Skin Conditions Affecting the Feet and Legs
Hyperhidrosis – Hyperhidrosis is the medical term for excess perspiration. This commonly affects the hands and soles of the feet. The clinical appearance is sometimes a general redness of the feet with moist skin that is cool to touch. It is sometimes in response to mental or emotional stress. This can cause burning, itching and blister formation. The moist environment can lead to a fungal infection of the skin if not treated. When there is a bad odor associated with this it is called Bromhidrosis. Bromhidrosis occurs due to the normal bacteria that harbors on your skin producing biochemical biproducts.
Treatment of both Hyperhidrosis and Bromhidrosis is usually by having good hygiene and by managing the amount of sweat produced. Your feet should be washed daily with soap and water, then dried thoroughly between the toes to remove the dead skin. Socks and shoes should be kept clean and not shared between individuals. Avoid wearing dark synthetic socks, pantyhose, and occlusive shoes like vinyl. Absorbent powders and talcs may be used to reduce friction. Perspiration reduction can be achieved with topical antiperspirants. Caffiene, teas, and sodapop stimulates sweat production and should be avoided as well. Since sweat production is related to stress, reduction in stress and relaxation techniques may be helpful. See your podiatrist for further advice as there are many treatment options available.
Plantars Wart – A plantars wart is caused by a virus known as the human papilloma virus. They are sometimes called Verrucae plantaris, or just verruca. As a virus, warts are contagious. If left untreated they can spread to other areas of the body or other people you are in close contact with. Children and people with weaker immune systems are more vulnerable to the wart virus.
Symptoms of a plantars wart include an abnormal growth of skin in its outer layers. The wart does not penetrate into the deep layers of the skin. Warts on the bottom of the foot may become more painful as a callous may additionally form due to the friction and extra pressure caused by the wart. Warts may be a single lesion, or may group together and for a mosaic type of wart. They may appear spongy with small red, brown, or black spots caused by small blood vessels which bring nutrients to the wart tissue. The warts may be painful, especially in areas where you put direct weight on them. Warts are typically more painful when squeezed side to side. Warts are very commonly mistaken for a corn, callous,or a porokeratosis but are indeed a completely different problem with a different treatment plan. Visit your podiatrist to distinguish the difference.
You can prevent getting a wart by avoiding going barefoot in public places like showers, gyms, locker rooms and around a swimming pool. Wear sandals or something to cover the bottom of your feet.
Treatment of a wart can be accomplished by many methods. Sometimes several of these treatments are utilized at the same time as they can be stubborn and difficult to treat. Your doctor may apply some acid to remove the layers of skin that are affected. This should be closely monitored with your doctor. The wart may also be frozen or burnt off the area. Surgical cutting of the wart can also be done to rid the wart from the foot. This does not insure the virus is still not in your body. Warts may also be treated with a laser to vaporize the tissue. With all types of treatments there is usually a wound that forms and needs time to heal making it more painful to walk on. Reoccurrence is fairly high and the wart may also just disappear on its own.
Blisters – Blisters can occur with any type of friction against the skin. It is an elevation of the skin from the underlying structures filled with clear or bloody fluid. The most common areas on the foot that they occur are at the back of the heel, the ball of the foot, and at the toes.
Blisters can be caused by poor fitting shoes, hyperhidrosis, or structural deformities like bunions, hammertoes, or haglund’s deformity.
You can prevent blisters by decreasing or modifiying either the activity or the shoewear causing the friction. Make sure shoes are proper for the activity you are doing. Allow a break-in period for all new shoes. Sometimes proper socks decrease the friction as well. A simple change in shoes can sometimes alleviate the pain, talk to your podiatrist about this.
Diagnosis is usually made by clinical examination. Podiatric Care usually depends on the size of the blister, extent of involvement, and location. Blisters can lead to infection which can become severe. It is not always best to “pop” or deroof the blister as the covering can be protective. The cause of the blister should always be treated to prevent further injury.
Calluses – A callous is hypertrophic (thickened) epidermis (outer layer of skin) that is caused by excessive friction or intermittant pressure. Callouses can occur anywhere on the body but is more common on the bottom of the foot due to the gravitational forces the body applies to the bones of the feet. Common areas of the foot for callouses are under the “ball of the foot” due to a plantarflexed metatarsal. Callouses also develop where shoes wear against bony prominences where an exostosis has developed. A callous along the back of the heel may form heel fissures.
A callous is more of a symptom rather than a condition. To fully treat a callous, this underlying condition needs to be discovered and treated appropriately. Diagnosis of the underlying condition is important before treatment is rendered. Many people mistake callouses for plantars warts.
Podiatric Care may involve your podiatrist debriding the callous with a sharp blade on a regular basis. This is only a temporarily solution as the symptom is being treated but not the actual cause. It will likely return over time if this is all that is done. Callouses can also be treated with using a pumice stone following bathing where the callous has softened. In some instances your shoes can be modified or orthotics made to control the structure of your foot to decrease the pressure causing the callous. Surgery may be performed for a callous to fix an underlying structural or other pathological problem.
Tinea Pedis – Tinea Pedis, also known as Athlete’s Feet, is a fungal infection on the skin. It is a disease that mostly affects adults. It is caused by microscopic organisms that can grow on many surfaces that we live around. The fungus lives on the layers of dead skin our body produces.
Common symptoms of a skin fungal infection are redness and scaly skin. The skin may be dry or moist. It may affect just the bottom or the foot, between the toes, or the entire foot. It may become very intchy. If breaks in the skin are formed a secondary bacterial infection may also occur.
Tinea pedis can be prevented by controlling the external factors that make it favorable for the fungus to live on your feet. Your feet should be washed daily with soap and water, then dried thoroughly between the toes to remove the dead skin. Hyperhidrosis, or excessive sweating of the feet should be avoided and treated appropriately. Socks and shoes should be kept clean and not shared between individuals. Avoid wearing dark synthetic socks, pantyhose, and occlusive shoes like vinyl. Avoid going barefoot in public places like showers, gyms, locker rooms, and around a swimming pool.
The cause of a foot fungus is usually from any one of many microscopic organisms invading the skin when there is a proper environment for there survival. There is no way of avoiding fungus and microscopic organisms. High use of chemotherapy, antibiotics, and immunosuppressive drugs make you at risk for having the fungus. Those with a compromised immune system, such as those with diabetes or HIV infection may have an increased risk as well.
Diagnosis of a fungus on your skin can be done by laboratory test performed by your doctor to detect the organisms. Many times your podiatrist can look at the condition of your skin and have a high suspicion to make the diagnosis based on the physical examination. There are many skin conditions that can mimic the appearance of a foot fungus, you should see your podiatrist for a diagnosis before treatment is started.
Treatment of a foot fungus may be as simple as improving the hygiene by keeping your foot dry and clean. There are multiple creams, lotions, and powders that can act as an anti-fungal medication to rid the microorganisms from your skin. The biggest problem most people face is when they apply creams between the toes. The toes are a warm, moist environment for the fungus, when creams are rubbed in the area, they usually do not dry out properly and promote the fungus to remain. You should never use creams or lotions between the toes. See your podiatrist to determine the best treatment for your condition.