Foot problems Dr Rob Hicks Each foot is an engineering masterpiece made up of 26 bones, 33 joints and more than 100 muscles, tendons and ligaments. But we tend to ignore our feet and take them for granted - until something goes wrong.

In this article

Corns and calluses Plantar fasciitis

Athlete's foot Toenail problems

Verrucas Foot note

Thick and hard areas of skin (calluses) can appear anywhere on the feet where persistent rubbing or uneven pressure occurs. The most common places are the heel, the ball of the foot and the side of the toes, where flat feet, bunions or ill-fitting shoes may be responsible. As time goes by calluses may become cracked and painful or develop into corns.

Corns come in two types:

• Soft corns appear between the toes because of unusual pressure
• Hard corns are found on the top or the end of the toes, or the soles of the feet and are caused by abnormal pressure

Corn plasters can sometimes help and two types are available over the counter in pharmacies - medicated and non-medicated.

Medicated corn plasters contain salicylic acid to soften and break down the hard skin, and can sometimes help on the sole of the foot. They should never be used on or between toes where the skin is much more delicate and they must never be used by diabetics whose feet might be easily damaged.

Non-medicated plasters, usually small doughnut-shaped pads, tend to be more effective as they relieve pressure from the corn.

Using a pumice stone or an emery board can also help with removing hard skin but they don't work well for corns, tending to remove the overlaying hard skin but leaving the deeper and more painful corn 'root'.

Moisturising helps to prevent recurrences of corns on the sole of the foot, but shouldn't be used for soft corns as they will already be moist.

If the problem persists, visit a podiatrist (chiropodist). He or she may recommend a padded insole. Correctly fitted footwear also plays an important role in avoiding or remedying foot problems.

The plantar fascia is a fibrous band that stretches between the heel and the base of the toes. It helps to maintain the structure and shape of the foot. This can often be the cause of severe heel pain. Plantar fasciitis causes small tears to appear on the heel and becomes inflamed and extremely painful.

Typically, pain is felt first thing in the morning after getting out of bed but recedes after around 30 minutes as the band is stretched and the swelling is reduced. Pain can also be felt under the arch of the foot after prolonged walking or standing.

Plantar fasciitis is more likely if you have:

• Flat feet
• High arches
• Weight problems
• Suddenly become more active (you have begun an exercise programme, for example)

It can get better with rest, but this can take a long time and the pain can be so severe it prevents some people from walking.

Treatment involves resting the foot as much as possible, applying an ice or heat pack to the heel, stretching and strengthening exercises, taking anti-inflammatory medicines or wearing appropriate footwear and insoles.

It's not only athletes who get this fungal infection, which loves to grow in warm, moist areas of the body. Between sweaty toes is an ideal home for the fungus, which is usually picked up from swimming pools and communal changing rooms.

It makes the skin itchy, red and sore and, if not treated, the skin soon becomes soggy and starts to crack and peel. The fungus can also spread to the toenails.

If the area affected is moist, it should be treated with an anti-fungal spray; if the area is dry, use an anti-fungal cream. These are available from your pharmacist without prescription. In mild cases powder can be used.

To prevent it returning, pay attention to drying between the toes after bathing. Regularly dabbing between them with surgical spirit on cotton wool is a good idea for very sweaty feet. Make sure you allow your shoes or trainers to dry out for at least 24 hours after you've worn them - this means not wearing the same ones every day.

Never use creams between your toes as this will make them more moist.

During an average three months, a toenail grows 1cm (at 0.1mm each day). White spots can appear following simple knocks to the nail, vertical ridges appear with age and fungus can invade from the surrounding skin.

Avoid pointing anything sharp down the sides of a toenail because it can become infected and will be swollen, red and painful. Similar symptoms happen when the toenail grows into the corner - an ingrowing toenail.

Usually, removal of the offending nail spike by a podiatrist, gentle cleansing and sometimes antibiotics are all that are required to treat an ingrowing toenail, but an operation to remove part of the toenail is sometimes necessary.

These are caused by a virus that infects the skin. They're similar to warts on hands. They can be difficult to spot and are often painless when small. They usually appear as areas of rough skin, sometimes with tiny black spots in them.

Most often they're passed around where it's wet and people are walking barefoot, such as at swimming pools and in gym showers. They're easier to treat when small. Salicylic acid treatments from the pharmacist can work if they're caught early.

Other treatments include:

• Freezing with liquid nitrogen
• Electrosurgery
• Laser treatment
• Surgical removal

Simple footcare and wearing correctly fitting footwear will ensure your feet stay healthy.

• Keep them dry
• Wear clean socks each day
• Allow shoes time to dry
• Wear correctly fitting footwear
• Moisturise the skin, but don’t use cream between the toes

This article was last medically reviewed by Dr Rob Hicks in April 2008