Conditions

The North West London Mobile Foot Clinic has built its reputation on having a long-term, caring relationship with its patients. Regularly visiting patients at home has enabled us to get a clearer picture of their day to day needs. It is especially important, in the care of the elderly and those with limited mobility, to provide a holistic approach.

At the North West London Mobile Foot Clinic we are aware that the person is not just a corn attached to a patient but other factors maybe going on in their life, such as the inability to obtain suitable foot wear. Or an underlying condition delaying healing or making the feet more sensitive.

What I Treat And Questions Answered

Corns:

Now the first thing is, corns don’t have roots. They grow where hard skin is under excessive pressure, on a relatively small area of the foot. This is due to the way you walk, shape of your feet and is aggravated by poor footwear. The corn may be tiny and give you a lot of pain or enormous but relatively pain free. It all depends on where it’s located and nerve distribution. So why does it hurt? Because this usually cone shape lesion is pressing on the lower (living dermis layer) of skin where your nerves are found and are, as said, on a pressure point.

Calluses or hard skin:

This type of lesion can form for a similar reason as a corn but the pressure is much lower and is associated with shearing or a rubbing force. The speed at which corns and calluses return varies, due to the forces discussed above.

Treatment:

Usually, these lesions can be painlessly removed. Sometimes a chemical will be applied to reduce any corn that may remain and dressings applied if the site needs to be protected. Foot care advice may be given and if conditions allow, appliances or insoles advised.

Dry cracked skin:

This sometimes bears no relation to your health but can be due to skin conditions such as eczema or psoriasis, health issues such as poor circulation, diabetes or certain hormone imbalances resulting in lack of nourishment to the skin or deterioration in the nerve supply. Sometimes certain drugs such as steroids can be a cause.

Treatment:

The Podiatrist can advise on what emollients and abrasives may help the condition.

Ingrown toenails:

These can be caused by excessive trauma caused by one event or intermittent trauma over many years. This leads to the nail root or matrix distorting causing pain at the sides of the toes. When found in teenagers it’s usually caused by tearing instead of cutting the nail with clippers. This may leave a spike of nail or allow the groove along which the nail grows to shrink. Result, the nail gets lodged and grows into the skin, causing pain and sometimes infection.

Treatment:

Some patients prefer palliative treatment to keep the condition under control. In some chronic conditions a minor surgical procedure may be appropriate.

Clawing toes:

This condition describes the bending of the lesser toes where the toe bone or phalanx nearest the foot rises up and the middle and most distant phalanx point down towards the ground. There are variations on this known as mallet and hammer toes. In the case of a mallet toe it’s the end phalanx that points down to the ground. In the case of a hammer toe the deformity is at the middle phalanx and the end phalanx lies flat. So the toe adopts a triangular shape. The aggravating cause may be repeated trauma associated with poor footwear but the underlying cause is a fault with the walking cycle causing the foot to ram into the shoe. Often the condition is asymptomatic but sometimes arthritic changes cause pain and the excessive pressure leads to the formation of callus or corn.

Treatment:

This can be preventative, involving changes in footwear. The application of pads and props to stop the deformity getting worse and if bad enough, surgery by a podiatric surgeon may be advised to correct the condition.

Verrucas:

Sometimes mistaken for corns, they are caused by the Human Papilloma Virus. Often, they have a cauliflower like appearance. This is due to the virus irritating the skin, causing little blood capillaries to come to the surface. This is why I would advise against the patient taking a blade to them. They vary in size and number for reasons not fully understood. The virus likes damp conditions, so young people that tend to have sweatier feet, and those that use communal changing facilities are more vulnerable.

Treatment:

The virus is very successful as it doesn’t go into the bloodstream so avoiding detection by the body’s immune system. If the verruca is detected then it is not unusual for it to go of its own accord, however this is not always the case. If you have NO underlying health problem such as a circulatory disorder or diabetes I would recommend that when you first notice a verruca, treat it with a mild over the counter product. If the lesion doesn’t go after six weeks, see a podiatrist. I have access to stronger preparations which are more successful at treating these lesions. The thing is not to worry as they are not inherently dangerous, just unsightly and only uncomfortable if on a pressure point. As a preventative measure, don’t go bare foot in a communal environment, wear flip flops.

Athletes foot and fungal infections:

As with verrucae, you are more vulnerable in damp conditions. Commonly found in between the toes as a red scaly, itchy rash with well defined borders. I often see this problem in chefs or patients who have to wear protective boots for work. Sometimes a fungal infection manifests itself in the toenails causing yellow streaks along the nail with thickening and weakening of the nail.

Treatment:

Usually involves the application of anti-fungal creams and gels which I can advise you on. To counteract excessive sweating, surgical spirit may help. Fungal nail treatments are more difficult to cure as treatment is necessary until the infected nail has grown out.

Management of feet affected by diabetes:

Diabetes is caused by the body’s inability to control blood glucose levels. The reason why it is so important when it comes to feet is that the condition can cause nerve damage and circulatory problems. This leaves the feet much more open to injury and reduces their ability to heal. As a podiatrist I’m able to recognise problems before they become serious.