January 07th, 2025

How to have happy feet
Nine to noon/national programme

Why do we get corns or bunions and what can be done about it? Should you tackle your own ingrown toenail? And socks, cotton or wool?
 
Christchurch podiatrist Simon Wheeler is the man in the know about how to look after our feet.
 
Toenails
A little but often is his trimming advice.
 
“Rather than once in a blue moon and trying to cut them right back, aim just to cut them straight across the free edge.”
 
Buying the right shoe
Wearing a properly fitted shoe with support and cushioning, is important, and Wheeler suggests supporting your local shoe shop is the way to go.
 
“The trend at the moment is purchasing online, but it’s quite hard to buy footwear online. I think it’s best to actually be fitted at a shop.”
 
Socks and foot hygiene
They need to be changed daily, he says.
 
“Some people sweat more than others, some people will have to change socks more often than daily, particularly if you have gone out and done some sport or activity.
 
“You want to make sure you've got moisture wicking socks. Thin cotton socks do not move moisture away from the skin. You end up sitting in a pool of sweat or moisture.”
 
Go for woollen socks, he says.
 
Toenails as we age
Toenails, like skin and bone, are living and respond to load or to irritation, he says.
 
“They generally thicken because they suffer from trauma. And obviously the older, the longer we live, the more trauma they suffer.
 
“So that's why they thicken up. The most common reason that could be like a one-off trauma, you dropped a hammer on it a cricket ball or whatever.”
 
 
Toenail fungus
“It's common, it's hard to treat. It gets into the nail bed and then in the nail,” he says.
 
Treatments include prescription medication which can “have some quite harsh side effects.”
 
Laser treatment is also an option, but prevention is the best method, he says.
 
“Foot hygiene, first signs of fungal skin infections, athlete's foot, get onto a fungal cream really quickly.”
 
Over the counter anti-fungal creams are highly effective, he says.
 
“The creams for skin infection are 100 percent very effective. Once it starts to get into the nails the more in depth it is in the nails the harder it is to treat.”
 
In-growing toenails
The condition is often hereditary, he says.
 
“They're quite often present in their early teenage years as we start to sweat a bit and the feet are growing.

“And then again, it can be as a result of trauma. You've got to trim them straight across and the risk of you cutting them back yourself is that you introduce a portal for infection, or you miss some of it and you make it a hell of a lot worse.
 
“If you've got an ingrowing toenail with what looks like a skin infection, I would seek podiatry help immediately, as quick as you can.

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Listener questions:
 
The soles of my feet are covered in coarse, scaly skin and underneath red weeping skin, it's very itchy. I'm desperate.
 
“That sounds like a skin infection of some sort. And so, you should seek medical attention for that. So, a GP or potentially your local podiatrist.”
 
What do I do about thick, yellowing skin that’s become painful?
 
“This is known as a callus, the skin is a living tissue, it responds to what load you put through, the thickened skin or the calluses is its way of protecting itself.
 
“However, often that goes too far. And that yellow thickened skin becomes quite uncomfortable to stand on so often a podiatrist would debride that and take that skin away, which provides instant comfort.”
 
I have damp skin splits that happen between my toes is that athlete's foot?
 
Yes, skin hygiene; natural fibre socks, so we're getting moisture wicking, and antifungal cream, over the counter from the pharmacist.”
 
 Is it important to wash and dry feet when you're in a shared space like a gym shower?
 
“You probably want to wear some real simple, rubber old-school jandals in the shower. And definitely dry thoroughly. So, they're not damp when you're putting them into footwear particularly in the winter.
 
“Otherwise, they're just moist going into that warm, damp environment.
 
“Some people are prone to it, there's no doubt about that. Like some people just seem to get athlete's foot at the sniff of going to a shared shower
 
“If you’re prone you can use the creams for prevention, use sprays these help and anti-fungal talcum powder that you can pop your socks or shoes.”
 
Another listener suffered from painful cracked heels
 
“People that are prone to heel fissures tend to get them again and again, so if you get them, you're going to get them in the future.
 
A regular moisturiser, and you can get cracked heel balm which is a bit thicker. It’s really good to use regularly, especially at the first sign of the crack.”
 
What's your advice for the management of bunions to reduce pain and prevent worsening?
 
“There's, different types of orthotics. Prefabricated ones, but you can get custom made ones which, are probably significantly dearer. But they do a phenomenal job.”
 
Should I pop my blisters?
 
“Probably not, it does give pain relief, but also potentially leads to infections. So salt-water bathing maybe, you’ve got to keep them clean.”

Reference:         https://www.rnz.co.nz/national/programmes/ninetonoon/audio/2018939449/how-to-have-happy-feet