Take steps now if you want fab­u­lous feet

From ath­lete’s foot to corns and fun­gal nails, Liz Con­nor finds out how spe­cial­ist treat­ment could fix those trou­ble­some toot­sies once and for all

The Scotsman - - TRAVEL & OUTDOORS -

Sum­mer is on the way – but this might not be great news if you live in dread at the thought of hav­ing to get your feet out. How­ever, whether your feet just need a bit of TLC and pam­per­ing, or a stub­born foot con­di­tion is caus­ing bother, there’s no need to suf­fer in si­lence. Foot con­di­tions might be em­bar­rass­ing, but they are gen­er­ally very com­mon and treat­ments are avail­able.

Some­times, this might mean tap­ping up a spe­cial­ist for some ex­pert ad­vice, to sort those toot­sie trou­bles once and for all.

Here, lead­ing po­di­a­trist Tony Gavin, founder of Osgo ( osgo. co. uk), talks us through some of the com­mon foot is­sues he reg­u­larly treats.


Bu­nions are one of the most com­mon fore­foot de­for­mi­ties – even celebri­ties, such as Victoria Beck­ham, get them – and they can be very painful. Gavin ex­plains: “A bunion, or hal­lux val­gus, is a change to the bone struc­ture at the base of the big toe. It’s an en­large­ment of the joint and a change in di­rec­tion of where the big toe ‘ points’, to­wards the sec­ond toe.” This leads to an in­crease in the size of the joint, and of­ten the for­ma­tion of an over­ly­ing ‘ bursa’ ( a fluid- filled sac be­tween the joint and the skin), which may be red and swollen. “It’s ba­si­cally the body’s way of pro­tect­ing the joint,” notes Gavin.

“Man­ag­ing any pain is a key part of a po­di­a­trist’s role when treat­ing bu­nions. The first port of call is to en­sure that there is ad­e­quate room in any footwear. In some cir­cum­stances foot or­thotics ( tai­lor- made in­soles, pad­ding and arch sup­ports) can help.” How­ever, in many cases, surgery to cor­rect the bunion might be needed. If bu­nions are caus­ing you prob­lems, see a po­di­a­trist to dis­cuss re­fer­rals.

Fun­gal nail in­fec­tions

Crusty, thick­ened yel­low toe­nails are a tell­tale sign of a fun­gal nail in­fec­tion – and it’s im­por­tant to get them checked out and treated quickly, as the in­fec­tion can spread and be no­to­ri­ously stub­born. “Fun­gal nails cause dra­matic vis­ual changes, which can be un­sightly,” says Gavin.

“They can make the nail change colour, thicken, and break more eas­ily.”

They can also cause more pres­sure on the end of the toe and be­come painful. “As the fun­gal in­fec­tion pro­gresses, they can pro­duce a very dis­tinct odour too,” adds Gavin.

The good news is, fun­gal nail in­fec­tions are treat­able – al­though more se­vere in­fec­tions may take a while to dis­ap­pear com­pletely. “There are a va­ri­ety of treat­ments, but suc­cess de­pends upon an ap­pro­pri­ate plan. Med­i­ca­tion needs to act on the af­fected ar­eas, which can be dif­fi­cult with top­i­cal prepa­ra­tions. A po­di­a­trist may thin down a fun­gal nail or in­tro­duce very small holes into the nail and ap­ply an anti- fun­gal med­i­ca­tion,” says Gavin.

Corns and cal­luses

“Per­haps the most com­mon rea­son that peo­ple seek treat­ment from a po­di­a­trist is to deal with cal­luses or corns, as they can be very painful and make walk­ing dif­fi­cult,” says Gavin. Pres­sure plays a big part in the for­ma­tion of cal­luses and corns, which of­ten look like very hard, raised ar­eas of skin. “In­ter­mit­tent com­pres­sive forces [ from walk­ing] cause a re­sponse from the skin to pro­duce cal­losi­ties,” Gavin ex­plains. This layer can at first be pro­tec­tive, but they can quickly be­come painful.

A corn, mean­while, is a small, usu­ally con­i­cal struc­ture that forms from pres­sure. “It’s formed within the skin, is very hard and can cause a lot of pain,” says Gavin. “Com­mon lo­ca­tions for corns are the tops of toes, or un­der­neath the metatarsal heads on the plan­tar as­pect of the foot [ near the ball of your foot]. A po­di­a­trist can re­move a corn in a pain­less pro­ce­dure, and of­ten pre­vent them re­turn­ing by us­ing or­thotics or ad­vis­ing footwear changes.”

Ath­lete’s foot

Itchy, sore and easy to catch, Ath­lete’s foot is rel­a­tively com­mon. “It’s a fun­gal in­fec­tion of the skin, usu­ally seen be­tween the toes or on the sole of the foot,” says Gavin. “Ath­lete’s foot can be very un­com­fort­able at its worst, or mildly itchy at its least se­vere. It of­ten causes skin to flake, peel or even split too.

“Scratch­ing the skin in­creases the like­li­hood of the skin split­ting, which in turn can lead to a sec­ondary in­fec­tion. Split skin can also be very painful to walk on.”

Gavin says the in­fec­tion is caused by der­mato­phytes – fungi that thrive in the con­di­tions we place our feet in ev­ery day: “The en­vi­ron­ment in­side of shoes is dark, warm and moist, which just so hap­pens to be the per­fect place for a fun­gal in­fec­tion to thrive.”

Luck­ily, treat­ment is usu­ally quite ef­fec­tive.” Top­i­cal prepa­ra­tions [ creams] are usu­ally very suc­cess­ful un­der the ad­vice of a po­di­a­trist,” says Gavin. “En­sur­ing your socks and shoes are changed fre­quently can also re­duce the risk of the in­fec­tion re­turn­ing.”


Ver­ru­cae, or ver­ru­cas, are a com­mon com­plaint among chil­dren and adults alike. “A ver­ruca is a small, be­nign, skin le­sion – ap­prox­i­mately 1cm in di­am­e­ter – com­monly found on the bot­tom of the foot.” Over- the- counter treat­ments some­times work, but

“The most com­mon rea­son peo­ple seek treat­ment is to deal with cal­luses or corns, as they can be very painful”

due to the na­ture of the virus, some out­breaks can be very stub­born. If this is the case, a po­di­a­trist may of­fer ad­di­tional treat­ments to help get them un­der con­trol.

Foot odour

“Foot odour is of­ten linked to ex­ces­sive sweat­ing ( hy­per­hidro­sis), which cre­ates an en­vi­ron­ment where bac­te­ria can thrive. There can be a num­ber of causes for sweat­ing, which may be re­lated to ma­te­ri­als in hosiery or shoes, ac­tiv­i­ties, or even a sys­temic cause,” says Gavin.

If over­pow­er­ing foot odour is be­com­ing a prob­lem, a po­di­a­trist can ad­vise on the best course of ac­tion. This may in­clude anti- bac­te­rial med­i­ca­tion, a sim­ple change in sock ma­te­ri­als and, in some cases, footwear changes or or­thotics.

What next?

Feet can of­ten be a source of em­bar­rass­ment, but if you’re suf­fer­ing with any of the above is­sues, you don’t have to re­sign your­self to a sum­mer stuck in train­ers or closed- toe shoes. Con­tact your GP to see if you qual­ify for NHS po­di­a­try treat­ment, or search online for a lo­cal pri­vate prac­tice. A qual­i­fied po­di­a­trist should be reg­is­tered with the Health and Care Pro­fes­sions Coun­cil ( hcpc- uk. org). n

Pho­to­graphs: PA

Bu­nions, fun­gal in­fec­tions and cal­luses can be painful and un­sightly, but a po­di­a­trist can help get your feet back in shape in time for the sum­mer and walk­ing bare­foot on the beach.

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