Parasites can easily filter a breakage in the skin, leading to foot infections. Podiatrist André Serge Zammit tells Stephanie Fsadni how to treat them.

Feet are very prone to infections, and if these are not diagnosed properly and immediately, they can lead to prolonged discomfort and pain.

“The skin on the soles of our feet is about 50 times thicker than the rest of the body, to offer better protection,” explains podiatrist André Serge Zammit.

“However, our feet are always in contact with the floor and enclosed in shoes. Parasites can easily filter a breakage in the skin, which can be caused by excessively dry or moist skin. Also, feet normally sweat nearly one-and-a-half litres of sweat a day, creating a perfect, humid environment for parasites to live in.”

The most common foot skin infections are caused by viruses, bacteria and a variety of fungi. The most common viral infection on our feet is the verruca, the appearance of which is similar to that of a corn or callus, but which is much more painful when pinched. It is also characterised by black spots and grows especially at the bottom of the foot.

“These are quite painful and the feeling is that of having a splinter in your foot or having been stung by a sea urchin,” says Mr Zammit.

Like other viruses, this kind of infection can spread easily, and one should especially beware of communal pools and showers, where people walk barefoot.

Verrucae are usually treated by destroying the infected cells, using a topical acid prepration or by cyrotherapy. Sometimes podiatrists monitor a verruca, which can “go away on its own, especially among children”.

Bacterial infections occur when there is a breakage in the skin and poor foot hygiene.

This can happen, for example, in cracked heel skin.

Like bacteria, fungi thrive in humid, dark and wet areas, and can even be stored in shoes

Another example of a common skin bacterial infection in hot, sweaty feet is a condition called pitted keratolysis. Often confused with athlete’s foot, this bacterial infection affects the horny layer of the sole of our foot, and is characterised by crater-like pits, particularly on weight-bearing areas.

“These types of infection are especially common among people with a standing job, such as salespeople, or those working in catering,” remarks Mr Zammit.

Treatment consists of advice on proper foot hygiene and, if necessary, use of topical antibiotics.

Athletes’ foot or tinea pedis tops the list of fungal foot infections. Again this may result from keeping feet wet for prolonged periods of time or wearing closed shoes that do not breathe. It can cause peeling, cracking and scaling, redness and itching and burning between the toes.

Like bacteria, fungi thrive in humid, dark and wet areas, and can even be stored in shoes.

Nail fungal infections are also very common and sometimes hard to treat.

“Damaged nails, caused by trauma such as dropping something on our toes or wearing ill-fitting hoses, are a great place for fungi to live on or under,” points out Mr Zammit.

Trauma will cause the nail to detach from the nail bed, creating a great place for fungi to thrive or breed.

Podiatrists can debride the contaminated area before advising the adequate treatment.

Mr Zammit points out, however, that not all deformed or discoloured nails are a sign of such a fungus, and thus, one can only discern what one has by visiting a podiatrist.

“First and foremost, one should get a good diagnosis,” claims Mr Zammit.

Bad foot odour is usually due to an increased amount of bacteria and sweat either on our feet or within certain shoes. So, ideally, one identifies the problem before self-treating.

The best way to deal with foot infections, however, is to prevent them altogether, emphasises Mr Zammit. The key to foot hygiene lies in keeping our skin healthy.

“Our skin must be not too dry and not too moist and clean, to discourage the proliferation of parasites,” he says.

One must also beware of the materials of shoes one chooses to buy – the more breathable the material, the better.

“Good leather is the most breathable, but there are also different types of leather, depending on the part of the hide used, as some are more breathable than others.

Socks help absorb extra moisture, but if one has a 12-hour work shift or is staying outdoors for such long hours, it’s a good idea to change them in between. Mr Zammit recommends socks with a high percentage of cotton.

There are also special insoles for people whose feet sweat a lot. Be sure to dry the feet properly after showering and even put some talcum powder between the toes.

To avoid cracks or breakages, one should moisturise the skin daily and remove extra dry skin with a pumice stone at least once a week.

It is also important to ventilate shoes and change them frequently.