Warts

Warts are caused by a virus that penetrates the skin, forming a raised, fleshy bump. They can crop up on any part of the skin, including the feet. Some warts go away on their own without treatment; others recur, grow in size, or spread to form clusters of warts. In general, warts are not harmful and do not cause pain or discomfort; however, they are contagious because they stem from a virus.

On the foot, warts can grow on the sole and toes, as well as any other part. Plantar warts occur on the sole of the foot and are flatter and less fleshy than most other warts. They can result from walking barefoot on dirty, germy surfaces that harbor the virus. Viruses prefer a warm, moist environment, so public areas with wet floors, such as swimming pools and showers are perfect breeding grounds for plantar warts. Plantar warts on the heel or ball of the foot can be painful and sensitive due to the pressure placed on these areas of the foot.

To avoid plantar warts, wear plastic or rubber shower shoes, slides, or flip-flops rather than walking barefoot on damp floors or ground, especially in public areas. Remember, warts are contagious and will spread person-to-person or to other parts of the body. Maintain proper foot care, keeping feet and footwear clean and dry.

There are over-the-counter wart treatments; however, warts can recur or resist treatment (consult a doctor before taking or using any medication). Wart removal is best left to a doctor; podiatrists can safely treat any wart on the foot using a variety of methods, such as prescription medications, surgical removal, and laser cautery.

Ulcers

Ulcers are persistent wounds or sores that do not heal properly or become chronic. Ulcers on the feet occur mainly due to reduced nerve sensation, poor circulation, vein dysfunction, and constant pressure to a particular spot. Diabetics are prone to foot ulcers. Ulcers may or may not cause pain and can be accompanied by swelling, discomfort, redness, itching, burning, and irritation.

Foot ulcers can crop up due to metatarsal deformities that impact the bottom of the foot, exposing particular spots to constant pressure that causes the skin to callus, separate, and possibly become infected. For bed-ridden patients, foot ulcers can form on the backs of the heels due to constant pressure on the skin from the bed.

Ulcers have four stages of severity that are based on how deeply the wound or sore penetrates through the skin:

  • The first stage of ulcers involves redness and irritation that occur where bones protrude or constant pressure is applied. The affected area’s skin may stay red even after pressure to the spot is alleviated. There may be accompanying discomfort and pain.
  • The second stage of ulcers involves the top two layers of skin. Blistering, peeling, and cracking skin are signs of stage two ulcers. Tenderness and pain are felt in the area of the ulcer.
  • The third stage of ulcers involves deeper penetration in skin breakdown. The tissue between the skin and muscle are affected, and broken, bleeding skin appears. At this point, pain may diminish because of more severe tissue damage.
  • The fourth stage of ulcers involves even deeper penetration of damaged tissue, pervading all the way to the muscle, tendon, and bone. It can result in bone or blood infections. Again, the damaged tissue may not generate pain or discomfort.

Ulcers should be treated by a doctor who can properly evaluate, diagnose, and treat any underlying medical conditions, as well as properly care for the wound to prevent infection.

Swelling

Edema is the swelling of one or both feet, ankles, and/ or legs due to fluid accumulation. It can occur as a result of various medical conditions and is fairly common, particularly in the elderly who may suffer from weakened circulatory systems or diseases. In some cases, the swelling can indicate a serious medical problem or health issue, such as heart, kidney, or liver dysfunction. The swelling can also result from inflammation of tissue due to an injury or inflammatory disease such as arthritis.

  • Edema of the lower extremities can result from the following conditions:
  • Medical diagnostic tests, treatments, procedures, and therapies
  • Medications
  • Injuries or burns
  • Allergies and reactions to the environment (sunburn, insect bites)
  • Sitting (during lengthy flights or car trips) or standing for prolonged periods of time
  • Nutrition imbalances and lack of proper nourishment
  • Kidney, liver, or heart failure
  • Hormone imbalances (estrogen, birth control pills, testosterone)
  • Menstruation and pregnancy
  • Surgery in the foot, ankle, or leg
  • Excessive bodily fluid
  • Vein and circulation problems

To treat edema, the swollen lower extremity can be raised while lying down to place the affected area higher than the heart. Edema can be prevented by walking to improve circulation to the legs and feet; be sure to stand up and walk around during prolonged periods of sitting, even during traveling. Avoid constricting clothing on the legs that can cut off circulation. Exercise is a good way to keep blood and bodily fluids flowing properly, and diets high in sodium should be avoided.

Since edema can indicate a more serious underlying medical condition, it is best to consult a doctor for prolonged or recurring cases of swelling in the lower extremities, as well as edema accompanied by other symptoms.

Skin Allergies

Skin allergies occur when the skin becomes inflamed and irritated from exposure to or contact with a particular substance. The two types of contact dermatitis, or skin allergies, are irritant dermatitis, which is caused by a non-allergic reaction to an irritating substance, and allergic dermatitis, which is caused by an allergic reaction or sensitivity developing from an irritating substance.

Irritant dermatitis can result from prolonged exposure to, contact with, or improper use of an alkaline or acid substance. Some common substances that trigger irritant dermatitis are soaps, detergents, pesticides, chemicals, rubber materials, and certain hair products. Even overexposure to hot water can cause this type of skin allergy.

Allergic dermatitis results from an allergic reaction or sensitivity to a particular substance. It can be chronic or develop with repeated exposure to the allergen over time. Common allergic dermatitis triggers are adhesive materials, skin antibiotics, personal hygiene and cosmetic products, fragrances, fabrics, metals, poisonous plants, rubber, and latex. Airborne allergens can also cause allergic dermatitis.

Symptoms of contact dermatitis commonly crop up on the hands, face, neck, and scalp, as well as other areas of skin that have been exposed to the irritant. The skin may have patches or areas inflamed with redness and rashes, accompanied by itching and/ or burning. It may be warm to the touch, itchy, scaly, and crusty. Upon contact with a known irritant, the exposed area of skin should be washed and rinsed thoroughly to get rid of the potential allergen.

Treatments to provide relief of contact dermatitis include emollients for sensitive skin, topical steroid skin creams, antibiotic ointments, or even prescriptions. Always consult a doctor before using any type of medication. Doctors can also test patients to identify trigger allergens if chronic contact dermatitis is a problem.

Psoriasis

Psoriasis is a skin condition that can appear on the legs and feet, as well as other body parts. It is a chronic disease of the immune system wherein new skin cells surface too rapidly, causing inflamed, flaky, thick patches of skin buildup. Psoriasis is characterized by the appearance of thickened skin patches with white, red, and grayish-silver pigmentation. The areas can be small and localized or larger and more widespread. Psoriasis can cause itching and pain as it progresses.

On the feet and toenails, psoriasis may be mistakenly assumed to be athlete’s foot and other fungal infections. Psoriasis can also affect the joints in the feet and legs, causing arthritis. Psoriasis can be hard to treat, but psoriasis sufferers may gain relief from moisturizing lotions and creams, anti-inflammatory medications (check with a doctor before taking any medication), and prescription medications issued by a doctor.

 

Lesions

A skin lesion is a variation on the skin’s surface, where the affected area is a different color or texture from the surrounding skin. Skin lesions can appear on any part of the body, including the legs and feet, and may be present at birth or develop over time due to conditions such as acne, injuries, diseases, aging, sun damage, allergies, and cancer. Skin lesions can be small or large and can vary in number. Some examples of common skin lesions are freckles, moles, warts, birthmarks, acne, rashes, and boils.

Although most skin lesions are benign, any change or difference in skin tone or texture should be observed, as changes may indicate that a harmless skin lesion has become malignant. Diabetics and those suffering from weakened immune systems may have skin lesions as a result of the disease. Areas subjected to sun exposure, such as the tops of the feet, can be sites where cancerous skin lesions develop, such as malignant melanoma and actinic keratosis. AIDS or HIV-positive people may have Kaposi’s sarcoma lesions appear on the soles of the feet. These cancerous skin lesions are purplish in color, irregularly shaped, and spread out on the skin’s surface.

If you have a skin lesion that has changed in size, shape, or color, be sure to have it immediately checked by a medical professional. A podiatrist can assist you with skin lesions on the feet and legs. Suspicious or malignant skin lesions must be removed by a doctor.

Gangrene

Gangrene, or dead body tissue, occurs when blood flow and oxygen are cut off or severely restricted. Gangrene can result from bacterial infections deep frostbite, or open sores that do not heal properly. Those with weakened circulatory systems and nerve damage, such as diabetics, are more prone to foot gangrene.

Gangrene is characterized by acute, sudden pain or numbness in a lower extremity, which may be accompanied by skin that feels cold and looks darker than usual. Wet gangrene shows signs of tissue decay; redness, oozing, swelling, and foul odor at the site may be present.

It is important that gangrene areas are removed surgically to prevent infection that can move quickly throughout the body and cause death. If gangrene is suspected, seek immediate medical help.

Frostbite

When outdoor temperatures drop to near or below freezing, frostbite can occur after exposure to cold conditions for an extended amount of time. Frostbite can involve damage to the skin, tissue, and even underlying nerves, muscles, tendons, and bones in more severe cases. The body reacts to exposure to cold by constricting its blood vessels, which restricts the flow of blood and oxygen, particularly in the feet, hands, ears, nose, and lips. A lack of circulation can lead to dead skin and tissue.

Frostbite most commonly affects the elderly and diabetics, as they have poorer circulation to these areas. Children are also more susceptible to frostbite because of their smaller extremities. Those who are exposed to cold temperatures for long periods of time, such as outdoor workers and the homeless, are at an increased risk for developing frostbite.

Superficial frostbite affects only the three layers of the skin and can penetrate to the third, or subcutaneous layer. Deep or advanced frostbite is a very serious condition, when the damage has spread to the nerves, muscles, tendons, and even bones. In this case, the skin may turn white, blue, or even black. The frostbitten areas may have gangrene, or dead tissue, which may need to be surgically removed to prevent infection. Although frostbite sufferers can fully recover, they may experience a lasting sensitivity to cold and be more prone to future cases of frostbite.

If frostbite strikes, immediately get medical help and find a warm environment. Rather than warming the skin with too hot of a source, such as sitting close to a portable heater or fireplace, gradually return the skin to a warmer temperature. Thawing the skin and then subjecting it to refreezing is particularly dangerous.

Frostbite can be prevented by avoiding prolonged exposure to freezing temperatures. If you will be outside in frigid temperatures, keep the feet warm and dry by wearing appropriate socks and boots. Go inside frequently to warm up, and be sure to remove any wet clothing, as wet skin is more prone to frostbite. Again, do not thaw and refreeze frostbitten skin.

Foot Odor and Sweaty Feet

Since the feet have over 250,000 sweat glands, problems with foot odor are quite common. The condition of smelly feet can arise from sweaty feet due to the accumulation of bacteria that feed off of the sweat. Since feet sweat are prone to sweating, shoes and socks are a dark, damp environment that serve as a friendly host to the bacteria that live off of perspiration and sweat. Feet can become overly sweaty due to hyperhidrosis (a genetic condition) or as a result of stress, medications, body changes, or fluid consumption.
To conquer foot odor and sweaty, smelly feet, special care must be taken of the feet directly, as well as socks and footwear. Here are some helpful pointers to control sweaty, smelly feet:

  • Wear clean socks made of cotton or another absorbent material and change them at least once a day; be sure to always wear socks with closed footwear to absorb sweat
  • Wear clean footwear made of breathable materials to allow air circulation; alternate footwear and do not wear the same pair for consecutive days
  • Clean feet daily with warm, soapy water, then rinse and dry well
  • Apply powder to clean feet to help absorb excess moisture
  • Soak feet daily to help control odor (there are Epsom salt, herbal, black tea, and vinegar foot soak remedies that are recommended)

Corns

Corns form on the toes due to friction or pressure from rubbing against footwear or even other toes. The friction and pressure thickens the skin and inflames underlying tissue. Corns can be soft; these are open sores between the toes. Hard corns develop on top of the toes or on the outside of the little toe. Ill-fitting footwear and toe deformities can cause corns.

Treat corns by soaking the foot in warm, soapy water, then rubbing the skin with a pumice or appropriate foot file. Donut-shaped foam pads can reduce friction and pressure on the corn. Podiatrists also have methods for reducing corns.