In Gibraltar, we are very lucky to have weather that allows us to wear flip-flops or sandals for most of the year. This feels liberating, but considering that most foot problems are worsened by summer shoes, this comes with a range of health problems for your feet. Sandals, flip flops and ballet flats, whilst pretty, offer almost no arch support for your feet. This can exacerbate problems such as over pronation, shin splints and collapsed arches - AKA the dreaded 'flat feet'. Not only are these problems unsightly, they can lead to joint pains and straining of knees and hips. Wearing open shoes can lead to a build up of hard skin (callous) and makes toes more vulnerable to injury. Feet are exposed to germs from the street, which can lead to infections if the skin is broken. So what is the best way to care for your tootsies? Varying your footwear and alternating shoes every day or so allows feet to have variation in pressure points and keeps shoes fresher. Everyone should have a daily foot routine of washing, carefully drying between the toes and applying moisturiser to dry skin. Diabetic patients should check daily around the feet and between the toes for signs of skin damage. Keeping nails trimmed, and cut straight across can help avoid ingrowing toenails. Patients with diabetes or sensory neurological problems of the legs need to take particular care of their feet, and should already be having annual foot-checks. They should NEVER cut their own toenails. Many people need more intensive treatment than can be done at home, so have professional foot treatments. These may be provided a beautician or a podiatrist. Beauty salons offer pedicures of varying degrees of luxury and should be considered as a pampering treatment rather than heavy duty foot repair. They typically involve a foot soak, gentle scrub, superficial exfoliation and application of cream before cuticles are trimmed and nail varnish is applied. These relaxing treatments will keep your feet looking pretty and can remove a small amount of dry skin. However they are unable to tackle any significant calluses or other foot problems, and are not suitable for those with certain medical conditions. They may cause harm to patients with diabetic feet because even the smallest skin break or burn from hot water could lead to catastrophic, non healing infections in the feet. To really care for your feet, a trip to the podiatrist/chiropodist is in a different league. No longer the reserve of the older generation, podiatry offers a ‘medical pedicure' which is a superpowered pedicure capable of restoring the most unpleasant of trotters and transforming them into glorious things of beauty. A medi-pedi involves medical assessment, surgical excision of dry skin using blades and drills, nail assessment and care, application of nourishing foot cream and overall foot health examination. This is then topped off by an application of medical nail polish which unlike traditional nail varnishes, actively improves the health of your toenails! Podiatrists are experts in all things foot related and can assess and treat ingrowing toenails, bunions, calluses, collapsed arches and gait problems. Treatments are carried out by medical professionals in a safe and sterile environment. The results of this are far superior to and will by far outlast those of a standard pedicure. It’s worth mentioning that Pedicures are one of the most common ways to spread fungal infections, warts and veruccae. Beauticians use a variety of methods of cleaning equipment and some may be inadequate to prevent cross infection. Don’t be scared to ask before embarking upon treatment because all good beauticians will be happy to discuss their infection control policies. Podiatrists always use disposable blades and all other equipment is autoclaved to ensure 100% sterilisation; so you can be confident that your feet will be happy and healthy. As a doctor, I would always recommend that diabetic patients choose a podiatrist over a beautician for pedicures. Actually, scratch that - I think everyone should give it a try. JG Podiatry, Ocean Medical Clinic, Gibraltar www.jgpodiatrist.com The Foot Medic, Bearsden, Glasgow. www.foot-medic.co.uk Margaret Dabbs, Marylebone, London www.margaretdabbs.co.uk by Dr Heather Robertson
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