Self-Treatment of Minor Foot Problems

Authors and Disclosures

W. Steven Pray, Ph.D., R.Ph., Professor of Nonprescription, Products and Devices,, School of Pharmacy,, Southwestern Oklahoma State University,, Weatherford, OK

Sidebar: Odorous Feet: Pitted Keratolysis?

The pharmacist is occasionally approached by patients who complain of unacceptable foot odor. If the patient is someone (e.g., a member of the military on active duty) whose feet are frequently subjected to moisture, and the foot has a rash with an unusually foul odor, the problem may be pittedkeratolysis.^[6] In this condition, the bacterium Corynebacterium flourishes in warm, wet boots, causing a rash, usually on the weight-bearing foot surfaces. Lesions are white, wet plaques with a scalloped border, with pitting of the associated stratum corneum. This malodorous condition may persist for decades. The condition is not self-treatable. In one case, twice-daily topical clotrimazole cream and clindamycin solution and a nightly application of ammonium chloride cleared up a ten-year infection.^[6]

Sidebar: Patient Information: Caring for Your Feet

Your feet are marvels of engineering, capable of bearing many tons of weight throughout the day. Most of the time, they do so without much difficulty. However, there are several things you should know about shoes to help keep your feet problem-free.

Shoes serve several purposes. They shield your feet from heat and cold, prevent you from stepping on dangerous objects such as splinters and nails, support the bones and ligaments of the foot, and cushion your feet when you walk. Therefore, shoes should contribute to your comfort and protect your feet. They should not cause injury.

Shoe problems begin with the choice of a particular shoe, which is too often dictated by fashion rather than comfort and ease. The shape of the foot is essentially a rectangle. Many women, however, choose short, narrow shoes that are more of a triangle in shape, with a sharply pointed toe box (the space into which the toes must fit). These kinds of shoes usually elevate the heel of the foot from two to five inches, which adds to the problem. With each step the toes are forced with more pressure into a small area, which places them in an unnatural position. Over time, the toes may become permanently deformed.

Another mistake people make when purchasing shoes is failing to take into account the fact that feet vary in size during the day. By the afternoon, for instance, your feet will have gained some fluid in them due to the force of gravity. It is best to buy shoes in the late afternoon or at night, when the swelling is at its maximum point. By doing this, you run the risk of the shoes being looser during the day, but that is preferable to the more serious problem of having them fit too tightly. Select shoes that are light, since heavier shoes cause more stress for the legs and feet. Leather is the best choice, since it is porous, unlike most synthetic materials. Allow for the fact that thicker socks are worn when it is cold.

Running or sports shoes should share several characteristics. Studs on the soles help distribute the shock of the foot hitting the ground. The heel should be raised through the use of a triangular cushion beneath it, known as the heel wedge. This wedge should be resilient, to provide a "spring" during sports activity. The middle of the shoe (midsole) should be flexible so the Achilles tendon does not bear undue stress. This molded pad at the back of the shoe is important for preventing irritation of the Achilles tendon at the back of the foot.

Problems of the foot range from serious conditions that a physician or podiatrist should examine, such as ankle sprains and toe fractures, to minor and self-treatable problems, such as blisters, corns and calluses.

Your pharmacist has numerous products for minor foot problems. If you have a question about the severity of a foot problem and whether a visit to a podiatrist or a physician is necessary, Consult Your Pharmacist.