming pools are most associated with picking up the virus. It is also possible in hotel bathrooms, gyms, and even sharing a towel with an infected person.

Q. What treatments are available?

A. There are many treatments available and any good chiropodist will be able to offer many options. In theory the quickest, most convenient method is cryosurgery. This is where verrucas are frozen. I use nitrous oxide for this, as the depth of freeze is less severe than liquid nitrogen. Once frozen the patient can forget about the verruca until the next visit. They can swim without fear of passing it on to anyone else.

For those where cryosurgery is not suited topical treatments containing salicylic acid can be used. There are many varieties available to choose from. I use a machine called a Bio-gun that direct a stream of negatively charged ions at the verruca and as they pass through they help to kill off the virus, this is used in conjunction with a topical treatment.

There are homeopathic remedies available such as Teatree oil, Marigold tincture, and Thuja. All treatments are best administered on the advice of the chiropodist.

Q. Will they disappear without treatment?

A. They can disappear on their own without treatment, although they can last for many years. In the meantime they can get bigger, spread across the foot, and other people can become infected

Q. Can I treat verruca myself?

A. You can buy over the counter treatments such as gels and paints containing salicylic acid that you can apply yourself. The important thing to remember is to remove as much hard skin as you can before applying the topical treatment, by using an emery board. This treatment must be carried out daily for it to be successful. Please remember there is no guarantee that any verruca treatment will work. It depends on the type of the verruca and on the general health of the person who has it.

Fungus

Q. How many fungal infections are there?

A. The two main fungal infections are Athletes foot, and fungal infections of the nail. Each type is broken down into smaller categories but the treatments will be the same. Athlete’s foot affects the skin between the toes, sometimes spreading onto the upper surface and the underside of the foot.

Q. How are the caught?

A. The fungal spores are mostly air-born, so any communal area can be source of infection.

Q. What are the best treatments?

A. A chiropodist can give good advice on treatments available. Athlete’s foot is easy to treat with many over the counter creams, lotions, or sprays all being successful. However, it is very easy to re-infect yourself by wearing contaminated shoes. Regularly spray the inside of your shoes with an anti-fungal spray to help kill any spores hiding in the toe area.

Toe nails are a different matter as the nail protects the fungus. A visit to the chiropodist is the best course of action to receive professional treatment.

Q. What are the symptoms?

A. With Athletes foot itching is common with the skin breaking down, macerating, so that it can become quite sore and open.

Nail infections cause the nail to appear yellow, becoming hard and brittle. Thickening of the nail is also common.

Q. My nails are thick; does this mean a fungal infection?

A. Thickened nails do not necessarily mean a fungal infection. Although it can make nails grow thicker. Traumas such as dropping a heavy weight onto the nails, or someone treading on them can cause the growth patterns of the nails to change making them grow thicker. Usually these changes in grows patterns are irreversible.

Poor circulation, particularly in the elderly, can cause nails to thicken as well. Skin complaints such as eczema can affect nail growth, but when the eczema is controlled the nail can grow normally again.

Perspiration

Q. My feet are quite sweaty, what can I do?

A. Excessive perspiration can be a problem. The skin between the toes can become broken, blisters may occur more frequently, and they are more prone to pick up fungal infections. Washing them regularly is essential, and wiping them over with surgical spirit is very good in controlling perspiration. It will also help stop blisters occurring. This will need to be done daily. Also it help to let your feet breath, when you can, take your shoes off and wear open sandals.

Q. My feet smell, does it mean they are dirty?

A. Smelly feet do not mean dirty feet. The odour comes from decomposition of keratin, a substance found in the skin, due to excessive perspiration. It gives the skin between the toes and the balls of the feet a worm-eaten pitted effect. Fungal development will worsen the situation. Regular washing, wiping with surgical spirit, using anti-fungal talcum powder, and letting the feet breath are all good methods of bringing the situation under control.

Q. My skin gets so dry it cracks, particularly at the heel, why is this?

A. One of the characteristics of skin is elasticity, it is able to stretch and return to normal. When the skin gets excessively dry or thick it loses its elasticity but it still needs it stretch, particularly when the heel hits the ground during walking, so it just cracks. This can become very painful. There are two things you can do to help. Firstly, regularly use a foot file to remove surface dry, dead skin cells. Do this when the feet are dry and not wet. Having done this then bath or shower, dry thoroughly, and apply a good penetrating cream. I use a cream that contains 25% urea, a substance that helps the skin retain moisture thereby reintroducing elasticity back to the skin. This will need to become part of your normal routine.

Drink lots of water daily and take oil supplements such as cod liver oil capsules to help rejuvenate the skin.

Why are my feet developing bunions?

A. Bunions are usually hereditary and related to posture. There are certain predisposing factors that bring on the development of bunions. Even if you wear flat shoes all the time if you have any of these factors then bunions will gradually appear. High heels and pointed toes will speed up the process. If you are concerned that you may be developing bunions then visit a chiropodist. In my case I will give you a full biomechanical assessment to establish exactly which factors are causing them and prescribed a pair of orthotics. Orthotics are in-soles made specifically for individuals from casts taken of the feet. They help realign the posture and compensate for the factors causing the bunions, dramatically slowing down, or stopping their development further.

Q. Why do diabetics need to take special care of their feet?

A. Diabetes, whether insulin-dependent or non-insulin-dependent, is a disease that has a nasty effect on many parts of the body and in particular the feet. The three main factors that cause concern are; the blood supply to the feet is reduced because of disease in the arteries and smaller blood vessels making them thinner. The sense of feeling is reduced or disappears completely because of peripheral neuropathy. The immune response system is greatly reduced thereby the patient is not able to fight off infection.

It is possible for diabetics to walk around with splinters, thorns, or drawing pins in their feet and not know they are there. Therefore the resulting infection will be very difficult to treat because the body is not able to help itself due to diminished blood supply and immune system. The result very often is a diabetic ulcer, leading to gangrene and amputation. By being careful and having regular trips to the chiropodist and the doctors the condition can be successfully controlled without the need for such severe conclusions

Any diabetic should never in any circumstance walk around barefooted, and they should also visit the chiropodist regularly to have their toe nails cut and have their feet checked over properly.

If you have any questions you would like to ask, e-mail me and I will do my best to answer quickly.