Routine foot hygiene is by far the best way to prevent most foot conditions from developing.  Diabetics,in particular, need methodical foot care and daily foot examinations to ensure that problems do not develop with their feet.

Washing is the first priority and you should wash your feet everyday.  Scrub both the tops and bottoms of your feet and between your toes. Drying your feet is just as important especially between the toes.

If your feet perspire heavily then you should wash more frequently. The perspiration and the resulting odour may be controlled by the use of an anti-perspirant spray applied to the sole of the foot.  Use foot powders in you socks and change your socks and/or hosiery frequently.  Stronger anti-perspirant sprays may be available if necessary on prescription from your podiatrist.

Trim your toenails after a bath or shower when the nails are softer. Cut your toe nails straight across Using nail clippers and leave them as long as the tips of your toes. Round off the corners slightly with the clippers or an emery board so that sharp corners don't catch on socks or stockings. Do not cut your nails too short; leave a little white part showing. This will prevent your toenails from growing crooked as well as from developing nail infection. Never cut down the nails into the corners or on the sides as this can also lead to ingrown toenails as the nails grow into the flesh of your toes.

At the end of the day there can be a buildup of toxins and metabolites in your feet due to poor circulation. A light massage of the feet and leg elevation can help to re-establish good circulation and also help prevent varicose veins.

Follow these simple tips to prevent the most common foot conditions from developing and keep your feet healthy for life.

 

Worried about your sweaty feet - and the smell that goes with them?

Too much sweating of the feet will lead to an odour.  That sweating may be due to a normal but high activity, or it may be due to a medical condition.

Excessive perspiration in the feet can be a function of over-active autonomic nerves. We have no voluntary control over the autonomic nervous system which controls automatic functions of the body such as blinking and breathing. So if our autonomic nervous system is damaged due to trauma or accident to the spine or lower limbs, this can result in over-or under-activity of the autonomic nerves. Over or under-active autonomic nerves may also be inherited.

Other systemic conditions such as tuberculosis, overactive thyroid gland, under-active adrenal glands, viral infections and certain nervous conditions relating to anxiety and stress can also cause excessive perspiration, 

Normal, day to day conditions may also lead to excessive perspiration.  Waterproof or protective footwear such as gumboots worn for long periods as a necessary condition of employment in some trades do not allow air circulation and are not absorbent causing excessive perspiration.

So your sweaty feet may be caused either by a medical condition or just by your living and working conditions together with the footwear you are using.

Regular washing is the obvious answer - so why do they still smell?

Some medical conditions such as diabetes mellitus and renal failure can give an odour to perspiration.

The natural bacteria of the skin also have a very short lifecycle. In just a few hours, the bacteria grow, multiply, die and decay, leading to the unpleasant odour.  Excessive perspiration in the feet promotes faster than normal growth of the skin's natural bacteria.  So more perspiration means more bacteria both alive and dead and more odour.  It is an ongoing cycle.

Assumining you don't have a systemic medical problem, and even if you do, you can minimise the extent of the problem by choosing shoes and sandals made from breathable materials, leather or porous natural fibres so that air can circulate. Artificial materials with no porosity do not allow any air to circulate and causing excessive heat build up and perspiration.

Even in cool weather, your feet can be working very hard inside your shoes raising the temperature and givng off water vapour while perspiring.  Your shoes will readily absorb both the moisture and the salts exhuded.  Together with the dead skin cells and natural bacteria they provide a perfect breeding ground for fungal infections. So take every opportunityh to change your shoes and allow them to dry out somewhere with fresh air and sunlight.

Use anti-perspirant foot sprays first thing in the morning to minimise perspiration.  Use absorbent foot talc in socks and closed shoes to dry up any perspiration produced. Change your socks frequently and always after any sports activity.

Some of the worst effects of diabetes on the lower leg can include ulceration, infection, gangrene, and even amputation. Beyond that, for someone with diabetes, a neglected foot problem can even be life threatening. There are two main reasons for this.

• Damage to the nerves caused by the diabetes may cause numbness of the feet, so that the warning signals of pressure and pain are no longer present- this is called neuropathy.
• Blood circulation to the feet can be poor.  This causes slow healing - referred to as peripheral vascular disease (PVD)

Diabets causes high blood glucose levels - hyperglycemia.  This damages nerves and blood vessels. Looking after your feet, that do all the work of carrying you wherever you go in your daily life, could save a limb and even your life.  Some 40-70% of all lower extremity amputations are reported to be related to diabetes mellitus. Diabetes sufferers who are over 40 years old or have had diabetes for more than ten years are the most at risk.

Loss of a limb can have serious financial implications both for the patient and for society.  Lengthy hospital stays, rehabilitation, and the requirment for lengthy social services and home care. The patient is also likely to suffer loss of income and emotional stress. Fortunately, it would appear that amputations can be reduced considerably (in some cases by 50%), by implementing certain strategies. These include:

• Regular inspections of the feet & footwear by trained people
• Preventative foot & shoe care for patients at high risk
• Providing more and better information to families and carers together with better teamwork with professionals.
• Early detection of peripheral vascular disease with suitable intervention.
• Continuous follow-up of patients with previous ulcers
• Registering amputations and ulcers in order to provide accurate data.

These strategies have already been reported to have had substantial cost savings which are likely to be significant as research has shown that during their lifetime 1 in 10 people with diabetes will develop a foot problem

It may not be apparent to diabetes sufferers that their feet and legs are particularly at risk as a result of their diabetes.  They continue to be just as much at risk as people without diabetes, but are much less able to recover.  The routine range of foot problems such as those resulting from a high-arched foot, flat feet, deformed toes, bunions, calluses, corns, blisters, fungal infections etc. all continue to affect diabetes sufferers - but with much higher significance.

The risk for the diabetes sufferer is that the foot is often unable to respond to the stresses placed upon it. We tend to forget that the whole weight of the body is carried through the feet and legs.  This weight causes high pressure in localised areas and leads to callus formation.
Diabetes can lead to loss of feeling, so the sufferer won't know of the pressure because there will be no pain and eventually the skin can break down leading to the formation of an ulcer. Sometimes a foot with such loss of feeling can become swollen and deformed and changes shape permanently, this is a serious condition referred to as Charcot foot.

Stabbing or shooting pains, pins and needles or tingling sensations can be the first signs of this loss of feeling.  As the condition worsens, some people describe "ants or water running down the legs," or "a feeling of walking on cotton wool."

Hardening or narrowing of the arteries are among the changes that take place in the feet. This starves the tissues of blood and Occasionally a vessel may become completely blocked.  This leads to intense pain and the flesh tissues begin to die due to lack of oxygen.

In such cases, immediate referral to a vascular specialist is required. Other typical symptoms of PVD include pain in the calf of the leg when walking short distances or climbing stairs. Your feet or legs may seem to be permanently cold or your toes discoloured either red or blue. Loss of hair on the toes or dry shiny skin on the feet and lower leg are other symptoms.

Frequently, diabetes sufferers are not aware of the significance effect their condition can have on their feet and legs and ultimately on their quality of life.  Make sure that you are not among them.

Diabetes can have a serious effect on your feet and legs – and therefore on your long term mobility.  Sufferers from diabetes are therefore well advised to take good care of your feet and legs.  Basic care at home is a good start – but always bear in mind that timely intervention by a professional is necessary.  So be sure to visit your doctor or podiatrist at the first hint of any problem.

• Inspect feet daily for cuts, bruises, or any changes in shape.  This should pose no problem during your daily personal hygiene.
• Always wear shoes & socks even indoors.  Your feet need protection and support at all times.  
• Do not use chemical agents or plasters to remove corns or calluses.  Your feet may no longer be able to recover from what you used to think of as ‘superficial’ problems – and need professional care whenever you have any abnormality. 
• Wash feet daily & dry thoroughly, especially between the toes.  This minimises the risk of  infection from external sources.  Of course, this is a good opportunity for that daily inspection.
• Make sure your shoes fit correctly; always feel & look inside them for irregularities that may affect your foot before buying.  When in use, look for red areas on the feet which can indicate pressure on your foot that you may not be aware of.
• Cut your toenails to the curve of the nail and file to a smooth shape with an emery board
• Don't soak your feet.  Again, you want to maintain your feet in a clean, dry, stable condition not expose them to abnormal situations.
• Protect your feet from very hot or very cold conditions.  This can affect the blood flow to the foot or cause excessive sweating neither of which are welcome.
• Try to avoid putting pressure on the legs with garters or tight sock tops.  These can affect the blood flow to the surrounding area.
• Make sure that you moisturize dry skin to make it more flexible and prevent it cracking which will provide an opportunity for infection.

Diabetes can lead to loss of sensitivity in the feet and legs.  So don’t rely on whether you can feel discomfort to tell you if something is going wrong.  You may not feel it until it is too late.  So careful, methodical, routine inspections are the order of the day.  And don't be afraid to ask - get professional advice early whenever you find anything unusual.