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Pay attention to your feet

Podiatrist tells how to toe the line on foot health

By Bonnie Miller Rubin, Chicago Tribune reporter

May 9, 2012

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With warmer weather, out come the sandals … and neglected feet. The scaly heels, yellowed nails and thick calluses that have been under wraps all winter are now on full display. No wonder there are a half-dozen "I Hate Feet" groups on Facebook.

We brought a long list of common foot problems to Dr. Leonard Vekkos, a podiatrist who has been practicing since 1984. He treats patients at Adventist Bolingbrook Hospital, among other local hospitals.

Q. Why do toenails seem to thicken as we get older?

A. As we age, several factors can contribute to changes in nails. The most common issue is the development of a fungus infection called onychomycosis. People need to realize that fungus is present in everybody's environment. Aging may also result in decreased circulation to the toenails, and diabetes or other medical conditions put people in an immuno-compromised state which makes them more susceptible to these infections.

Q. For the treatment of fungus, what treatments are available?

A. The thickness caused by fungus can cause skin infections that can lead to serious problems. In general, many fungal infections can be treated by debridement (trimming and cleaning) in order to relieve discomfort.

There are prescription topicals such as Penlac and prescription oral medications, such as Lamisil. Both have advantages and disadvantages. ... With topical medication, there are no side effects, but the disadvantage is that it requires nail debridement on an almost daily basis. Additionally, patients are unable to utilize any nail polish. With the oral medications, it requires liver function tests prior to starting treatment. ... But the advantage is that a patient can continue using nail polish. It also works on a systemic basis, so that the fungus is addressed from the inside out. ...There is no cure for fungus infections.

Q. Can flats be as harmful as stiletto heels?

A. Obviously high heels can cause issues over a long period of time ... because the gait is affected, causing issues in the front part of the foot with the toes. ... On the other side of the spectrum, wearing of flats or nonsupportive shoes such as flip-flops can also result in heel pain, arch pain, leg and back issues. .... Everything is related to the type of foot that you have. That's why it's important if there are any problems to see a podiatrist for an evaluation.

Q. Do you see a lot of problems with unsanitized instruments from pedicures?

This is actually a very important issue that we as a podiatry community have been dealing with in our educational blogs. In my own experience, I have had my fair share of women who have pedicures suddenly developed changes in the nails that are consistent with a fungus infection. There may be instances in which certain pedicurists are not properly cleaning and sanitizing their instruments between clients. They don't necessarily have to be sterilized as much as cleaned properly and placed into a sanitizing solution.

Q. What is the best way to treat a blister?

A. Blisters are a result of friction and end up becoming filled with a fluid. In general, the fluid from the blister needs to be removed in order to reduce pain and pressure. ... The hole in the blister should be large enough so as to not allow fluid to reaccumulate. The roof of the blister will then be covered with a topical salve or antibiotic ointment and a Band-Aid. ... After several days, the roof of the blister will become loose and can be removed. I am a big believer in utilizing vitamin E oil once the blister has come off to allow for proper healing.

Q. Are ugly feet an inevitable part of aging, like gray hair or wrinkles?

A. Obviously, our feet are not immune to the changes that occur with time. ... Addressing these issues depends on the symptoms and how much it impacts quality of life. I am not a believer in performing cosmetic foot surgery because of the potential complications. ... But if cosmetic issues such as bunions and hammertoes become painful, then addressing them through some sort of correction would be appropriate. It is important that people take care of their feet on a daily basis. Such simple things as cleaning between the toes, seeing a foot specialist when pain begins, ... these are all important aspects of keeping your feet healthy throughout life.

Q. What is the one thing you wish people would do to take care of their feet?

A. Pay attention to them. But because they're at the end of our body, no one thinks about them ... until they hurt.

brubin@tribune.com