Why do I get horrible callus on my feet?

Everyone gets hard skin or callus.

I never see a single foot during my day's list that has not got some form of hard skin somewhere on it.

Some people have more than others and if I look at my own feet I have areas of hard skin on my heels and on the insides of my big toes (see...bet you thought my feet would be baby soft!!)

A callus forms on the foot when there is enough traction, weight and friction applied repeatedly in one place. Certain people can take up to 10000 steps a day. Even a relatively inactive person will take up to 4000 steps just pottering around.

This, coupled with wearing shoes (evolution didn't prepare our feet for shoes....), extra weight, sports activities or demanding jobs and you can start to have some sympathy with what your feet go through each and every day.

The only way to stop getting callus is to stop walking or weight bearing!


Callus are part of the body's defence to help protect our feet from these external forces.

A little bit of callus is fine but some people develop more than others, or their callus becomes painful.

I always find it interesting to note a patients callus pattern as you can get a pretty good idea of certain factors such as how they walk, maybe what their hobbies are and the type of shoes they wear.

I have also been accurately able to guess the type of job the patient does just form the pattern of callus on their feet..... (not sure whether that is something to be proud of or not!!)

The above picture show the basis patterns of callus I see on an everyday basis.

So....is there anything you can do to stop these areas of hard skin developing?

In a word NO! Unless you take to your bed and never walk again. 

Most foot care is maintenance rather than permanent cure.

A foot file,

and some decent foot cream or moisturiser is your best defence. Specialist products such as Flexitol Heel Balm has a higher content of Urea in which is proven to help decrease the build up of callus.

Other products such as callus cream don't stop the callus forming it just makes it softer to remove. These products often contain salicylic acid so should be used with caution. Likewise, callus knives can be useful for home use but I have seen some nasty injuries from these so please be careful!

Smokers feet?

Is there such a thing as 'smoker's feet'?



I obviously see many pairs of feet every day and the feet of smokers are quite unique in their presentation.

Most have a an abundance of hard skin. With this I don't mean just a small patch of callus on the heel or side of the big toe.

I mean thick, yellow, wax like callus. Generally on the heel area but can be over the forefoot area, on the ends of the toes and on the side of the big toe.



I mean A LOT of callus. Excessive,. And despite it being pared off every few weeks by a professional, it returns to an identical state.

When it is pared off with a scalpel blade it comes off like peeling a potato or whittling a candle down.... sorry to be graphic!



So is this really down to smoking?

The following is a very simplified reason as to why this is happening....

Remember the feet are the farthest point away from the heart.

Every time you smoke the tobacco components absorbed through the lungs reach the heart immediately.

According to research (see ref below) there is a 42% reduction in blood flow after just one cigarette. In very basic terms your blood vessels get narrower.

Being as these blood vessels run to every single part of your body delivering the oxygen and other components vital to stay alive, you are denying each and every part of your body with nearly half of what it needs to function normally.



The effects last up to 90 minutes after each cigarette. If you smoke regularly then these effects are pretty much permanent until you are asleep.

As your feet are so far away from the heart, the heart is already working harder than other areas to get the blood to and from the area. When you smoke, you compromise this even more.

Over time this lack of blood flow starts to affect how the skin grows. Being as our skin is constantly renewed it is being renewed in less than perfect conditions.

Collagen, the essential element of the skin that gives it the elasticity and flexibility is reduced by lack of blood flow and oxygen in the blood. This is why smokers also get more wrinkles!

Less collagen = less elasticity = thicker skin = more callus on your feet.

This is just ONE aspect of how smoking can affect your feet. Each cigarette contains 4,000 different chemical elements.........

For more information.....

http://www.podiatryinstitute.com/pdfs/Update_2012/2012_38.pdf

Relationship between Smoking and plantar callus formation of the foot

Thomas J Merrill, DPM, Virginio Vena, DPM and Luis A Rodriguez, DPM

Insect bites on your feet?

Summer is finally here and I am seeing more and more insect bites on the feet... (including my own I hasten to add!)

So why do the little blighters tend to head for your feet and ankles?



Mosquitoes, midges and horseflies all love odour. Even if you can't smell yourself, the cocktail of bacteria that is naturally found on our bodies, particularly our feet, are sensed and smelt by pesky biters up to 100 feet away. Entomologist Daniel L. Kline experimented with using dirty socks as a mosquito lure, and found his 3-day-old socks were irresistible to them. Specifically, it's the bacteria that grow on human feet that seems to draw a crowd.



Mosquitos in particular are heat seeking missiles. Anything warm, including your feet, are seen as a ready meal. Feet and hands are useful in temperature control of the body. Think how you stick your feet out of the duvet to cool off at night, or how your hands and feet are the first to feel the cold when it's frosty outside.

Once they land on you the puncture wound of a bite is usually injected with saliva from the insect. This is a chemical cocktail of substances designed to make blood flow quickly and painlessly to the bug as it tries to get its fill and avoid being squished. This is why you don't usually feel anything until it is too late..

.

The worst thing you can then do is SCRATCH! But we can't help it.... especially when you are in bed and the bite is throbbing. Just one little scratch won't harm, but the more you scratch the more you scratch the more you scratch. Agh!

Scratching causes release of histamine.



Histamine is a chemical that the immune system uses to help protect the body’s cells against infection. The immune system is the body’s natural defence against illness and infection.

If the immune system detects a harmful foreign object, such as bacteria or a virus, it will release histamine into nearby cells. The histamine causes small blood vessels to expand and the surrounding skin to swell. This is known as inflammation and it can lead to nearby tissue becoming red and swollen. It can also affect the nerves in the skin, making the skin feel itchy.

Most bites (be thankful we don't live in a country with nasty diseases) will settle on their own within a day or two, particularly if you don't scratch!!!

A cold compress can help and anti histamine cream will help reduce the swelling and some of the itchiness.



If things persist then taking an oral anti histamine tablet can be useful.

Occasionally people who have been bitten can have a nasty reaction called anaphylactic shock which causes the body to over react to a substance and can be fatal if untreated. If someone displays symptoms of urticaria (hives - lots of very small raised red bumps clustered together), nausea, vomiting, hypo-tension or respiratory problems soon after a bite, dial 999.

Other complications can include a secondary infection to the site. I often see patients that have scratched a bite area and have blisters, swelling and weeping sores. If the patient is compromised with other medical conditions this infection can lead to potentially dangerous cellulitis which can require hospitalization and anti biotic.



Be sensible. Most bites settle on their own with nothing more than an anti histamine cream or tablet. If things start to look worrying, change rapidly or get worse, then consult a medical professional just to be on the safe side.

References 

J Appl Physiol. 1982 Nov;53(5):1228-33.

Restoration of thermoregulatory response to body cooling by cooling hands and feet.

Van Someren RN, Coleshaw SR, Mincer PJ, Keatinge WR.

 

10 Ways to Guarantee You'll Get Mosquito Bites

How to Lure Bloodthirsty Mosquitoes

By Debbie Hadley, 

CAMERON WEBB, THE UNIVERSITY OF SYDNEY

MONDAY, 30 APRIL 2012NHS choices website

Smelly sweaty feet?

Many people are suffering in the ‪‎heatwave‬, especially if they still have to go to work and can't sit around in ‪flip flops‬ all day. 

There are some great products on the market now which really do help..... Think about your socks. Many runners already know the benefits of decent socks that wick moisture away from the foot. They are usually man made technical fibres rather than cotton socks, but they make a huge difference. Check out ‪SPEEDSOCKS‬ at wiggle.co.uk.

Using a specialist foot ‪‎anti‬perspirant is also one that is cheap and really work. Check out the range at ‪‎Boots or other pharmacists. Remember that you get maximum results after using them for two weeks or more. Finish off with a sprinkle of powder in your socks and shoes.....

My personal favourite is Zeasorb.com, which I use for many of the ‪Ultrarunners‬ that I treat. This is super fine and absorbs more than 7 times more mositure than normal talc. As yet I can only find it online but keep me posted if you find somewhere that sells it.

Feedback is always welcome as to what you personally find helps your feet in hot weather....

I have white patches on my toenails when I took my nail polish off....

A couple of patients have recently visited the Clinic convinced they have a fungal nail condition.

Both ladies showed signs of slightly yellowed nails and white patches, which looked chalky in appearance, on the surface of the nail.

Usually this is caused by fungal invasion of the superficial layers (the very top layers) of the nail plate to form "white islands" on the plate and known (unsuprisingly!) as white superficial onycomycosis.



The air around us, and most surfaces, are covered with microscopic dust particles, fungal spores and bacteria. Most of these are not harmful to us in any way until they get the perfect conditions for growth.


Some of these fungal spores live on keratin (which our skin, hair and nails are made of) and these can start to penetrate the toe nails and cause a fungal infection.

In both these cases, the fungal spores, which were quite harmless, have been sealed in against the nail by continuous layers of nail polish. Not only does this prevent them from being cleaned away, but provides them with a sealed environment in which to florish.

Coupled with a nice warm, damp, dark inside of a shoe creates a perfect fungal greenhouse in which the fungus takes hold.



If caught at an early stage, as with both these ladies, the fungal spores and damage can be easily eradicated by drilling. I used a small burr and in a painless process just took away the surface which holds the spores.

In the long term, if the ladies use nail polish every now and again (rather than continuously) and are vigilant against further infection, they should suffer no long term problems.

P.s The yellow colour of the toenails was  just an over indulgence on the spray tan bottle! It stains your toenails just as much as your skin!!!