The importance of good foot hygiene goes far beyond the need to keep the feet from becoming dirty and developing odor. Proper foot hygiene can prevent the development of numerous foot problems, and for some individuals may save their leg from amputation. This article will discuss the way people can properly care for their feet and keep them healthy for years to come.
Foot cleanliness is an important part of keeping the body clean. Anyone who has ever walked barefoot can relate to that when the soles of the feet become soiled. However, even those who wear shoes all the time are still at risk for ‘soiling’ of the feet. This soiling comes not from dirt but from the natural shedding of the skin, combined with sweat residue, sock lint, or shoe debris if one does not wear socks. All of this material provides a good platform upon which bacteria and fungus can accumulate, and eventually this can cause skin infections. The most common infection seen in the skin is that from a fungus.
This infection is commonly called Athlete’s foot, and millions of humans (if not nearly all) suffer from this condition from time to time. While this condition is easily treated, the long term presence of fungus can distract the skin’s immune system and lead to the sneaking in of bacteria into the cracks and skin ripples that are found in Athlete’s foot. Bacteria is also present in soil and on walking surfaces exposed to other bacteria (like in kitchens and baths), and barefoot walking can potentially expose the skin to these organisms. Bacterial infections are not as benign as Athlete’s foot, and can enter the skin and spread up the foot into the body. For diabetics and others whose immune system is not as strong, these infections can pose a serious risk to the health of the foot and leg, and occasionally they result in an amputation if the infection is serious enough.
By washing the foot, especially in between the toes, the debris and soil that fungus and bacteria accumulates on is removed, and the skin is left with a healthy top surface. Vigorous scrubbing is not necessary, and can lead to skin irritation if one is too aggressive. Careful removal of soap residue is needed, as is the careful drying of the foot and toes to prevent skin irritation from lengthy water exposure.
Another important aspect of good foot hygiene is to keep the feet well moisturized. From time to time, especially in the winter, the foot skin will dry out. For some, this is a result of genetics or diseases which reduce the moisturization of the skin. With drier skin comes more cracks and crevasses that bacteria and fungus can use to enter the skin. Dry skin can also potentially painful cracks so deep that a wound develops. The practice of soaking the foot to either make it moister or to remove fungus or bacteria only makes this worse, as soaking depletes the skin of vital oils that help keep it moist. Some bacteria also thrive in foot baths, and frequent soaking can sometimes cause infections. The daily application of a good moisturizing cream to the feet can keep the skin moist and its surface smooth. It is important not to place the moisturizing cream in between the toes, as this area is at risk for fungus development that can also follow overly moist toe spaces.
Toenails are often ignored when foot hygiene is taken into consideration. Like every other part of the foot, the toenails need care and maintenance to prevent problems from developing. Nails that are too long are at greater risk of breaking off when the toe is stubbed. This can lead to pain, inflammation, and possibly infection of the skin around the nail itself. Nail damage can also lead to the introduction of fungus under the nail itself. The nail will become discolored, thickened, and misshapen from this infection. It is treatable, but a nail fungus infection requires a lot of time for eradication. Keeping the nails short can prevent some of this nail injury by reducing the likelihood of the nail lifting up during an injury event. In turn, this can reduce the chance that a nail fungus will develop. Although generally benign, nail fungus is still a chronic infection and should be avoided. However, not all changes to a nail’s color or appearance is simply a fungus. Any color change in a toenail should be evaluated by a foot specialist or dermatologist, as some skin cancers or body-wide disease appear as changes to a toenail.
When trimming nails, care must be taken not to cut too deep into the skin sides. The reason for this involves ingrown nails. Ingrown nails develop as a result of genetics or gradual pressure injury to a nail. Contrary to popular belief, they are not caused by cutting the nail, as the nail grows from the deep end of the toe, which is not affected by the way it is cut. However, by cutting the nail too short into the side of the skin, one irritates the skin. A reaction then develops which causes skin inflammation. The inflamed skin becomes irritated against the ingrown nail that did not previously bother it, and pain subsequently is felt. Infection can follow as bacteria becomes trapped within the swollen skin border. While this condition is easily and permanently treated in-office by a foot specialist, avoiding it by trimming the nails without cutting into the skin may be an easier option.
Properly fitting shoes are another consideration in foot hygiene. Shoes are worn for many reasons, although the basic reason for shoes is to protect the feet from the ground. This protection is at risk when one wears poorly fitting shoes simply for fashion or convenience. Shoes that are too tight, too narrow, or too shallow will cause skin irritation to occur where the shoe rubs the skin. If the irritated area is over a prominent bone, such as on the toes or sides of the foot, the skin may start a process to protect itself. This process leads to the formation of corns and calluses, which is simply a thickening of the top layer of the skin created to protect the skin. Corns and calluses can cause pain, and in some cases (especially in diabetics and the elderly) can lead to the development of wounds underneath them. By reducing the shoe pressure on the skin through the use of a properly sized and fitted shoe, the development of corns and calluses can be slowed or even eliminated.
When a shoe is worn that is too big for the foot, the foot will move and piston within the shoe during walking. This ultimately can lead to toenail bruising as well as foot pain. When purchasing shoes, one’s foot should be measured by a knowledgeable shoe clerk and the shoe fitted to that size, considering length AND width. A foot’s width is often ignored when purchasing shoes, especially given that many retailers have scaled back the selection of different widths in stock. In the long run, purchasing shoes at a quality shoe store that carries many widths is better that the convenience of a discount retailer that has more styles but less sizing variations. The style of the shoe needs to be considered as well. Someone with a wide foot due to bunions and flat feet should not be in a tight pair of pointed flats. Unfortunately, many people stubbornly refuse to change shoe types out of concern for fashion or the inability to change old habits.
As one can see, the importance of foot hygiene involves much more that just the act of keeping the foot free from dirt and odor. Keeping the skin and nails healthy prevents the development of infections, and keeping the skin smooth and comfortable prevents the development of painful lesions that can limit activity and the enjoyment of life. Making time for the foot during daily body care can pay off in a big way over the long run.
Dr. Kilberg provides compassionate and complete foot and ankle care to adults and children in the Indianapolis area