If your feet still hurt with well-fitting shoes, or your feet have changed shape so much that no pair of shoes fits well, a podiatrist or other foot expert may be able to recommend insoles or other shoe inserts to allow you to walk comfortably. However, you will still need to replace your shoes at 500-mile intervals (or earlier), and you will most likely need to replace your inserts as well.
I put moisturizing lotion on my feet every day, but the skin on them is still dry and itchy.
Try switching to a thicker lotion or cream, and apply the product more than once a day. For very dry skin, moisturizer should be applied two to four times a day. However, be careful not to put too much between your toes. Too much wetness in this area increases the risk of skin breakdown and infection.
If increased moisturizing doesn’t improve dryness, flaking, or itching, see your primary-care doctor or foot doctor. Very itchy skin is sometimes a sign of a fungal infection such as athlete’s foot.
I have thick calluses on the bottoms of my feet. How can I get rid of them?
Calluses are your body’s way of telling you that you are applying too much pressure to a given area. If you do not have neuropathy, you can use over-the-counter tools to “grate” or file down the callus. The Ped Egg, for example, works well. After reducing the callus, moisturize the skin with a high-quality cream.
If you have neuropathy, calluses are far more serious, because you run the risk of developing an undetected wound underneath the callus. Do not try to treat calluses yourself; instead, have your foot doctor check them regularly. You can prevent calluses in the future by modifying the shoes or insoles you wear to reduce the stress on the area getting callused. Over-the-counter insoles can sometimes work well. For more significant problems, your foot specialist may prescribe insoles or shoe modifications.
Rarely, surgery is required to correct the underlying deformity leading to calluses. This may be considered as an option if a callus puts a person at high risk for developing a foot ulcer.
I’d really like to get a pedicure so my feet look good in sandals, but I’ve heard that people with diabetes shouldn’t get pedicures. Why is this?
People with diabetes are often advised not to get pedicures because of the possibility that salon workers will create small (or large) breaks in the skin while performing the pedicure. Any break in the skin is an access point for dirt and germs, possibly leading to an infection. The other concern about pedicures is that the toenail clippers and other implements used will not be clean, also raising the risk of acquiring an infection at the nail salon.
This doesn’t mean that pedicures are completely off-limits for people with diabetes who have good foot health. Provided the salon is reputable and has a good record of safety, you can get pedicures. However, if you have neuropathy or significant vascular disease, it’s best to forego pedicures: The potential consequences of getting an infection are too high.
I have a hard time cutting my own toenails. Is this something my doctor or a nurse could do for me?
Yes. It is best if a trained medical professional does this, particularly if you have neuropathy or vascular disease. Neuropathy can cause you not to notice small cuts that may occur if toenails are cut improperly or too short, and vascular disease in the legs and feet make you more vulnerable to infection of wounds on the feet.
Your health insurance may cover this type of foot care, but only if your doctor or podiatrist provides evidence that it is medically necessary.
My doctor says I need to treat the fungal infection in my toenails, but I don’t want to take another drug. How important is it really to treat this?
Generally, nail fungus is a cosmetic problem. However, when you have diabetes, fungal infections of the toenails can put you at greater risk for other types of infections and skin problems, particularly as you age. These include bacterial and secondary fungal infections of the skin. For this reason, if your doctor recommends it, you may benefit from a local or systemic treatment for nail fungus.
