SKIN CONDIDTIONS: Hard skin / Corns / Sweaty feet / Cracked skin / Blistering /Athlete’s foot / Verrucae
This is when the outer layer of the skin thickens in response to abnormal pressure or stress.
The most common cause is footwear, especially if a high heel is worn. The body tries to protect its self but unfortunately if it is allowed to build up too much it can become painful. However, hard skin should never be painful to treat by a competent podiatrist! Relief is usually instant.
Where there is the greatest pressure or stress on the skin a corn may form. These can be the common hard corn, or the multiple pin-headed type, the seed corn. In essence, these are inverted cones of hard skin. Like hard skin, there are no nerves in them and so removal is painless.
If the corn has been left for a long time and has become chronic, it is possible that blood vessels may have grown into the area and produced a vascular corn. These corns are far more sensitive to the patient.
All corns should be removed by a professional as soon as they are detected. They can often be permanently cured if the cause is removed. Self removal can give rise to vascular corns over a period of time and is not recommended. Vascular corns can be permanent.
This can be an embarrassment to many but can have an underlying cause that can be treated.
Adolescence, occupation and footwear are common causes. Hormonal changes, anxiety and pain in the feet can also be responsible. The latter may not be as obvious to the patient as it would be to the podiatrist. Sometimes an imbalance in the way the foot is functioning may be the cause.
The podiatrist will endeavour to ascertain the cause of the sweating , (known as hyperidrosis) and treat accordingly. We are not phased by sweaty and sometimes smelly feet, and so the patient should not be ashamed or embarrassed to see us.
Cracked skin is commonly a very dry skin and needs re-hydrating with a good foot cream usually one containing urea. It often occurs around the heel area as a result of the patient’s weight, or open back shoes. If the cracks are allowed to become deep, the edges will not heel unless they are reduced by a podiatrist.
A moist form can occur in between the toes and is often associated with athlete’s foot. Usually there is an intense irritation at the site.
The common form of blister occurs when the superficial layers of skin have an influx of fluid from damaged tissues. This damage is caused through a shearing / fiction stress to the skin. If the blister involves much deeper tissues there can be involvement of blood vessels causing a blood blister.
These blisters should not be burst as they remain sterile and should just be covered to prevent further damage. They will eventually resolve on their own. However, if there is a great deal of pain it may be necessary for the fluid to be released by a professional.
There are many dermatological conditions that can cause blistering such as excessive sweating, psoriasis, athlete’s foot, allergies etc. Too many to name here.
Family tendencies can be present and is some cases this is known as bullous pemphigoid.
This is a term used to describe a group of common fungal infections of the skin. On the feet it is called tinea pedis.
Athlete’s foot can present as itchy and sometimes blistery but sometimes no symptoms exist. We can offer a test with 85% accuracy. If found in between the toes it usually looks white and peeling but it can also appear dry . Elsewhere on the feet red dots may be seen with inflamed patches.
This condition is very catching and must be treated with an athlete’s foot preparation. If left untreated the fungus can invade the nails which is a very difficult infection to clear. (See under nail conditions).
If the treatment doesn’t appear to be working then a different preparation should be acquired. There are many different types of infecting fungi and it is usually trial and error to find the appropriate treatment. Once the fungus seems to be eradicated treatment should be continued for a further 2 weeks. This is so that the remaining dormant spores will be destroyed as well. Often people stop treatment too soon and when the environment is right such as warm, the fungus re-infects the skin. A good practice is also to treat the footwear with an anti-fungal powder.
This is a very common viral infection of the skin picked up by direct contact. This virus likes warm moist damp areas to live and the feet present the perfect environment to live in. Normally, it does no harm to the skin in the long term. Often pain arises through the hard skin that forms over the lesion or the altered pressure response to walking differently.
Verrucae can appear in many different forms from single lesions to multiple. Often black dots are seen but not always. These black dots are small patches of dried blood from broken capillaries within the Verruca tissue. Side pressure, such as squeezing the skin may elicit a pricking sensation. This is usually a positive diagnosis for a Verruca.
For the majority of people, from the initial contact with the virus the immune system sees it and destroys it. Unfortunately for some however, during the few months it takes the virus to change the appearance of the skin, the immune system does not destroy it and the patient is left with the Verruca. Verrucae do not always have to be treated and will usually be destroyed by the body’s natural defence system.
The decision whether or not to treat the Verruca has to be the patient’s choice. No one can predict exactly how long treatments will take, but what we will endeavour to do however, is to take a good patient history and advise the patient as to which treatment in our opinion may be the best for each individual. For some patients the best treatment is the conservative approach. This involves removal of the callus only, purely for comfort.
Options for treatment are varied and range from the application of regular acid treatment to the more unusual magic plasters and banana treatments. At our clinic, we offer patients a variety of chemical treatments, freezing with liquid nitrogen, swift microwave therapy (see Advanced Technology for more info) as well as advising on conservative treatment. We constantly keep the patient informed of treatment progress and will discuss with the patient whether a change or combination treatment will speed up the treatment.