The Scotsman

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

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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

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.”

Verrucas

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.
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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