The best treatments for common foot problems

Source: Best Health Magazine, May 2012

Maybe you were born with dry or problem feet. Or maybe you’ve been wearing shoes that are too tight or heels that are too high. No matter what the cause, 40 to 50 percent of the population can expect to encounter corns, calluses or cracked heels at some time, says Douglas Lamb, a podiatrist in Victoria.

Both corns and calluses are skin that has toughened, thickened and hardened due to friction and pressure. While corns may be inflamed and occur on or between the toes, calluses grow in a larger area on the bottoms of the feet and don’t usually hurt. ‘Typically, calluses form on the heels, the outsides of the big toes or under the major joints on the balls of the feet,’ says Lamb. When calluses on the back edges of the heels become thick, dry and hard, the skin can split, crack and even bleed. Women are more likely than men to experience these uncomfortable conditions, thanks to footwear that is too tight, puts too much pressure on the toes and balls of the feet, or has an open back that lets the heels slide around. Dry skin can exacerbate foot problems (especially cracked heels), as can flat feet and over-pronation (the tendency to roll feet inward as you walk). ‘Some people have bone deformities, such as hammertoes and bunions, that cause friction in certain areas and encourage the development of corns and calluses,’ says Robert Chelin, a Toronto podiatrist and the past president of the International Federation of Podiatrists. ‘The best way to prevent them is to practice good foot hygiene, buff with a pumice stone and moisturize regularly, and wear supportive shoes that fit well.’

Look for footwear that’s made of leather, which is breathable and allows sweat to escape’the less you sweat, the less dried out your feet will become’and has a 1.5-inch heel. This slight wedge is a more natural height for a woman’s foot than a flat shoe. The shoes should have ample width and toe room. Cotton socks help minimize callus and corn formation by providing cushioning and reducing friction, but if you’re going barefoot in sandals, invest in ones with sturdy, supportive arches, a heel cup and a back strap whenever possible.

Although corns, calluses or cracked heels may be unsightly, if they aren’t causing you discomfort, they can be left alone. According to Lamb, calluses provide some protection to the skin, and active people with healthy feet shouldn’t overtreat the condition. Chelin says tough skin is more desirable for going barefoot or barefoot running. He suggests that athletes lubricate or moisturize their skin to reduce friction and prevent blister formation.

However, see a doctor if these areas become painful or inflamed, or if your skin has deep cracks that start to bleed (which can lead to infection). You should also seek medical attention for these conditions if: you have diabetes, poor circulation or impairment to the nerves of the feet; you have experienced no improvement after using over-the-counter (OTC) remedies; the pain has changed; or the condition has worsened. Otherwise, start with one or more of the following treatments.

Salicylic acid treatments

Examples: Dr. Scholl’s 2 Drop Corn & Callus Remedy; Curad Mediplast Corn, Callus & Wart Remover; Freezone Corn Remover Pads; ProFoot Velvetex Corn Removers

How they work: Available in medicated patches or liquid drops, salicylic acid softens thickened layers of skin. ‘This makes it easier to use a pumice stone or emery board to remove the dead skin,’ says Chris Tsang, a pharmacist and pharmacy manager at a Real Canadian Superstore in Winnipeg. The fast-drying liquid treatment (Dr. Scholl’s) acts like a liquid bandage; comprised of about 12 to 17 percent acid, it is best for hard-to-reach areas such as between the toes. The patches (Curad, Free zone and ProFoot) are more concentrated (up to 40 percent acid) and can be trimmed to fit the targeted corn or callus.

What you need to know: Careful application is critical. Avoid getting the salicylic acid on any part of the skin except the corn or callus itself, since it can irritate and burn healthy skin, and may even lead to infection. Liquid remedies may be used daily; patches can be left on for up to 48 hours. Before reapplying, soak your feet in warm water and gently buff the dead skin with a pumice stone or emery board. Avoid these treatments altogether if your skin is cracked or bleeding, you have diabetes or poor circulation, or you are pregnant or breastfeeding.

Intensive moisturizers

Examples: Dermal Therapy Heel Care Cream; Eucerin 10% Urea Foot Cream; Flexitol Heel Balm; Sween Atrac- Tain Superior Moisturizing Cream with 10% Urea and 4% AHA; Uremol 20 Intense Relief Moisturizing Cream

How they work: ‘Using a good medicinal moisturizer is key,’ says Chelin. ‘Because the skin on the soles of the feet is about 2.5 times thicker than the skin on your face, you need something that will penetrate the layers of tissue to keep them supple and soft.’ Urea, found in the products listed above, is a potent hydrating agent and softens hard, dry skin. It’s available OTC in up to a 25 percent concentration (Dermal Therapy). Alpha-hydroxy acids (Eucerin and Sween Atrac-Tain) can also be helpful, since their exfoliating properties encourage the scaling off of dead skin.

What you need to know: Apply these at least once a day, ideally at night and after you have soaked and buffed the area (wear socks to bed to keep sheets clean). They’re safe to apply on the entire foot, including corns, calluses and cracked heels, as long as the crack isn’t open or bleeding.

Footcare inserts

Examples: Airplus Gel Save My Soles; Dr. Scholl’s For Her Heel Cushions; Intelligel Corn Pads; Pedifix Visco-Gel Moleskin Protective Padding

How they work: OTC shoe inserts (Airplus) and heel pads (Dr. Scholl’s) can help prevent calluses by providing additional cushioning. ‘They reduce the stress forces on the balls of the feet to give a more stable foundation,’ says Chelin. ‘However, they won’t help corns since those are on top of or between the toes.’ Instead, consider non-medicated corn pads (Intelligel) or moleskin (Pedifix, which can also be used on calluses). Even if you don’t use a salicylic acid medication at the same time, covering the area will soften it and make it easier to smooth down, says Lamb.

What you need to know: If you’re still experiencing calluses after trying OTC shoe inserts and heel pads, Lamb recommends seeing a footcare professional for an assessment and possibly custom-made orthotics (see ‘At the Doctor’s Office,’ on page 79). Non-medicated corn pads and moleskin bandages may be left on for up to 48 hours before soaking and buffing.

What to do if these treatments don’t work

For corns, calluses or cracked heels that aren’t responding to OTC remedies (or cannot be self-treated due to a medical condition such as diabetes), see a licensed podiatrist (contact your provincial podiatry association or licensing body for a list). Treatments may include trimming calluses or corns with a blade (never attempt this at home), or using orthotics to address alignment issues. Chelin also injects some patients’ feet with hyaluronic acid, which creates a pad on the soles to prevent calluses (and therefore cracked heels) for up to two years. In rare cases, surgery is necessary to correct the bones that are causing friction.

This article was originally titled "Save your soles" in the May 2012 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!