How can we help?

HOW CAN WE HELP?

Did you know that a quarter of all our bones are found in our feet?

Each foot contains 26 bones, 33 joints and a network of over 100 muscles, tendons and ligaments.

Our feet have about 250,000 sweat glands which produce up to half a pint of perspiration each day. There are approximately 8,000 nerves in the feet—that's more per square cm than any place else on our body.

Maintaining our foot health is important for all of us. Feet are our body's foundation, so keeping them healthy is vital. Years of wear and tear can be hard on our feet with guestimates suggesting that the average adult walks at least 75,000 miles in their lifetime!

Overuse, shoes that don't fit properly and even genetics can lead to injuries and disorders of the foot which can really affect our mobility and wellbeing.

We help people of all ages and abilities to look after their feet and successfully treat a wide range of conditions

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We help patients with a wide range of problems including;

Thick and discoloured nails

Corns

A corn is a painful area of thickened skin which often develops where there has been increased pressure. It is different to callus in that the area of hard skin is more concentrated and forms deeper into the skin, which makes it more painful.

Corns can be anywhere on the foot, but often are located on the sole or on/ or between the toes, or even on the tops of toes. They are best described as a small area of thickened skin which may be tender to touch.

What causes a corn?

A corn can develop when an area is put under too much pressure, and the body produces an area of thickened skin to protect the area. As this thickened skin continues to accumulate, the area often becomes painful. Common causes of corns include;

wearing high heels, ill-fitting shoes or shoes that are the wrong size
not wearing socks with shoes
Foot and biomechanical abnormalities
Excessive activity such as running or walking

How can we help?

If you have diabetes, heart disease or problems with your circulation, do not try to treat corns yourself, as these conditions can make foot problems more serious.

Treatment of a corn begins with an assessment to determine the underlying cause. This allows us to decide the most suitable treatment plan for you. The overlying hard skin is removed, and the corn is then enucleated (cut out) by using a scalpel. For most people this procedure is painless, but some severe corns may be uncomfortable to remove, in both cases it is not uncommon for there to be some bleeding.

As corns are usually caused by foot structure and footwear, there is a risk of recurrence and how quickly the corn may return depends on a variety of factors, which we will discuss. Including what action you can take to reduce the risk;

Footwear advice
Using different padding techniques to reduce pressure
Attending podiatry appointments to prevent the corn building up to a painful level

Callus

Calluses are larger patches of rough, thick skin, most often found on the sole and heel of the foot or the sides and surface of the toes. If left untreated, they can cause discomfort. Callus build up can be particularly dangerous in patients with poor circulation or diabetic neuropathy, as the combination of excessive pressures and lack of sensation can lead to the formation of ulcers, which if left untreated can cause infection.

What causes callus?

Callus is usually caused by an underlying problem such as a bony deformity, a particular style of walking or more often inappropriate or poorly fitting footwear. Some people have a natural tendency to form callus because of their skin type. Older people have less fatty tissue in their skin and this can lead to callus forming on the ball of the foot.

How can we help?

Callus treatment involves the removal of the thickened areas of skin using a scalpel blade

The aim of callus treatment is to remove the excessive pressure that is causing its build-up, reduce any discomfort and improve both the appearance and function of the skin.

As part of the treatment, we will assess and determine the cause of the callus and as such offer advice regarding

Footwear
Padding techniques to reduce or redistribute pressures. Older people can benefit from padding to the ball of the foot, to compensate for any loss of natural padding.
Emollient creams that can help delay callus building up and help improve the skin’s natural elasticity.
Orthotic intervention to relieve any excessive pressures
Attending podiatry appointments to prevent the callus building up to a painful level

Cracked heels

Cracked heels can develop when the area of skin around the heel becomes excessively dry and begins to crack or when the area is too soft and wet, making it more susceptible to splitting. When the condition of the skin around the heel is abnormally dry or wet and the area is put under pressure from the weight of the body, the skin cannot stretch and spread to accommodate the increased pressure as it normally would and so it begins to split.

Cracked heels can be an issue for patients as they are often painful and unsightly, however split heels can be a more serious issue as provide a means for infection.

What are the causes of cracked heels?

The following are some of the more common causes of cracked heels;

Wearing inappropriate footwear such as open back shoes
Standing for long periods
Autonomic neuropathy
Certain medical conditions such as diabetes
Being overweight

How can we help?

Typically, we help our patients by undertaking a combination of the following;

Debriding (removing) the hard skin around the heels with a scalpel
Reducing the hard skin using a foot file
Advising patients on home emollient use, footcare and footwear

Foot Centre patient before treatment

Foot Centre patient after treatment

Chilblains

Chilblains (also called pernio) are small itchy, red (and sometimes purple) swellings on the skin, which can become increasingly painful, swell and dry out leaving cracks in the skin that expose the foot to the risk of infection. They occur on the toes (particularly the smaller ones), fingers, the face (especially the nose) and the lobes of the ears. They can also occur on areas of the feet exposed to pressure, for instance on a bunion or where the second toe is squeezed by tight shoes. They can also lead to blisters and break down to become a small ulcer prone to infection.

Who is most susceptible to developing chilblains?

Chilblains are caused by the skin's abnormal reaction to cold. They develop when the tiny blood vessels under the skin constrict under cold conditions reducing the flow of blood until the area warms up again and causes some leakage of fluid into the surrounding tissue. Not everyone develops them - it depends to a large extent on the efficiency of your circulation. People with poor circulation and other health problems involving their blood vessels are likely to be more prone to developing chilblains. In addition, damp or draughty conditions, dietary factors and hormonal imbalance can also be contributory factors. It is thought that rapid temperature changes from cold to hot can also be a cause: if the skin is chilled and is then followed by too rapid warming next to a fire or through using a hot water bottle, chilblains may result.

How can we help?

We can help by assessing the skin in the affected area looking for cracks or signs of infection. If appropriate, reducing any overlying callus or if the skin has broken or is ulcerated treating the area and applying a dressing

We will advise you as to how to prevent chilblains from recurring and also information as to home management

Athletes Foot

Athlete’s foot is a fungal infection of the skin that can lead to intense itching, cracked, blistered or peeling areas of skin, redness and scaling. It can occur on moist, waterlogged skin, usually between the fourth and fifth toes initially, or on dry, flaky skin around the heels or elsewhere on the foot. Large painful fissures can also develop and the condition can also spread along all five toes and sometimes to the soles of the feet if left untreated.

What causes it?

It is caused by a number of fungal species that you can pick up from someone else shedding infected skin, typically in communal areas such as pools, showers and changing rooms, or anywhere that you walk around barefoot. Athlete’s foot can also be passed on directly by person-to-person contact, although people who sweat more are more prone to infection.

Once your feet have been contaminated, the warm, dark and sweaty environment of feet in shoes or trainers provides the ideal breeding ground for the fungus. However, athlete’s foot also occurs in dry, flaky areas. It’s quite common in summer with sandal wearers. The sun makes your skin dry out so it loses its natural protective oils. This combined with the constant trauma from sandals makes your feet more prone to infection.

How can we help?

If left untreated, the fungus can spread to the toe nails, causing thickening and yellowing of the nail, which is much harder to treat. Fungal infections are highly contagious and can spread to anywhere on your skin, including your scalp, hands and even your groin. This is especially likely if you use the same towel for your feet as for the rest of your body.

Athlete’s foot is usually treatable at home, but we can help you by advising the best treatment for your particular type of athlete’s foot. And also (if the fungal infection has spread to your nails) by reducing the thickness and cutting back the nails thereby exposing the infected nail bed to a lighter, cooler environment.

Thick Nails

Thick toenails are a common complaint in podiatry in which thickening of the nail plate can cause discomfort, difficulty finding proper fitting footwear and in some cases ulceration under the nail plate.

What causes thick nails?

A nail can become thickened for many different reasons, including;

Following an injury such as 'stubbing' it against something or dropping something on it
Fungal nail infection
Inappropriate or poorly fitting footwear
Certain medical conditions or poor circulation
Treatments such as chemotherapy
Ageing

How can we help?

Thickened nails can cause pain and discomfort and are extremely difficult to self-treat. We can help by determining the cause of the thickening in order to aid prevention and/or future management, and also by undertaking a careful trimming and filing down of the nail.

Verrucae

A verruca is a wart on the foot (usually on the sole of the feet or around the toe area) which is caused by a virus.

Verruca on the feet appear flattened in shape when compared to other warts; this is because of the pressure caused by standing and walking. A common misconception is that verruca have roots; Verrucae do not have roots, instead what 'appears' to be the root is actually a cluster of tiny blood vessels.

Podiatrists diagnose a verruca based on the signs and symptoms and an examination of the affected area. It is important that people visit a podiatrist as a verruca can mimic other conditions.

The signs and symptoms of verruca may include:

Feeling like you are walking on a pebble
Area of roughened skin (the skin may be spongy or scaly and may appear brown or grey)
Tiny black dots may be visible; these are in fact blood vessels.
A verruca may appear alone or in a cluster.

What causes verrucae?

They are caused by the Human Papilloma Virus (HPV), which is contagious through direct person-to-person contact. There are various forms of HPV, which all relate to various parts of the human body but the HPV virus is thought to thrive in moist, damp environments such as swimming pools, changing room floors and communal shower areas. It is possible to contract verrucae simply by walking across the same floor area as someone with a verruca, especially if you have any small or invisible cuts or abrasions that make it easier for the virus to penetrate.

Who gets a verruca?

Verrucae are common because anybody can catch a verruca; however some people are more susceptible than others, and these include:

People who walk bare foot in communal areas
People who live with someone who has a verruca
Children and teenagers
People who have a weakened immune system

How can we help?

We will assess and examine both feet, and the area itself and advise on the best approach for you.

Treatment varies as is dependent upon the age, location, size and the number of verrucae present.

Treatment for verruca may include:

Debridement; if you have a verruca that is not painful, there is a chance the body may kill the virus on its own; We can help by undertaking the usually painless removal of the he overlying surface of the verruca, which is usually painless, although during this process the verruca may bleed due to the blood vessels within the verruca leaking. Sometimes, just debriding (removing) the overlying skin is enough to stimulate the body’s immune system to fight the infection.
Acid based treatment; One approach to treatment is to use acid in a paste form to destroy the infected tissue; the type of acid treatment we use is stronger that over the counter treatments you might purchase from your local pharmacy and is a preferred approach by some because it is a painless procedure
Cryotherapy: This approach is using extreme cold temperatures to destroy the infected tissue by carefully applying liquid nitrogen or nitrous oxide. It can however feel quite uncomfortable.

Please be aware no single verruca treatment option is 100% guaranteed to be successful. Sometimes the verruca may have spread, or do not disappear for many months/years.

The Foot Centre

01883 348544

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