Winter feet

Welcome to a brand new year! Happy January 2020.

As ever, it begins in the thick of an English winter and cold weather brings its unique challenges to feet.

Most lucky feet are nestled away in warm socks and fully enclosed shoes, which we wholeheartedly encourage. However, let us not forget that a warm, moist environment is as desirable to bacteria and fungi as it is to toes, so do be mindful to wash your feet and change your socks daily.

If the skin is dry and/or cracked, applying moisturiser directly after washing is the most effective time, as moisturiser works best by locking in the moisture of the water. It provides comparatively little moisturisation on its own. Apply it directly to areas most prone to dryness such as heels and soles, but avoid applying it between the toes. It is rare for the area between the toes to require extra moisture, and an excess of moisture encourages both splits and fungal infections.

A hot bath is very tempting at the end of a cold day, but though a swim in molten lava might not sound such a terribly unappealing prospect while you are still shaking off the snow, the reality is less comforting. Fingertips are much better at sensing the temperature than toes are. Always check the water with your fingers first before taking the plunge. Now, enjoy!

Sensible footwear! We have faith in you, but we would be remiss not to mention it. Ice and heels are not a good combination. Fully enclosed, well-fitting flat shoes with a rubberised sole with ‘grip’ are favourite for braving a slippery pavement. Remember not to forget your insoles if you require additional support.

Socks. If the cliché’s are true then a lot of people just received at least one new pair. Check the material label and look for natural materials.
Moisture wicking, breathable and antibacterial fabrics such as Merino wool are a good warm choice for the winter months. Bamboo socks or socks with techy new terms such as CoolMax and DryMax are moisture-wicking but tend to be lighter than Merino Wool, for those who prefer a less toasty sock.

Showing signs of Fungal infection? Highly Discoloured toenails (yellow or black) and/or thickened or misshapen toenails? It is not unexpected at this time of year. Home use topical solutions such as Curanail or Amorolfine will help to eradicate the condition, but be committed and patient. It may take anything from 6 months to eradicate the condition. 
A visit to your podiatrist to ave your nails thinned regularly may boost results. Dulwich Podiatry has a five minute fungal testing service if you are not sure if what you have is a fungal infection.

Other conditions to be on the lookout for at this time of year include Chilblains and Reynauld syndrome.

Chilblains

Chilblains are small, itchy, red or dark blue swellings on the skin which are a result of the body reacting to cold temperatures. These areas are most common in the extremities of the body due to the weaker blood supply.

Ultimately, diminished circulation is the reason why chilblains occur, and the mostly wet damp and cold UK weather makes them a lot more common here. When the temperature drops the blood vessels near the surface of the skin constrict to keep the blood temperature at the right level. However, once the temperature gets back to normal (going from being out in the snow to room temperature for example) the blood vessels then dilate and this causes a rush of blood that the blood vessels may not be able to handle, which causes a small leak from the vessels to the skin, which causes the itching feeling and possible swelling.
Chilblains can be uncomfortable but rarely cause long term effects and usually heal within a couple of weeks as long as exposure to the cold is avoided. Avoid scratching at these areas as it may cause a wound and ultimately a portal for infection.

The main way to prevent chilblains is to keep your extremities warm (in this example feet). Wearing big warm socks is always a given around winter/ Christmas time, however it is actually warmer to wear a thin sock underneath and another slightly wider sock over top. This creates an air gap between the two socks and this air gets heated up by the body and keeps your feet warmer. But do ensure the socks don’t squeeze your toes, restricting the bloody supply further.
Changes to diet and also general health can also help prevent chilblains and keep your feet in good health. For example, a small change you can make would be to apply moisturiser to the feet which stop the feet drying out and the skin cracking (BUT NOT IN BETWEEN THE TOES).

Raynaud Syndrome

Over 10 million people have Raynaud syndrome in the UK and symptoms can be mild to severe. It is a condition which causes episodes of reduced blood flow to the extremities such as fingers, toes and sometimes even ears, nose and lips.

The small blood vessels in the extremities become over sensitive to changes in temperature and stress and can sometimes change colour from white due to restricted blood flow, to blue due to deoxygenated blood, to red when blood flow returns. The numbness and tingling feelings are caused by the blood vessels contracting or being in spasm then the lack of blood flow followed by the rush.

Raynauds can affect anyone but it is most common in young women. It can be caused by other health conditions such as rheumatoid arthritis, lupus or scleroderma.

Episodes can be very uncomfortable and sometimes painful and can also cause numbness and tingling.  Other symptoms include swelling, extreme sensitivity to slight temperature change and ulcers due to tissue damage.

Raynauds cannot be cured but treatments can help to reduce discomfort and pain.

Things that can be done to help at the time include keeping warm especially at the extremities and exercise can help to improve circulation. Avoid stress, caffeine, smoking and alcohol use, which can reduce circulation and worsen the condition.