Skin is the protective outer layer of the body. It is designed to be a barrier to fluids and germs and to protect the body from damage. Where there are changes in the condition of your skin it can affect how well it is able to act as a barrier.
When skin becomes dry it is less able to stretch and can become prone to splitting. Often splits can occur around the heels and where they are deep enough to cause bleeding they can become infected if not cared for properly. Dry skin is easily prevented by applying cream to the dry areas (not around or between toes) daily.
Sometimes skin can get sore or thicken where it rubs against the tops and sides of shoes or because of the way you walk. A good tip is to check the fit and condition of your shoes. The size of your feet can change as they swell during the day or if you wear thicker socks. If the painful area is on the tops of your toes then it is often the shoes rubbing and you may need to get a bigger size. Your feet can also rub on seams or splits, or become painful if the cushioning inside has worn out, so it is worth checking your shoes and thinking about if there is a particular pair that causes problems, which you can then stop using. To help soften the thickened skin and keep it flexible and less painful you can apply cream daily, but this should not be between the toes as this can cause them to become too damp.
If the skin between your toes looks white and soggy (macerated) then it has become too damp. After washing your feet it is a good idea to dry between your toes as this will help prevent this problem and also clean out any trapped sock fluff etc This can be done with a dry flannel if your toes are packed tightly together and helpful aids can be purchased to assist with this if you have trouble bending over. Sometimes in-between the toes can get very damp if you have sweaty feet and wear closed-in, plastic shoes or polyester socks a lot. This can be helped by changing to more natural fibres such as cotton, wool or leather so that moisture is not trapped in as much. A daily application of surgical spirit with a cotton bud can help dry out the area and discourage infection, but also spending some time resting without shoes and socks may help.
If the skin between your toes looks white, soggy and is itching a lot, you may have got a fungal infection. The advice above will still work but you may also find using an anti-fungal spray helpful. Creams are not recommended for between the toes as this can add to the moisture levels, causing damage to the skin and possibly enabling the problem to re-occur. Fungal infections can occur on other parts of the foot and may appear as patches of dry skin, sometimes with what appears to be dry blisters of skin. This may or may not itch. These can be treated with an anti-fungal preparations that can be purchased from a pharmacy or on prescription. You may need to also treat shoes and wash socks on a high temperature to kill fungal spores which may re-infect your skin and nails
Thickened skin (callus or callous) can sometimes become very sore. This often occurs because there is no rest from the cause of the friction or pressure over the area. Where possible the cause needs to be identified so it can be avoided or addressed such as shoes with more cushioning or better fit of shoe for your foot shape. Sometimes it is because the callus has become thick enough to cause the pressure or is affecting the skin around it causing pain. Regular use of a foot file and application of cream can reduce the thickness of the existing callus and the continued regular application of cream can prevent it getting thick again. Continued use of the foot file should not be as frequent in case this causes callus to form. When checking your feet, dry skin will appear normal when wet but callus will appear more yellow, both will respond well to regular application of cream. If you notice that your skin or callus under your feet appears white and soggy then you may have the beginnings of an ulcer. It will be painful if you have good sensation, but if you have neuropathy (loss of sensation) then you may not notice any pain. If you suspect it is an ulcer (a wound where the skin is broken due to pressure) you should contact a medical professional for help and a referral to the Podiatry Service.
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