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Foot Care Q&A: Part 1

by Joy Pape, RN, BSN, CDE, WOCN, CFCN

Dennis Janisse: To prevent athlete’s foot, keep your feet clean and dry. Wear socks that wick moisture away rather than absorb it. There are socks made with copper, which has antifungal properties. For example, check out Aetrex Copper Sole Socks.

Dr. Scheffler: First determine if that is what you have. Many times it looks like dry skin. Over-the-counter athlete’s foot preparations won’t do any harm. If one of them works, great. If you have it, know that it will most likely come back. If it is in your nails, shoes, or elsewhere, it all needs to be treated. The over-the-counter products won’t penetrate your nails. You most likely have to treat your nails as described earlier. You must also treat your shoes and your home environment.

5. I have hammertoes. What is the treatment for that?

Hammertoes are the permanent bending — or downward curling — of one or both joints in the second, third, fourth, or fifth toes. It can also happen in the first toe (the big toe), but it is not as common there. Most problems arise in the second toe due to the longer length of the toe.

Dr. Wu: Hammertoe treatment is dependent on how rigid or stiff it is. This simple test helps determine the rigidity of the toe: Use your finger to try to straighten out the toe. If the toe can be straightened, it’s what we call a “reducible” deformity. If the toe cannot be straightened, it’s what we call a “nonreducible” deformity. For the toe that can be straightened, there are hammertoe straps and splints that can help realign the toes. It is important to have your podiatrist recommend one for you, however. Not all of the hammertoe devices you may see advertised in magazines will be the right one for you.

For a toe that cannot be straightened, surgery is usually necessary to correct the hammertoe. In general, we advise people to switch to more comfortable footwear. Pointed and high-heeled shoes are not recommended, because both force the toes to rub against the front part of the footwear. People who develop corns and calluses from the hammertoe may want to see a foot doctor to have them trimmed and may benefit from toe padding to help prevent further irritation. Corticosteroid injections are used from time to time to alleviate the pain and swelling. Some people have gone so far as having their foot doctor inject dermal fillers to internally pad the area to allow them to wear high-heeled shoes without irritation.

Dr. Smukler: Hammertoes are bone deformations. You cannot really treat them without surgery. There are straps to prevent blisters or protect existing blisters from developing into open wounds. Without proper treatment, sooner or later a callus will develop.

Dr. Scheffler: Hammertoes are a deformity. The best treatment is surgery for straightening the toe. If you have neuropathy or peripheral arterial disease, however, surgery may not be an option for you. You need to remove pressure from the bone on the inside, and from the shoe on the outside. Wear shoes with a wide and deep toe box. There are products that hold the toe in a straightened position, such as so-called Budin splints, and gel pads to cushion the underside of the toes. It’s best to see your podiatrist for a recommendation on what you need.

Dennis Jannise: Shoes can accommodate most hammertoe-type deformities. Unfortunately, many people don’t like the way the shoes look because they are similar to the way their feet look. Surprise! Toe gadgets with straps and elastic really don’t work and can be very dangerous for people who have diabetes.

Dr. Beauchamp: Hammertoes come in various forms. Some of them are rigid, and some are flexible. There can be multiple causes for the deformity such as hereditary orthopedic deformity or biomechanical compensatory changes. Some respond well to padding and splinting devices, and some may require surgical intervention.

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