5 essential things to note for feet and toenail care

Neglect your feet and pay the price.

At best, they might smell bad and embarrass you.

But worse, unsightly and persistant fungal toenail infections could develop from poor hygiene.

Just a little care and effort can reduce your chances of getting these and most other foot problems.

1 STINKY FEET

Podiatrists say the best way to avoid stinky feet, as well as a fungal infection, is to keep the feet clean and dry.

"In the majority of cases, feet smell bad due to the by-products of bacteria acting on the sweat that our feet produce," said Ms Chelsea Law, principal podiatrist at Khoo Teck Puat Hospital.

Good hygiene helps reduce the odour. Feet, including the area between the toes, need to be cleaned daily with soap and water, she said.

It is also important to dry the feet thoroughly, particularly in between the toes, to lower the risk of getting a fungal infection, she added.

So change your socks every day. Socks act as a protective layer between the feet and the shoes, helping to absorb moisture from the feet.

Those who sweat excessively from their feet should wear cotton socks, which would allow moisture to be wicked away from their feet, said Ms Law.

Air your shoes after wearing them, so that they can dry and be less likely to smell or breed bacteria.

Ms Joann Lim, senior podiatrist at Changi General Hospital, encourages people to air their shoes for as long as 72 hours after wearing them.

Do not wear the same pair of shoes every day. Alternate between a few pairs, so that each pair can dry out.

To treat foot odour, you can easily get off-the-shelf foot spray and powder that help to get rid of the bacteria that cause the odour.

To make the products work better, use them on both your feet and on the shoes, advised Ms Lim.

For severely stinky feet, anti-perspirants can be used on the soles to reduce sweating, said Ms Law.

Charcoal insoles may also help to reduce odour, she added.

Nail Fungus

2 NAIL FUNGUS

Fungal infections can occur on skin or nails where it is darkest and most moist.

A common example is athlete's foot, which often develops in the moist areas between the toes. It is contagious and emits a foul odour.

Fungal nail infections, also called onychomycosis, occur when fungi - made up of tiny organisms - get inside the nail.

Such infections can change the appearance of the nails permanently. They tend to occur more in toenails, which see light less frequently, than in fingernails.

Ms Jessica Tennant, a podiatrist at Orchard Clinic, said fungal toenail infection is among the three most common toe problems at her clinic, with the other two being ingrown toenails and thick toenails. She said: "The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured with a white, black, yellow or green tint.

"If left untreated, the skin can become inflamed and painful underneath and around the nail."

Untreated fungal infections can cause feet to become very dry or result in blisters.

Dry feet are prone to getting lesions and such open wounds can invite bacterial infection, warned Ms Lim. So a simple fungal infection can rapidly become more complicated.

Treatment could be as easy as applying an off-the-shelf anti-fungal solution.

A podiatrist would be able to advise patients if they should thin the nail by shaving it down so the anti-fungal solution can be better absorbed.

Fungal infections can take a few weeks, months or even years to clear, depending on the person's foot hygiene. Ms Tennant said ageing is the most common risk factor for fungal nails.

This is, she said, due to diminished blood circulation, longer exposure to fungi and nails which grow more slowly and thicken, increasing susceptibility to infection.

"Aside from keeping good foot hygiene, there is not much that you can do to avoid fungal infections," she said.

Be wary when you get a pedicure as unclean equipment can infect your nails.

If the foot bath at the nail salon is not properly cleaned after a pedicure, fungi can live there and infect the next person using the tub.

As fungi thrive in warm, moist places, you can get a fungal infection if you walk barefoot in damp public areas such as swimming pools, locker rooms or shower rooms.

Thick and Ingrown Toenails

3 THICK TOENAILS

Thick toenails are another common problem when people age, Ms Tennant added.

"Sometimes, people mistake the symptom for fungal nails, but if you have worn tight shoes all your life, or have engaged in a sport such as tennis or running, you very likely will have thick toenails, especially on the big toe.

"This is because over time, our nails get thicker due to trauma and constant pressure on them."

There is no cure for this, but it does make toenail cutting difficult.

Those with thick toenails can get a podiatrist to cut their nails for them.

4 INGROWN TOENAILS

Ingrown toenails occur when a part of the toenail digs into the skin, causing a great deal of pain and sometimes infections.

Ingrown toenails can happen because of the use of tight footwear or the wrong nail trimming techniques, said Ms Law.

Tight-fitting shoes restrict room for nail growth.

"If the ingrown toenails are due to poor trimming technique, the podiatrist should be able to trim them in a clinic setting without local anaesthesia," Ms Law said.

"In general, nails should not be trimmed too short nor too far down the corners. Ideally, they should be trimmed straight across and the edges filed to ensure no sharp edges dig into the skin."

In severe cases where nails are involuted or turned in, possibly due to trauma or congenital disorders, a more permanent solution, such as nail avulsion surgery, may be required.

Nail avulsion surgery removes the entire nail.

Corns and Calluses

5 CORNS AND CALLUSES

These occur when an area is subject to constant pressure, for example, the ball of the foot or the top of toe joints on a claw toe.

This is a toe that is bent like an inverted V such that it resembles a claw.

Corns are similar to calluses, but are concentrated in a small area and cause a lot more pain.

To prevent corns and calluses, check to ensure that your footwear is nice and roomy in the toebox, which is the most common place for them to occur, said Ms Law.

Wear shoes that fit correctly and do not squeeze your feet into shoes that are too small.

"Shoes should also have adequate padding in the forefoot (ball of the foot) area to cushion the impact of our feet contacting the floor," Ms Law said.

However, in certain cases where there is an extensive foot deformity such as a bunion, changing your shoes may not help to prevent calluses from growing.

In these cases, see a podiatrist to treat the problem, said Ms Law.

joyceteo@sph.com.sg


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