Foot care guide

2nd edition

HEALTHY

KEEP YOUR

FEET

Plan to Stay in Shape Today

Your feet are talking to you:

listen to them!

Familiprix suggests you take some time to become aware of your feet’s appearance and examine them from every angle

to ensure they are healthy.

© Familiprix Inc. 2019

WARNING AND EXCLUSION OF LIABILITY: All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means without the prior written consent of Familiprix Inc.

Familiprix Inc. or any people involved in creating, producing and/or delivering this document do not provide any guarantees, do not assume any responsibility for the accuracy, currency or content of this document, and shall not be held liable for any errors or omissions in the content thereof.

The content of this document is for information purposes only and is not intended to provide specifi c advice applicable to individual situations, and cannot replace the advice of a physician, pharmacist or any other health professional. Nothing in this document may be interpreted in such a way as to constitute a declaration, warranty, or advice of a medical nature. Readers must contact health professionals directly regarding any questions or advice concerning their health.

Table of

contentsPamper your feet, rain or shine! . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4To whom do you entrust your feet? . . . . . . . . . . . . . . . . . . . . . . . . . 8Maintaining your foot-care instruments maintenance . . . . . . . . . . . 11Good posture prevents pain and injuries . . . . . . . . . . . . . . . . . . . . . 13Keeping your feet warm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Children’s feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Foot problems 18Blisters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Calluses, corns and cracks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Plantar fasciitis and bone spurs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Bunions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Ingrown toenail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Onychomycosis (nail fungus) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Athlete’s foot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Dry feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Excessive perspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Plantar warts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

For diabetics 36Diabetes: a formidable enemy of your feet . . . . . . . . . . . . . . . . . . . 36Some tips to keep your feet healthy . . . . . . . . . . . . . . . . . . . . . . . . 37Regularly maintain your nails . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Choosing the right socks and shoes . . . . . . . . . . . . . . . . . . . . . . . . 40What to do if you have problems with your feet . . . . . . . . . . . . . . . 41Sources and useful links . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

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Pamper your feet, rain or shine!Many people neglect to look after their feet. But they deserve to be taken care of, just as we do with our face or hands. Our feet often overlooked, but they help us move and support the weight of our body day in and day out! That’s why we must establish simple, daily routines to keep them healthy. A well-pedicured, cornless foot with well-groomed, silky-looking and well-hydrated nails is appreciated, no matter the season. Pamper your feet. Take care of them and keep an eye on them; they will return the favour.

Foot care guide 5

Here’s a good routine to help you be more attentive to your feet:

Take care of them for 5 minutes everyday

1 Wash your feet properly. Use a mild soap and scrub well between and under your toes. Rinse them well.

2 Dry your feet properly, especially between the toes where infections can easily develop.

3 Examine your feet and make sure your skin is healthy.

4 Moisturize your feet well. Apply a moisturizer, ideally one without perfume or colouring, all over the surface of your feet after each bath or shower, except between your toes; that area must remain moisture-free at all times.

5 Let the cream penetrate and remove any excess before putting on socks or shoes.

6

TIPAvoid using instruments that are rough or sharp as they can injure you. Be gentle, the results may take a little longer, but they will be the same.

Avoid using instruments that are rough or sharp as they can injure you. Be gentle, the results may take a little longer, but they will be

Pamper them once a week.1 Get out the instruments and accessories you need.

Refer to the section: Maintaining your foot-care instruments on page 11.

2 Wash your hands.

3 Prepare your feet for care by soaking them for 5-10 minutes in warm water to soften any rough areas.

4 Remove corns and dead skin using a � le or soft pumice stone on moist skin. Rub in a continuous motion in the same direction and never back-and-forth.

5 Dry your feet properly, especially between your toes.

Foot care guide 7

6 Cut your nails in a straight line to keep the corners from piercing the skin and causing injury. If needed, round the corners gently with a � le. Never cut your nails shorter than where they attach to the toe.

7 Moisturize them with a cream made for dry or cracked feet or a refreshing, relaxing cream. There are many kinds on the market, ask your pharmacist for advice or consult your skin guide!

8 Finish by washing your instruments, and be sure to dry them thoroughly before storing them.

If you have a vision problem, get your feet cared for by a skilled

professional.Did you know?

You will fi nd a variety of instruments and products

needed for pedicures in the pharmacy.

To whom do you entrust your feet?To help you � nd the right resource, here’s a look at the di� erent kinds of foot care providers:

Podiatrists holdsa PhD in Podiatric Medicine. In Québec, they must be a member of the Ordre des podiatres. They are skilled at diagnosing and treating foot diseases. They may also prescribe certain medications, perform minor surgeries and prescribe orthoses.

Orthopedists are doctors that specialize in the muscu-loskeletal system. They per-form diagnoses and provide medical and surgical treat-ment for problems involving the bones, joints, muscles, ligaments and nerves.

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To fi nd a Podiatrist near you :

ordredespodiatres.qc.ca.treating foot diseases. They may also

prescribe certain medications, perform minor surgeries and prescribe

are doctors that specialize in the muscu-loskeletal system. They per-form diagnoses and provide medical and surgical treat-ment for problems involving the bones, joints, muscles,

podiatres.qc.ca.

DID YOU KNOW?

You don’t need a doctor’s prescription to consult

a podiatrist.

Foot care guide 9

Orthotists have specialized training in orthopaedic equipment for the human body. They can design, manufacture, adjust and modify orthopaedic devices following a consultation and according to the medical diagnosis.

Podiatry nurses o� er their services in private clinics, hospitals, long-term care centres or at home. They are not authorized to make a diagnosis, but may provide care related to the treatment of wounds or according to a treatment plan or prescription from a doctor or podiatrist.

Chiropodists and foot care hygienists provide basic care for routine use of the feet in addition to cutting and � ling nails. Some also o� er massage and beauty treatments.

Pharmacists can help you by determining if your situation requires professional consultation. They can advise you on e� ective non-pharmacological measures and give you information about treatments that are available over-the-counter.

TIPCheck with your insurer, are eligible for some services reimbursement.

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Are you buying a new pair of shoes? Finding good shoes is not easy! They should protect and support your feet while being comfortable. They must also be suitable for the activity for which they will be used.

Here are some tips to follow when buying a new pair of shoes:

1 Try them on at the end of the day when your feet are larger. Remember - your feet tend to widen as you get older.

2 Good shoes should be comfortable as soon as you put your foot into it for the � rst time. If it isn’t, choose another style.

3 To � nd out if the size � ts you, while standing, push your toes to the end of your shoe; you should be able to slip a � nger between your heel and the back of your shoe.

4 Natural leather and canvas are the best materials because they are soft, let your feet breathe and follow your foot’s natural movement.

5 Opt for shoes with as few inner seams as possible to reduce the risk of irritation.

6 Heel height should not exceed 5 cm (2 in.) to prevent you from putting too much weight on the forefoot (which can cause pain or a burning sensation). This also helps prevent back pain and muscle cramps in the legs.

7 If possible, alternate your pairs of shoes regularly. This will allow them to air out and change the pressure points.

8 Your shoe should have a wide toe to ensure su� cient space for your toes.

9 Choose a sole thick enough to cushion shocks and to protect your feet.

Foot care guide 11

Maintaining your foot-care instruments maintenanceContaminated or damaged instruments can cause infections or injuries. It is easy to avoid these unfortunate situations by following these few recommendations:

plongeant celui-ci dans de l’eau bouillante pendant 15 minutes.

1- CleaningCleaning the instruments will dislodge all the skin particles and dirt, which could hinder their proper operation and cause the proliferation of microbes.

Cleaning agent: dish soap, all-purpose soap

Directions: rub the instrument mechanically with a cloth and cleaning agent until there is no visible dirt, rinse with clean water and dry well.

2- DisinfectDisinfection is necessary to eliminate any bacteria, viruses or fungi that can cause infection.

Disinfecting agent: Isopropylic alcohol 70% or diluted bleach in cold water, in 1:10 proportion.

Directions: Let it work on the instrument for at least 1 minute, rinse with clean water and dry well.

If the instrument is made of heat-resistant material, it can also be disinfected by immersing it into boiling water for 15 minutes.

Handle disinfectingagents with gloves to prevent risk of injury.

Do not use them in spray format.

3- Additional informationNail fi les: Cardboard � les have a shorter shelf life due to the material from which they’re made. You will have to replace them regularly because they wear out faster and because they cannot be cleaned and disinfected. Metal or glass � les are more resistant to wear, and they can be maintained after each use. Before using them, check that they are not damaged, broken or rusty, in the case of the metal � le.

Nail clippers and nail scissors: These are usually made of metal, so you need to make sure they are sharp enough to avoid breaking the nail and causing an injury.

Pumice stone: This comes from volcanic rock, and it resembles a sponge with all the holes on its surface. It is therefore resistant, but spongy. To clean it well, use a small brush and soapy water to remove debris accumulated in the cavities. Regular disinfection is also suggested. Do not forget to store it in a ventilated space so that it stays dry between uses.

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It is strongly recommended to have two of each

instrument; one for your toenails and another for

your fi ngernails.

Foot care guide 13

GOOD posture PREVENTS PAIN AND INJURIESGood posture begins with your feet. After all, they are the base upon which your entire body is supported! Anatomically, there are many connections between your feet, ankles, knees, hips and back. Poor weight distribution over the soles of your feet, abnormal foot structure and poor biomechanical alignment could potentially a� ect your entire body. It’s another good reason to take care of your feet.

DID YOU KNOW? The mechanics of your

feet is one of the body’s most complex. It involves more

than 20 muscles, 30 bones, and even more ligaments

and joints.

Here are some tips to help you:ExercisePhysical exercise helps strengthen the feet, whether it's simple stretching or weight training. Physiotherapists and kinesiologists are the experts to provide you with the right exercises according to your situation. They can personalize everything according to your abilities and the desired progression.

Maintain a healthy weightBeing overweight increases the pressure on your feet and therefore the risk of pain and injury. Target a healthy weight for the health to ensure the health of your feet!

OrthosesThe role of plantar orthoses is to distribute the load under your feet while stabilizing and realigning the lower limbs. In addition, they help you feel comfortable and not as tired.

Good shoesShoes protect your feet while maintaining and stabilizing the body. It's not normal to experience foot pain while wearing shoes! To make a wise choice, refer to the section: “Are you buying a new pair of shoes?” on page 10 or ask your podiatrist, as they will be able to give you the best advice.

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Foot care guide 15

KEEPING your feet warmIn very cold weather, your feet are often the � rst parts of the body to get cold. Here are some tips so the young and old alike can enjoy being outside without worry.

1 Combine socks: wear a � rst pair made of synthetic � bre on your skin and wear a second pair over top that are made of natural � bre such Merino or Alpaca.

2 Keep your socks dry: have a few spare pairs and change them often.

3 Add an extra sole: to keep your feet even further from the cold.

4 Use toe warmers: placed on top of your toes, they provide heat for several hours.

5 Stay active! Physical activity increases the blood � ow in your extremities and therefore the temperature of your body.

Children’s feetIt is not uncommon for parents to pay attention to the health of their child’s teeth, eyes and other body parts, but to forget their growing feet.

Children’s feet grow quickly. During the � rst years, they will already reach half their adult size. Their feet are soft and malleable, and a simple abnormal pressure can deform them. Consider having their feet examined by a Podiatrist, especially if you notice one of these signs:

• You notice small bumps on their feet and toes.

• The soles of their shoes are worn unevenly.

• Your child tells you about recurring leg and foot pain.

• Your child complains of having tired legs and wants to be carried regularly.

• You notice that they are walking with their feet inwards or outwards.

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TIPWhile your children are growing, consider having their posture evaluated by a Podiatrist or an Orthotist. Their recommendations could prevent future deformation or pain.

Foot care guide 17

As the child begins to walk, it is recommended to let them go barefoot. This will help their feet develop properly by working all their small muscles. It will then be necessary to choose a light, anti-slip shoe with a soft sole. To check for the correct size, you must be able to slide an index � nger behind their heel and the back of the shoe.

It is important to teach your child to have good posture, as poor posture can sometimes cause the feed and legs to deform. The right postures to adopt are:

• Sitting, with back straight and legs stretched out;

• Sitting, with legs crossed;

• Lying on the back or side with legs stretched out.

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FOOT PRoblems In this section of our guide, we provide an overview of the most

common foot problems. You will fi nd useful information to identify, prevent and treat them. These tips will help you take better care of your feet!

Foot care guide 19

BlistersHow to identify themBlisters are small round or oval bubbles � lled with a clear liquid, often caused by repeated rubbing of the skin against the shoe.

How to prevent and treat them• Don’t wear shoes that are too big and avoid going barefoot

in your shoes, as this causes friction.

• Break-in your new shoes at home and wear them gradually (no more than two hours at a time) for several days.

• Wear socks that keep your feet dry or socks with two layers to reduce friction.

• Apply the contents of an anti-blister stick in places susceptible to friction. This product applies invisibly, lubricates the skin, reduces friction, and therefore prevents a blister from forming. The anti-blister stick is o� ered over the counter.

• React quickly as soon as you feel a burning sensation: then apply cushioned protection or a gel dressing. There are over-the-counter specialized dressings to prevent and treat blisters.

• Avoid puncturing the blister because as soon as the skin is damaged, there is a risk of infection. If you need to do it, � rst clean the area, and then apply an antibiotic ointment and dressing.

If you have an infection, consult a healthcare professional.

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Calluses, corns and cracksHow to identify themThese foot conditions are characterized by an accumulation of hardened skin. They are caused mainly by repeated pressure or friction of an ill-� tting shoe on your foot. A callus is rough, thick skin that is usually under the heel or toe, and usually painless. When it becomes severely dry, it can crack around the heel and form cracks. A corn is a small, thick bump of hardened skin that forms on the toes or between two toes, causing pain. There are also sometimes similar variations of these conditions found on the joints under the soles of the feet. They are usually yellowish in color, and they can be uncomfortable and cause a burning sensation when walking.

Callus Corn Cracks

Foot care guide 21

How to prevent and treat themFirst, � nd out what caused your foot problem and eliminate it. For example, are your shoes too big or too tight? Do they have seams or bumps inside of them?

• Take care of your feet as described in the section: Pamper your feet on page 4 and use a urea-based cream with moisturizing properties.

• Protective pads protect the feet against friction. They can reduce the pain and prevent the condition from recurring. Gel pads, in addition to protecting the skin, help soften it. Before putting on a pad, make sure you have enough room in your shoe and that the pad is the right size. Cleaning instructions are usually indicated on the packaging.

• Corn remover pads and liquid preparations help dissolve the corn. Before you apply them, you must protect the healthy skin surrounding the corn with a barrier product (for example, nail polish) to prevent irritation and in� ammation. It is also important to consult your healthcare professional before using these products to make sure they are right for you.

plantar fasciitis and bone spursWhat are they? Plantar fasciitis is a strong, heavy ligament running along the foot, from heel to toes. It functions as an elastic and is partly responsible for the curvature of the soles of the feet. Repeated stretching of this tissue can cause in� ammation and pain, so-called plantar fasciitis. When this in� ammation persists for a long time, it sometimes happens that a bone spur forms at the heel. A bone spur is not painful in itself, but plantar fasciitis is the problem.

• The repeated stretching of the plantar fascia can, among other things, occur in the following cases:

• Playing sports with sudden stops and starts, such as tennis and volleyball

• Running and jogging

Bone spurPlantar fasciitis

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Foot care guide 23

• Being overweight

• Hollow of � at feet

• A shoe lacking support

• Standing on a hard � oor for a long time

• Etc.

How to identify plantar fasciitisPlantar fasciitis is characterized by pain that usually starts at the heel and can extend to the toes. According to the individuals a� ected, the pain is very variable in intensity and duration. In general, the pain is more intense in the morning when you get up, and then it diminishes after you start walking. Although it may seem to be gone in the morning, the pain may come back in the evening after physical activity or when you resume activities after a period of rest.

TIPSome oral pain medications can relieve the pain associated with plantar fasciitis. Consult your healthcare professional to find out which one is right for you.

TIPTIPSome oral pain medications can relieve the pain associated with plantar fasciitis. Consult your healthcare professional to find out which one is right for you.

How to prevent and treat plantar fasciitis• Maintain a healthy weight.

• Wear shoes that are appropriate for the sport being played.

• Do foot stretching exercises before and after the physical activity sessions in which the plantar fascia is triggered. For example: massage the bottom of the foot (vis-à-vis the arch of the foot).

• Apply cold to the painful part of the foot if the pain reappears after doing a sport (a maximum of 10 minutes every two hours).

• Relieve the pain by using an arch support. This device helps support the plantar fascia and prevents stretching. Heel pads are also available over-the-counter. They absorb shocks during walking and reduce the pressure on the plantar fascia. Hell pads with hollow or removable centres reduce pressure on the heel, which alleviates pain.

• Important points to observe when using heel pads:

- They must be placed in a shoe deep enough to prevent the heel from lifting out of the shoe when walking.

- Be patient because healing plantar fasciitis can take a long time.

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Even if only one foot is painful, heel pads must be worn in both shoes to ensure both legs are

of equal height.

Foot care guide 25

BUNIONSHow to identify themThis occurs when the big toe deviates inward, forming a lump on the side of the foot. Bunions tend to be hereditary and mainly a� ect women after their 50s.

How to prevent and treat themBeing overweight and wearing high-heeled, pointed-toed shoes can make this problem worse. Ask the shoe store clerk or shoemaker to stretch your shoe where the bunion is. Wear wide-toed, � at-heeled shoes to avoid putting pressure on your bunion.

• Relieve the pain by soaking your feet for 10 minutes in warm water containing Epsom salt or applying ice locally. Some over-the-counter analgesic gels can be applied directly to the bunion when it is very painful. Consult your healthcare professional to � nd out what’s right for you.

• Prevent corns from forming on the bump as it may increase the pain.

• Wearing orthoses or specialized insoles can improve your feet’s comfort and slow down their deformation.

• Various protective pads, made with gel, or toe separators are available on the market and can alleviate pain.

• With bunions, sometimes the toes overlap. Prevent the toes from rubbing together by separating them and protecting the toe from above to prevent it from rubbing on the shoe.

When the above measures do not alleviate the pain, or it is di� cult to wear shoes, it is recommended to consult an orthopaedic specialist.

ingrown toenailHow to identify itPart of the nail, often located on the big toe, penetrates into the fold of skin around it and creates pain, redness and burning. When pressure is exerted on the ingrown toenail, the pain can be quite severe and if it is not treated, it can lead to an infection.

How to prevent and treat them• Avoid compressing the big toe, which is caused by wearing

very narrow shoes, a pair that is too small, high heels or socks that are narrow or too small.

• Don’t cut your toenails too short (see the section: Pamper your feet, rain or shine! on page 4).

• Control perspiration because moisture softens the fold of skin around the nail. Also avoid soaking your feet too often and for too long.

• If there is infl ammation, redness, pain or swellingapply saline compresses (available in the � rst aid products department) for � ve to ten minutes, three to four times a day. You can also apply an antibiotic cream that you will � nd over the counter, also in the � rst-aid section.

Consult a healthcare professional if there is no improvement after 48 hours or if the condition deteriorates.

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Foot care guide 27

Onychomycosis (nail fungus)

How to identify itIn general, a toenail fungus infection � rst attacks the big toe or small toe since they are the ones most likely to be damaged and su� er the e� ects of inappropriate footwear. The infection results in the a� ected nail changing colour, ranging from pale yellow to dark brown. In addition to the colour change, as the infection progresses, the nail generally thickens and becomes more brittle.

Did you know? Applying an antifungal cream

(cream that kills fungus) is not eff ective against fungal

infections in the toenails since it does not penetrate well

enough into the nail.

How to prevent and treat it• Keep your feet dry. Moisture and heat promote fungal

growth on an already damaged toenail.

• Put powder or use an antifungal aerosol (that kills fungus) in your shoes.

• Avoid cleaning your nails excessively. A pedicure or a vigorous cleaning of the underside of your toenails can cause them to become detached and thus predisposed to infection.

• Don’t wear ill-fi tting shoes that cause friction and/or pressure on the nails. Also avoid shoes that maintain moisture.

• Clean your instruments before and after your nail care. If necessary, infected nails should be cleaned last in order not to spread the infection.

• A treatment prescribed by a doctor is necessary to treat this type of infection. However, it is possible to slow down its progression and prevent its recurrence by applying a 5% acetic acid solution (vinegar) on top and underneath the nails regularly, two or three times a week.

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Foot care guide 29

Athlete’s footWhat is athlete’s foot? Athlete’s foot is a fungal infection that a� ects the feet. Because it is contagious, it can be caught directly by touching an infected person or indirectly by coming into contact with contaminated surfaces. Fungi causing athlete’s foot are mainly found around public swimming pools and in sports centre locker rooms, as they thrive in hot, humid environments.

How to identify itEarly in the infection, the skin between the toes often cracks. The edge of the cut is initially dry and red, but if you don’t treat it, it will become increasingly moister. The more the infection progresses, the more the skin starts to peel easily and small white scales come o� . Athlete’s foot can be itchy, burning and have an unpleasant odour.

TIPConsult your healthcare professional if you notice any ulcers, swelling, or one or more deteriorated toenails, as these symptoms could indicate a more serious infection.

Foot care guide

professional if you notice any ulcers, swelling, or one or more deteriorated toenails, as these symptoms could indicate a more

How to prevent and treat it• Keep your feet clean, fresh and dry. Dry your feet and

the spaces between your toes well with a clean towel after showering or bathing. Do not share your towel as you can transmit the infection.

• Wear sandals in locker rooms, public showers and around public pools.

• Wear cotton or wool socks that absorb moisture well, and change them as needed during the day.

• Sprinkle your feet with talcum or antifungal powderto absorb moisture.

• Don’t wear the same pair of socks two days in a row, let them dry. If you can, also remove the soles inside the shoes to dry and apply antifungal powder on them.

• Treat excessively sweating feet if necessary. This can cause of athlete’s foot.

• It is possible to use an antifungal (an over-the-counter medication that destroys fungi) to treat the majority of fungal infections.

• Be diligent about treatment. In general, the product should be applied for two to three weeks before the symptoms disappear. Then, you must apply the product for two more weeks to prevent the fungi in the skin from reactivating.

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Foot care guide 31

dry feetHow to identify itDry skin is rough and it is often covered with small scales (skin particles that come o� ). Dry feet is frequently accompanied by itching. This drying causes cracks to form in the skin and deeper cracks in severe cases.

Not all skin moisturizers are similarly e� ective. For example, to obtain satisfactory results on the very dry and rough skin of the feet, it is preferable to use a urea-based moisturizer. Consult your healthcare professional to � nd out which product is right for you.

How to prevent and treat it• Avoid frequent, long footbaths.

• Choose moisturizing, unscented and dye-free soaps.

• Use a non-foaming bath oil. Add bath oil a few minutes before the end of your bath to help lock moisture into your skin.

• Drink plenty of liquids. It is generally recommended to drink eight glasses of water a day (except in case of medical advice to the contrary) to keep your skin properly moisturized.

• To relieve dry feet and itching, apply a moisturizer on the feet that is unscented and colourless twice a day (ideally less than three minutes after bathing or showering to retain moisture). Do not apply moisturizer between the toes to avoid skin maceration.

Excessive perspirationHow to identify itExcess sweat leaves your feet wet and can even soak your stockings. It can cause your skin to soften and whiten, especially between your toes, as well as cause your skin to peel. There may also be a strong odour, caused by the presence of fungi and bacteria. These are ideal conditions to result in other foot problems, such as athlete’s foot, blisters, ingrown toenails, etc.

How to prevent and treat it• Wash your feet every day, and even more than once a

day as needed to eliminate bacteria. Always remember to dry the areas between your toes.

• Aerate your feet and your shoes as soon as possible at the end of the day.

• Avoid shoes made of synthetic and waterproof materials since they keep feet damp. Opt instead for shoes with a leather interior. In addition, an open shoe or sandal allows perspiration to evaporate.

• Remove the insoles from your shoes and dry them or wash them. There are insoles that help absorb excess moisture and neutralize odours, such as coal insoles. They are available over-the-counter in the foot care section.

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Foot care guide 33

• Avoid wearing nylon socks or stockings. Opt for lycra, spandex, polyester or polypropylene, which help eliminate perspiration

• Change your socks once or twice a day as needed.

• Look for an antiperspirant product rather than a perfumed deodorant. Aluminum chloride, an antiperspirant ingredient, helps to reduce sweat and odours, while a deodorant only masks odours. There are over-the-counter antiperspirants speci� cally designed for excessive perspiration. Consult your healthcare professional to � nd out which product is right for you.

Consult your healthcare professional if there is no improvement.

plantar wartsHow to identify themA virus causes plantar warts and more frequently a� ects young adults and children. There can be one wart or a cluster, often located on the soles of the feet. They are covered with a thin stratum corneum and sometimes have small black dots on the surface. The larger the warts, the more painful they are during walking and running. It is common to experience pain in the morning when you place your foot on the ground and also when you pinch the wart. Plantar warts are contagious and can be transmitted through direct contact or through objects that have been in contact with them.

How to prevent and treat them• Avoid walking barefoot in public places, as well as at home

if a member of your family is infected - the latter should have their own towels and bath mats to reduce the risk of contamination.

• Keep your feet dry (moisture helps warts to grow).

• Avoid contagion by covering the warts with a bandage during treatment and washing your hands after touching a wart or small skin that is dislodged. Also avoid scratching, cutting or bleeding warts to prevent them from spreading elsewhere on your body.

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Foot care guide 35

There are two types of over-the-counter products available to treat warts:Salicylic acid products work by gradually removing skin layers from the wart to the root. They come in the form of a cream, solution or dressings. For the treatment to be e� ective, it is important to follow all the steps below and to be very diligent throughout the treatment.

1 Wash your hands before and after each treatment.

2 Soak your foot for � ve to ten minutes to soften the skin.

3 Using a pumice stone, � le the excess corn on the wart without causing it to bleed.

4 Protect the edge of the wart with nail polish to keep skin healthy.

5 Apply the product or dressing.

6 Repeat these steps as recommended by the manufacturer or your healthcare professional for approximately 8-12 weeks.

Products that freeze the wartThere are products that cold-freeze the skin, causing a blister to form underneath the wart. Then, usually within 10 days, both the blister and the frozen skin fall o� , making the wart disappear.

The product is applied using a sponge tip. Choose a tip the size of your plantar wart to avoid damaging healthy skin. It is important to read the directions for use and all recommendations on the package since they vary from manufacturer to manufacturer.

3636

FOR diabEtiCSDiabetes: a formidableenemy of your feetFor people with diabetes, foot problems can cause serious complications!

In fact, over time:

• Diabetes can damage the nerves in your feet. In this case, the ability to perceive pain and feel hot and cold can be diminished. Small cuts or lesions can go unnoticed and get worse if they are not treated.

• Diabetes can also reduce blood circulation in your legs and thus slow healing and scarring of wounds.

• Diabetes can alter your defense system. It becomes more di� cult to treat an infection.

To prevent or delay the complications mentioned above, it is important to follow a few basic rules, such as maintaining your blood glucose in the range recommended by your doctor, have adequate control of your blood pressure, eat healthily, do physical activity, and quit smoking.

Foot care guide 37

some tips to keep your feet healthyBecause they are at risk of developing vascular (blood vessel) and neurological (neuropathy) complications, people with diabetes should pay special attention to their feet. This next section contains tips on foot care for people with diabetes. The care must be adapted according to the risks of developing complications. For more information, talk to your healthcare professional!

Take care of your feet every day: • Wash your feet every day with warm, soapy water.

If you prefer to take a bath, limit yourself to 15 minutes to avoid softening the skin.

• Check the water temperature with your elbow. Because your feet’s sensitivity is diminished, you could scald yourself without being aware.

• Use a mild, unscented soap to avoid drying the skin.

• Rinse and dry your feet well, by paying special attention between the toes. Sponge on the water, without rubbing the skin.

• If your skin is dry, apply an unscented moisturizing lotion daily, in a very thin layer and remove any excess cream. For a urea-based lotion, it is best to get a medical prescription. Do not apply cream between and under the toes, sores or abrasions.

• You should not use hot water bottles or heating padson your feet as they could burn you.

Examine your feet every day.Remember that an injury may go unnoticed in the absence of sensation, hence the importance of foot examination.

Carefully examine your feet under su� cient lighting to detect any injury, blister, in� ammation, infection (redness, pain, burning, discharge, hot to the touch), abnormal colour, or calluses. Consult a doctor, a nurse at the centre for diabetics, a nurse in podiatric care or a podiatrist if you notice an anomaly.

Get your feet examined by a doctor at least once a year or more often if there is a risk or presence of complications.

Test your sensitivity with a cotton swab at least once a month. Perform this test after removing your shoes and socks. Touch the surface of your feet and toes with a cotton swab to see how well you can feel it. If there is no sensation of contact with the swab or if you feel tingling or burning, consult a doctor quickly or go to a walk-in clinic.

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Foot care guide 39

regularly maintain your nailsWhen caring for your nails, avoid nail clippers and sharp instruments as they can damage your skin.

It is best to � le nails with an emery paper � le after the bath, while the nails are soft. File the nail by following the same direction, and do not rub back and forth. The nail should never be shorter than the tip of your toe. Round the corners to follow the curve of the toe. Always keep your � le clean and do not lend it to others.

If your nails are thick, ingrown or abnormal in shape, consult the nurse at the centre for people with diabetes, a podiatric nurse or a podiatrist. These health professionals may, if necessary, refer you to a doctor.

Choosing the right socks and shoesChoose your socks and shoes according to certain criteria to prevent injuries:Recommendations for choosing socks:

White or light-coloured cotton socks are preferred. They must � t snugly; the elastics must not impede circulation and the seams must not put pressure on the skin. There are socks that meet these criteria on the market; consult the nurse at the centre for people with diabetes, a nurse in podiatric care or a podiatrist. Remember to change your socks every day and even more often if you perspire excessively.

Recommendations for choosing shoes:

• Try on new shoes at the end of the day when your feet are larger.

• Always try on both shoes. They must be � exible and comfortable from the moment of purchase and have enough space inside for your toes, in length, width and height. The sole must be � exible.

• For women, heels should not exceed 5 cm.

• If you already have an orthosis, always bring it when you buy shoes.

• Break in your new shoes gradually, until they adapt to the shape of your feet.

• Before putting on your shoes, always check the inside with your hand to detect the presence of any small objects. A small rock, button, nail or even a tear or crease in the lining could cause injury.

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Foot care guide 41

• Wear socks with your shoes to prevent skin irritation.

• Wear rubber sandals in public places, such as swimming pools, beaches or showers.

• Avoid walking barefoot, even at home.

• Wear slippers if you have to get up at night.

What to do if you have problems with your feetIn the presence of corns, calluses or crevices:

1 Never apply dressings containing salicylic acid, liquids or special ointments. These products may cause ulceration.

2 Never attempt to remove calluses or corns yourself using sharp instruments.

3 You can use a pumice stone or exfoliation � le after a shower or bath when your skin is wet. Always moisten the pumice stone. Rub gently in the same direction to remove the surplus corn. Do not rub it back and forth. Do not try to remove all your calluses at one time because prolonged use of a pumice or exfoliation � le can damage your skin.

4 Consult the nurse at the centre for diabetics, a podiatric nurse, a podiatrist or your doctor, if needed, and especially if you have circulatory problems or if you do not feel any pain.

In the presence of corns, calluses or crevices:

1 Clean it with salt water. Boil 250 ml (1 cup) of water and 2.5 ml (1/2 teaspoon) of salt for one minute. Let cool. This water can be kept in the refrigerator for 24 hours.

2 Cover it with a dry dressing, taking care not to shake your foot. Do not apply tape directly to the skin.Check it every day for signs of infection,n such as redness, pain, hot to the touch, or any seepage with a foul odour.

3 As soon as one of these symptoms appears, consult your doctor or visit to a walk-in clinic.

If you have a plantar wart:

Never try to remove the wart yourself with instruments or chemicals. Consult your doctor, the nurse at the centre for people with diabetes, a nurse in podiatric care or a podiatrist.

If you’re in pain:

If you’re in pain (either resting or from exercising), see a doctor or go to a walk-in clinic for a check-up and for analgesic medication.

You have a big role to play in preventing or delaying complications with your feet. By taking a few minutes each day to care for your hygiene and gradually changing some of your habits, you will increase your chances to keep your feet healthy and ensure that you enjoy a good quality of life!

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Foot care guide 43

Sources and USEFUL links SOURCESDiabetes Québecwww.diabete.qc.ca

Are you at risk?www.preventiondiabete.ca

Ordre des podiatres du Québecwww.ordredespodiatres.qc.ca

USEFUL LINKSInformation about the prevention and treatment of certain foot problems www.familiprix.com (Health from A to Z)

Association des in� rmières et in� rmiers en soins podologiques du Québecwww.aiispq.org

Only pharmacists are responsible for pharmacy practice. They providerelated services only on behalf of a pharmacist/owner and use various toolssuch as the PSST! (Plan to Stay in Shape Today) program tools. 23

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IN THIS

GUIDEPamper your feet, rain or shine!To whom do you entrust your feet?Maintaining your foot-care instruments maintenanceGood posture prevents pain and injuriesKeeping your feet warmChildren’s feet

Foot problemsBlistersCalluses, corns and cracksPlantar fasciitis and bone spursBunionsIngrown toenailOnychomycosis (nail fungus)Athlete’s footDry feetExcessive perspirationPlantar warts

For diabeticsDiabetes: a formidable enemy of your feetSome tips to keep your feet healthyRegularly maintain your nailsChoosing the right socks and shoesWhat to do if you have problems with your feet

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Plan to Stay in Shape Today