Summer Blog Series: Blisters, Ingrown Toenails and Athletes Foot

August 30, 2012 Posted by Dr.Chang

Blisters are a result of the abrasion between your skin and sock or shoe. Because they can arise suddenly, it is important to take preventative measures to ensure your foot’s comfort. Preventing blisters begins with well fitting shoes, not too snug yet not too lose. Your socks should be snug fitting and made out of synthetic wicking material and with seams that cause minimal abrasion. Even after taking such precautions, many runners and athletes get blisters. If you find that you are prone to blisters, try regularly applying moisturizer to your feet, as dry skin is prone to friction, leading to blisters. Additionally, you may want to try rubbing your feet with Vaseline before a run if dryness is a problem for you, using foot powders to decrease moisture if your feet sweat too much, or wearing two pairs of socks so that they rub together instead of rubbing against your skin. You podiatrist may also prescribe prescription antiperspirants for more effective drying.

The rule of thumb is to leave small blisters intact so that the outer layer will protect the skin underneath. If you do get a blister on or off the trail, and it is large enough to see fluid inside, the best thing to do is to drain it and avoid it popping during activity. First, wash the affected area with soap and water. Sterilize a needle by rinsing it and soaking it in rubbing alcohol. Do not put the needle in a flame for sterilization as this method can lead to getting infectious carbon bits in your skin. Next, make a hole in the blister and squeeze out the fluid. Avoid removing the skin over a blister, because it provides padding and protection for the new skin growing underneath.  Finally, use hydrogen peroxide to prevent infection and wrap the area with antibiotic ointment and a bandage. You may want to use products like Second Skin or Band-Aid Blister Blocks, or soak your foot in Epsom salts to draw out fluid when you take off the bandages. If you find your blister is emitting yellow or green discharge, swell or reddens, you will want to see your doctor, as it is most likely infected. Additionally, if your blister is under or at the base of the toenail, see your podiatrist for treatment. Home removal of the toenail can cause infections and other complications, but your podiatrist will know how to drill a hole in the nail with an electric file.

Ingrown toenails are one of the most commonly treated ailments. These are nails that are incorrectly shaped, so that they curve and grow into the skin, usually at the sides of the nail. This irritates the skin, causing pain, redness, swelling and warmth in the toe. Your toe may incur an infection if the nail breaks the skin, allowing bacteria to enter and cause an infection (indicated by a foul odor and a discharge of discolored fluids).  Ingrown toenails can be caused by a number of factors. While they are often hereditary, they can be the result of traumatic injuries, improper trimming, poorly fitting footwear, and nail conditions (such as fungal problems).

Home treatment of ingrown toenails should be limited to consistently cutting and filing the nail straight across and soaking the nail in Epsom’s salt. Never cut notches in the nail, do not repeatedly trim the nail borders, and do not place materials (such as cotton) beneath the nail, as all of these methods increase the likelihood of bacterial infection. Over-the-counter topical medications only relieve pain but do not cure the symptoms. “Home surgery” on your ingrown nails is not recommended, since repeated cutting of the nail can cause the condition to worsen over time. If your nail does not improve, visit your podiatrist for a simple procedure. Dr. Chang and Dr. Murray can easily perform a minor surgical procedure. They will take off the small offending border that is causing pain and permanently remove it so that it does not grow back into your skin. Note that they do not remove the entire nail, so this simple procedure can alleviate your pain with minimal recovery time.

Athlete’s foot, officially known as tinea pedis, is a fungal infection between the toes and on the soles of the feet. With this infection the skin on your foot may feel itchy or painful, will have scales redness and blisters. Podiatrists will recommend the applications of a fungicide such as Desenex, Tinactin, Lotrimin or Lamisil. Using these products a few times a day for two weeks to a month will help remedy the irritation and other symptoms. If symptoms reoccur, be sure to rotate the fungicide you use so that the fungus does not build up a tolerance to one brand. You may want to try additional remedies for the itching, such as soaking your feet in a baking soda and water solution, removing the dead skin with a pumice stone, or rubbing fine sandpaper along the bottoms of the feet (and disposing of the sandpaper after use!).

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