Dr. Ami Sheth sees a lot of bashful patients. They have warts or nail fungus, calluses or athlete’s foot. They’re not only embarrassed because the conditions make them want to hide in sneakers during sandal season, but they cower in Sheth’s office because many think “it’s petty” to seek help, says Sheth, a podiatrist in Los Gatos, California, and spokeswoman for the American Podiatric Medical Association. “But it’s not petty,” she says.
While some foot problems are admittedly more cosmetic than medical, others have real consequences. Take calluses, for instance, which can seem like harmless annoyances. But if they’re not treated, they can change the quality of the skin, damaging its elasticity. “If the skin can’t stretch, it’s going to tear, and if it’s going to tear, it’s going to crack, and if it cracks, it can get infected,” Sheth says.
Certain populations, too, are at greater risk for complications from toe woes. “The game changes if you have diabetes,” Sheth says, since you may be more prone to infection, sweat more (or less) or have different muscle changes than people without the condition.
Older adults also need to treat their feet like royalty, says Dr. Mark Holzberg, a clinical assistant professor of dermatology at Emory University School of Medicine. “Keeping their nails trimmed, keeping their feet comfortable and [wearing] good-fitting shoes” is important for avoiding falls, the leading cause of both fatal and nonfatal injuries in adults ages 65 and older, according to the Centers for Disease Control and Prevention.
Even healthy young adults can fall victim to foot conditions that are unattractive and sometimes painful. Here are some of the most common — and what you can do to prevent or treat them. The sun and the sand are waiting.
1. Warts
Rather than on witches’ noses, warts often pop up on feet or between toes, says Dr. Chris Adigun, a dermatologist in Chapel Hill, North Carolina. “The wart virus is pretty ubiquitous,” she says. Most common are plantar warts, or those that appear on the underside of your foot and usually cave inward. “You can feel like you’re kind of walking on a marble,” Adigun says.
While over-the-counter salicylic acid treatments can work for warts if you apply them diligently, many people can’t rid themselves of their growths until a dermatologist freezes them off with liquid nitrogen or injects them with a medication.
Some warts go away on their own, but it’s better not to wait, since they are caused by the HPV virus and after many years can develop into a skin cancer, Adigun says. Better yet? Do your best to prevent them altogether by wearing flip-flops when you’re at the pool, for instance, or by covering up completely if your foot has a wound.
But don’t feel bad if you get one regardless, Adigun says. “Sometimes people do everything right and they still get a wart.”
2. Ingrown Toenails
When Adigun gets her toenails done, she asks the pedicurist to forgo the tools, which can damage the skin around the nail and lead to ingrown toenails — pieces of nails that grow into the skin. The painful condition can also be caused by constantly wearing narrow or pointed shoes, or by nails that have been clipped too short. “The problem is that when that nail grows, it has nowhere to go but into the skin,” Adigun says.
If you already have an ingrown toenail, try putting medical tape on the skin surrounding the nail and pulling it away. “Sometimes,” Adigun says, “if you do that, you save yourself a trip to the doctor and your pain is alleviated.” But if the toe gets more irritated or drains liquid, head to a clinician. He or she may need to remove part of the nail or even part of your skin to allow the nail to grow up and out.
3. Foot Fungus (Athlete’s Foot)
Foot fungus can look as bad as it sounds — either manifesting as red, scaly, wet and lacerated or simply very dry — but the good news is that it’s usually pretty simple to treat. “The best thing to do is walk into your drugstore and buy an antifungal cream,” Adigun says. If that doesn’t work after a week or two, go to your doctor, who can prescribe a prescription-strength product.
In worse news, athlete’s foot is contagious, so keep your feet protected and warn family members if, for instance, you share a shower. Then, stave off future infections by using an antifungal spray on your feet regularly. Untreated fungus can develop into secondary bacterial infections or invade the nails.
4. Nail Fungus
Nail fungus, which often causes nails to crumble or turn yellow, can make patients particularly self-conscious, Adigun says. “It’s amazing how much it impacts people’s sense of well-being and sense of appearance.”
But nail fungus is relatively common, accounting for about 40 percent of all nail disorders, according to Holzberg. While most people develop nail fungus from athlete’s foot that has spread, you can also be vulnerable if your toenail breaks or falls off from running a marathon, say. And like foot fungus, there’s a strong hereditary component. “You generally find fungal infections run in families,” Holzberg says. “Nobody knows exactly why.”
Treating nail fungus is more complicated than treating foot fungus, though. Over-the-counter topical treatments are aggressively marketed but rarely effective, Holzberg says. Even laser treatments have gained approval from the Food and Drug Administration, but only for “amelioration” of the fungus’s unfortunate appearance. Medically, “it really doesn’t work,” Holzberg says.
Treatment typically includes oral medications like terbinafine, which Holzberg says work about 80 percent of the time. “They’re pretty easily tolerated, good-safety-profile medications,” he says.
Even so, he encourages patients to use a topical product in addition to the pills — and to continue using it “every day for the rest of their lives.” If you’re predisposed to fungus, Holzberg says, “you’re often going to get it back again.”
5. Bunions
Bunions can create a catch-22: Sandals can make feet feel better, but they also tend to give the bony bumps center stage. “In the summertime, people [with bunions] start noticing that their feet don’t look like other people’s,” Sheth says.
A bunion is a joint misalignment where the big toe — or sometimes the little toe — swings inward and causes a protrusion. “Now the big toe doesn’t do its job because it’s totally out of the way,” she says. That can throw off your whole body’s alignment, spark arthritis in your toe joint or cause your other toes to curl under (hammer toes).
Mild bunion cases that aren’t painful can sometimes be kept relatively stable with monitoring, shoe inserts or by wearing supportive shoes. Other times, surgery is recommended to realign the joint.
“You never want to run into surgery when it’s not needed, but you want to catch it before you start having these secondary changes from other toes,” Sheth says. Her mission statement? “I want people to be able to do what they want to do for as long as they can do it.”
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5 Embarrassing Foot Conditions — and What You Can Do About Them originally appeared on usnews.com