Dr Sarah Jarvis Get your legs ready for summer
My Weekly’s favourite GP from TV and radio writes for you
We’re all thinking of shedding winter woollies (at last!) and letting our legs show. But at least in the winter we can forget about varicose veins or crusty nails. So are there steps you can take to get your legs in tip-top shape for summer?
Around this time of year I get an influx of patients – usually but not always women – asking for advice on their varicose veins. It’s hardly surprising, given how obvious these protrusions on your lower legs and sometimes thighs can be.
They happen due to weakening in the valves inside the veins which carry blood back from your legs to your heart. The valves should be one-way. If they leak, blood can flow backwards, putting further pressure on lower valves.
Varicose veins get more common with age. Being overweight is a risk factor for women but not for men (life isn’t fair!). Standing for long periods may make you more prone to them. They can lead to aching and swollen ankles towards the end of the day. Losing weight, keeping active (so the blood pumps more effectively back from your legs) and lying down with your feet above the level of your heart can help with aching and may make them less prominent. If they’re causing significant symptoms, you may be eligible for NHS surgery. Dry skin on the legs is very common. Use a moisturiser 2-3 times a day to replace lost moisture and avoid losing more. For sensitive skin, go for an unscented version. A little-known, distressing condition called lipoedema leads to deposits of fat in your
VARICOSE ECZEMA LEADS TO THICKENED, SCALY, DRY SKIN AROUND YOUR ANKLES. USE REGULAR MOISTURISERS AND SEE YOUR GP IF THE SKIN BREAKS DOWN
legs. The fat is dimpled, like cellulite, but losing weight doesn’t shift it. In fact, women (it almost exclusively affects us) with lipoedema usually look as if their legs are out of proportion to their bodies. It doesn’t affect feet so you may look as if you have a bracelet tight around your ankles.
Lipoedema often runs in families and tends to start at times of hormonal change such as puberty, pregnancy or sometimes menopause.
Losing weight doesn’t help and neither do water tablets, but regular exercise does. So does massage to help drain lymph – the fluid that runs through your lymphatic system, connected to your lymph nodes. In severe cases, liposuction may be advised, and is occasionally available on the NHS for lipoedema.
There’s lots you can do to improve the appearance of your feet. Thickened, crumbly, discoloured toenails are very common, and usually caused by a fungal infection. This often starts in one toe and gradually spreads: while it doesn’t usually cause pain, it’s not pretty. Your doctor can take a nail clipping to check the cause, and offer treatment (tablets or nail lacquer) if a fungus is isolated. Fungal infections love anywhere warm and moist, so avoiding sweaty feet is key. Change shoes regularly; keep your feet open to the air as much as possible; wear breathable cotton socks; and dry feet really thoroughly with a separate towel before putting on tights or socks.
Athlete’s foot, also caused by fungus, leads to itching, flaky skin and cracking between toes. It can usually be treated with anti-fungal cream from your pharmacist. Follow the same steps as for fungal nail infections, and use talc (or medicated anti-fungal powder from your pharmacist) liberally to absorb sweat. Next week: Is plant-based eating good for you?
IF YOU’RE HEADING SOMEWHERE SUNNY, PAY PARTICULAR ATTENTION TO BACKS OF KNEES AND OUTER HIPS WHEN APPLYING SUNSCREEN