Common foot ailments for walkers

Black toenails

Black discolouration beneath nails is usually caused by bleeding beneath the nail. If this is happening on a regular basis, especially to several toes, then you should check your shoe fit to ensure that shoes are not too short.

If bleeding continues and pressure builds beneath the nail you will require professional advice to release the fluid. Once the discolouration has occurred it will remain until it grows out with the nail plate. This can take three to six months. Note: discoloration beneath nails can also be caused by fungal growth.

Calluses and corns

Calluses form in a response to pressure and friction. This is initially as a protective mechanism but, as the hard skin builds up, it becomes painful. If there is a particularly localised or high level of pressure, the hard skin becomes condensed and this is a corn. Protective pads can be purchased at most chemists and may help. Most corn removal treatments involve strong acids, which do not discriminate between hard skin and healthy tissue. Instead of using these, seek the opinion of a chiropodist or podiatrist.

As the underlying cause is either abnormal foot function or bony prominence it is likely that the callus and corn will return. In many instances protective pads and specialised in-soles/orthoses will help to relieve this discomfort. However, surgical correction may well be necessary if the problem is to be cured.

In-growing toe nail

An in-growing toe nail occurs when the nail penetrates the skin to cause a wound and infection. This can be the result of trauma (e.g. stubbing your toe) or poor nail-cutting but is often related to increased curvature of the nail plate at the sides.
Symptons include painful toes, weeping, inflammation/redness around the nail and in severe cases a build-up of excess tissue (hyper-granulation). Many of the available treatments from the chemist are ineffective as these are unable to remove the nail penetrating the skin. Self help is not advisable because of the risk of infection.

Professional treatment from a chiropodist or podiatrist is advisable and, in some instances, a relatively straight-forward nail operation is required to prevent recurrence. Regular and good nail care can help minimise the problem. Nails should be cut straight across (i.e. do not dig down the sides). If you have a tendency to ingrown toe nails do not cut them short but cut them little but often. Depending on the severity of the problem, this should settle within a week when treated properly.

Blisters

Rubbing of the skin causes a build up of fluid between the layers of skin. If there is extreme trauma, then the blister may be filled with blood and will look black.

Generally, the blister should be left intact as removing the roof will make the area sore and pre-disposed to infection.

There are several proprietary dressings that are designed to reduce friction such as "Compeed". If the problem is recurrent or not settling then you should seek a professional opinion. Recurrent blisters on the sole of the foot may respond well to customised in-soles/orthoses.

Prevention is the best remedy so you should ensure that your shoes fit, are fastened properly and do not rub any prominent points on you feet. Two pairs of socks with the pair closest to your skin being high in cotton will significantly reduce friction. Depending on the severity of the problem, blisters should settle within 2 to 7 days.