Common foot problems for people with diabetes

Athlete’s foot : is a fungus that causes itching, redness, and cracking. Germs can enter through the cracks in your skin and cause an infection. Medicines that kill the fungus are used to treat athlete’s foot. These medicines may be pills and/or creams applied directly to the problem area. Ask your doctor to recommend a medication for athlete’s foot.

Fungal infection of nails: Nails that are infected with a fungus may become discolored (yellowish-brown or opaque), thick and brittle, and may separate from the rest of the nail. In some cases, the nail may crumble. The dark, moist, and warm environment of shoes can promote fungal growth. In addition, an injury to the nail can put you at risk for a fungal infection. Fungal nail infections are difficult to treat. Medications applied directly to the nail are available, but they only help a small number of fungal nail problems. Oral medications (pills) may need to be prescribed by your doctor. Treatment also may include periodic removal of the damaged nail tissue.

Calluses: A callus is a build-up of hard skin, usually on the underside of the foot. Calluses are caused by an uneven distribution of weight, generally on the bottom of the forefoot or heel. Calluses also can be caused by improperly fitting shoes or by a skin abnormality. Keep in mind that some degree of callus formation on the sole of the foot is normal. Proper care is necessary if you have a callus. After your bath or shower, use a pumice stone to gently remove the build-up of tissue. Use cushioned pads and insoles in your shoes. Medications also may be prescribed to soften calluses. DO NOT try to cut the callus or remove it with a sharp object.

Corns: A corn is a build-up of hard skin near a bony area of a toe or between toes. Corns may be the result of pressure from shoes that rub against the toes or cause friction between the toes. Proper care is necessary if you have a corn. After your bath or shower, use a pumice stone to gently remove the build-up of tissue. Do not use over-the-counter remedies to dissolve corns. DO NOT try to cut the corn or remove it with a sharp object.

Blisters: Blisters can form when your shoes rub the same spot on your foot. Wearing shoes that do not fit properly or wearing shoes without socks can cause blisters, which can become infected. When treating blisters, it’s important not to "pop" them. The skin covering the blister helps protect it from infection. Use an antibacterial cream and clean, soft bandages to help protect the skin and prevent infection.

Bunions: A bunion forms when your big toe angles in toward the second toe. Often, the spot where your big toe joins the rest of the foot becomes red and callused. This area also may begin to stick out and become hard. Bunions can form on one or both feet. They may run in the family, but most often are caused by wearing high-heeled shoes with narrow toes. These shoes put pressure on the big toe, pushing it toward the second toe. The use of felt or foam padding on the foot may help protect the bunion from irritation. A device also may be used to separate the big and second toes. If the bunion causes severe pain and/or deformity, surgery to realign the toes may be necessary.

Hammertoes: A hammertoe is a toe that is bent because of a weakened muscle. The weakened muscle makes the tendons (tissues that connect muscles to bone) shorter, causing the toes to curl under the feet. Hammertoes can run in families. They can also be cause by shoes that are too short.

Hammertoes can cause problems with walking and can lead to other foot problems, such as blisters, calluses, and sores. Splinting and corrective footwear can help in treating them. In severe cases, surgery to straighten the toe may be necessary

Proper foot care can help prevent these common foot problems! Here are some tips for good foot care:

• Take care of yourself and your diabetes. Follow your health care provider’s advice regarding nutrition, exercise, and medication. Keep your blood sugar level within the range recommended by your doctor.
• Wash your feet in warm water every day, using a mild soap. Test the temperature of the water with your elbow, because nerve damage can affect sensation in your hands, too. Do not soak your feet. Dry your feet well, especially between the toes.
• Check your feet every day for sores, blisters, redness, calluses, or any of the other problems listed above. If you have poor blood flow, it is especially important to do a daily foot check.
• If the skin on your feet is dry, keep it moist by applying lotion after you wash and dry your feet. Do not put lotion between your toes. Your doctor can tell you which type of lotion is best to use.
• Gently smooth corns and calluses with an emery board or pumice stone. Do this after your bath or shower, when your skin is soft. Move the emery board in only one direction.
• Check your toenails once a week. Trim your toenails with a nail clipper straight across. Do not round off the corners of toenails or cut down on the sides of the nails. After clipping, smooth the toenails with a nail file.
• Always wear closed-toed shoes or slippers. Do not wear sandals and do not walk barefoot, even around the house.
• Always wear socks or stockings. Wear socks or stockings that fit your feet well and have soft elastic.
• Wear shoes that fit well. Buy shoes made of canvas or leather and break them in slowly. Extra wide shoes are also available in specialty stores that will allow for more room for the foot for people with foot deformities.
• Always check the inside of shoes to make sure that no objects are left inside by mistake.
• Protect your feet from heat and cold. Wear shoes at the beach or on hot pavement. Wear socks at night if your feet get cold.
• Keep the blood flowing to your feet. Put your feet up when sitting, wiggle your toes and move your ankles several times a day, and don’t cross your legs for long periods of time.
• If you smoke, stop. Smoking can make blood flow problems worse.If you have a foot problem that gets worse or won’t heal, contact your doctor for advice and treatment.

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