Common Foot Problems

What are ingrown nails?
Ingrown nails, the most common toenail problem, occur when the nail borders curve into the soft tissue of nail grooves. Ingrown nails cause pressure and pain along the nail borders. The edge of the nail may cut into the skin, causing redness, swelling, pain, drainage and infection.

What causes ingrown nails?
Ingrown toenails are most commonly caused by shoe pressure. Ingrown toenails are also caused by:

• Improperly trimmed nails
• Crowding of toes
• Repeated trauma to the feet from normal activities (such as running, walking or doing aerobics)
• Heredity

How can I prevent ingrown nails?

• Cut your toenails after bathing, when they are soft
• Trim toenails with a nail clipper straight across, slightly longer than the end of the toes
• Do not round off the corners of toenails or cut down on the sides of the nails
• After clipping, smooth toenails with a file or emery board
• Avoid wearing tight, restrictive shoes

How can ingrown nails be treated?
Following the preventative steps above can help you avoid the need for treatment. To relieve discomfort from ingrown toenails, soak your foot in a solution of lukewarm water and salt, or lukewarm soapy water. Then apply an antiseptic and bandage the area.

If self-care measures are unsuccessful or if you have a nail infection, you may need a doctor's care. Ingrown nails may be corrected with surgery by removing part of the toenail and growth plate. Continuing to care for your nails properly and wearing well-fitting footwear can help you prevent ingrown nails from recurring.

What are mycotic nails?
Mycotic nails are nails that become infected with a fungus. The nail may be discolored (yellowish-brown or opaque), thick, brittle, and separated from the nail bed. In some cases, the nail may crumble.

What causes mycotic nails?

• Fungal organisms
• Dark, moist, warm environment of shoes, which promotes fungal growth
• Prior injury to nail, which can predispose nail to fungal infection

How can mycotic nails be prevented?

• Examine the tops and bottoms of your feet each day. If you notice blisters, cuts, scratches or other sores, care for them immediately.
• If you suspect an infected toenail, soak your foot in a solution of lukewarm water and salt, or lukewarm soapy water. Then apply an antiseptic and bandage the area. Although this may relieve discomfort, it is still recommended that you call a doctor.
• Wash your feet every day with mild soap and lukewarm water. Gently and thoroughly dry your feet.
• Care for your toenails regularly.
• Don't wait to treat a minor foot problem.

How can mycotic nails be treated?
If you notice an infected nail, do not try to remove any part of it. Also avoid over-the-counter medications unless prescribed by your health care provider.

Fungal nail infections are difficult to treat. Topical medications are available, but they only help a small number of fungal nail problems. Oral medications may be prescribed instead, including:

• Griseofulvin (Fulvicin)
• Terbinafine (Lamisil)
• Itraconazole (Sporanox)

Other treatment methods include periodic removal of the damaged nail tissue and preventative management techniques.

What are corns?
Corns are a build-up of callus tissue (hard skin) near a bony prominence of a toe or between toes.

What causes corns?
Corns may be the result of pressure from shoes, which rubs against the toes or causes friction between the toes.

• Wear properly fitted shoes; avoid very high-heeled, narrow shoes that push the toes forward, causing them to rub against the shoe
• Wear shoes with increased height or width in the toe area
• Use cushioned pads and insoles

How can corns be treated?
If you have a corn, do not try to cut it or remove it with a sharp object. Instead, soak your feet first in lukewarm, soapy water and then use a pumice stone to gently remove the build-up of tissue. Do not use over-the-counter remedies to dissolve corns.

Corns may be treated by wearing shoes with increased height or width in the toe area and using cushioned pads and insoles. Medications may also be prescribed to treat corns.

When other treatments have not been successful, surgery may be recommended. Corrective surgery involves removing internal pressure by removing a piece of the bone or changing the position of the bone so corns do not form.

What are calluses?
Calluses are a build-up of hard skin, generally beneath weight bearing bony surfaces. Calluses generally occur on the surface under the foot. Note: some degree of callus formation on the sole of the foot is normal.

What causes calluses?
Calluses are caused by an uneven distribution of weight, generally on the bottom of the forefoot or heel. Calluses can also be caused by improperly-fitting shoes or a skin abnormality.

How can calluses be prevented?

• Wear properly fitting, supportive shoes with shock-absorbing soles; avoid leather-soled shoes
• Use cushioned pads and insoles
• Limit periods of barefoot walking

How can calluses be treated?
If you have a callus, do not try to cut it or remove it with a sharp object. Instead, soak your feet first in lukewarm, soapy water and then use a pumice stone to gently remove the build-up of tissue. Use cushioned pads and insoles. Medications may also be prescribed to soften calluses.

When other treatments have not been successful, surgery may be recommended. Corrective surgery involves removing internal pressure by removing a piece of the bone or changing the position of the bone so calluses do not form.

What are plantar warts?
Plantar warts look like calluses on the ball of the foot or heel. They may appear to have small pin holes or tiny black spots in the center. They are usually painful and may develop singly or in clusters.

What causes plantar warts?
Plantar warts are caused by a viral skin infection that occurs on the outer layer of skin on the soles of the feet.

How can plantar warts be prevented?

• Because it is unknown how the wart virus is transmitted, it is best to avoid direct contact with warts from another person or from one part of your body to another
• Limit periods of barefoot walking

How can plantar warts be treated?
Do not use over-the-counter medications to dissolve the wart. If you are not sure if you have a plantar wart or a callus, let your doctor decide.

Plantar warts are difficult to treat with a 100% cure rate, since warts generally have an average lifespan of about 18 months, depending on the infecting virus. There is no vaccine to prevent against plantar warts.

In a doctor's office, topical medications and pads are often used to soften the thickened skin and relieve some discomfort. Freezing the plantar wart with liquid nitrogen is another form of treatment. Surgery may also be considered when other treatment methods are not successful.

When to see your doctor
If you have persistent foot pain, redness or swelling, it is important to visit your doctor. Self-diagnosis and treatment with over-the-counter remedies or "bathroom surgery" may delay treatment and cause more problems. Some foot problems are inherited or could be the sign of another health condition.