Treatment options
Treatment options
A range of products are available from the pharmacy to help treat common feet problems:
Feet should be washed daily with soap and dried thoroughly. An antifungal treatment can then be applied and there are different types available over the counter (OTC).
Fungistatics slow down the rate at which the fungus grows. Most fungistatics (e.g., miconazole, clotrimazole and tolnaftate) should be applied two to three time a day. For bifonazole, treatment is once daily. Treatment should usually be continued after the infection has cleared to stop it returning. Customers should be advised to read the directions for use as these can differ between products. Example: Canesten Bifonazole Once Daily 1% w/w Cream. Some products also contain hydrocortisone to treat inflammation. Examples include: Daktacort HC, Canesten Hydrocortisone Cream.
Fungicidal treatments kill the fungus and are usually applied once or twice a day for a week. The only fungicidal available over the counter is terbinafine. Example: Lamisil AT 1% Gel.
Acetic acid (e.g., EarCalm spray) can be used in otitis externa. It is an antifungal and antibacterial agent and should only be used by adults and children aged 12 years and over.
Antifungal nail solutions (e.g., amorolfine), or those that reduce the nail’s pH to make the environment hostile to fungal growth, are available OTC for mild infections. Examples include: Curanail, Nailner.
These treatments can take months to work, with toenails typically needing nine to 12 months of treatment. A healthy nail growing from the base is a sign that the treatment is working. Oral antifungal tablets are available on prescription.
Salicylic acid, silver nitrate and salicylic acid in combination with lactic acid destroy verrucas. Most take up to 12 weeks to work. Example: Bazuka Gel.
Freeze treatments may be suitable for stubborn cases or when rapid relief is desired, as they can remove verrucas in one treatment. Examples include Scholl Freeze Verruca and Wart Remover and Bazuka Sub-Zero.
Salicylic acid can be used to remove layers of hard skin, along with a foot file or pumice stone (pictured). Salicylic acid should not be used on healthy skin. Cushioning products help relieve pressure on the affected area, reducing pain and preventing reoccurrence. A moisturising cream containing ingredients such as urea can also help. Examples include Scholl 2 in 1 Corn Express Pen and Carnation Callous Caps.
The affected skin should be removed using a foot file, pumice stone or exfoliating product. Example: Scholl Velvet Smooth Electronic Foot Care System. The skin should then be rehydrated using a foot cream. Examples include Flexitol.
Painkillers, shoe insoles, bunion pads and correctly fitting shoes can help to minimise pain
Usually heel pain will ease in time, but customers should be advised to rest their foot or feet and avoiding running, excess walking or standing for long periods while it improves. Painkillers such as paracetamol may help ease pain. Wearing shoes with cushioned heels and a good arch support is important and walking barefoot should be avoided. Heel pads and arch supports may be suitable.
Important!
Having diabetes increases people’s risk of developing foot problems as the condition can reduce blood flow to the feet and damage nerves. It’s therefore important to encourage customers with the condition to check their feet every day and seek treatment for any problems straight away.
Added advice
In order to help keep their feet healthy, advise customers to:
- Wear properly fitting shoes that don’t rub and aren’t too tight
- Wear flip-flops in communal areas such as changing rooms and showers to avoid verrucas and athlete’s foot
- Keep the feet clean, dry them properly after a bath, shower or swimming and let air get to the toes when possible
- Wear cotton socks and change them everyday
- Alternate between different pairs of shoes so that they have the chance to dry out before being worn again
- Don’t share towels with someone who has an infectious foot problem such as a verruca, athlete’s foot or a fungal nail infection.
Signposting
For more information, you can:
- Your Counter Intelligence Plus training guide
- The NHS
- The College of Podiatry
- Diabetes UK
- Age UK.