Dreaming of Summer 2.o- Pedicure - Appalachian Spring Dermatology

Week Two: Get Pedicure Ready

I am re-blogging a series from years past called Dreaming of Summer, now known as Dreaming of Summer 2.0, with updates on my favorite products and what’s new in dermatology.

Shedding boots for flip flops and sandals each spring draws attention to our feet. Here are some tips to get pedicure ready for summer!

Foot fungus, scientifically know as tinea pedis, is common throughout the year. When shedding those boots for flip flops it is often an area of needed attention. Tinea pedis can present in a few different ways. Patients can have a dry scaly appearance to the feet, redness and peeling between the toes, or an itchy blistery rash that extends to the top of the feet. I most often recommend treatment with Lamisil cream over the counter or products containing the same active ingredient, terbinafine. I usually recommend treating one week past when you think everything is normal, which may take longer than what is recommended on the box. It is important to thoroughly treat, and not all antifungals are created equal. Lamisil has been proven to be the most effective OTC treatment. For patients who also have more extensive rash elsewhere on the body, I will sometimes recommend oral Lamisil pills for a few weeks. Wash and thoroughly dry, in the hot sun if possible, all shoes and flip flops that may be fungus filled. One of my most experienced dermatology professors recommended putting suspicious shoes away for one month. If they are still stinky one month later, throw them away.

Toenail fungus, scientifically known as onychomycosis, can also be hiding under nail polish all winter. Toenails grow very slowly, so we need to get a head start on them. It generally takes a whole year for toenails to grow from bottom to top, so it takes a while to see improvement if the entire nail is involved. Toenails can be infected with bacteria or fungus, or they can just be abnormal because of disorders like psoriasis that affect the nails. When nails are growing abnormal but are not infected, we call the nail dystrophy. To differentiate these things, I often recommend clipping the patient’s nail for a biopsy. Once we have a definitive answer, we can proceed with treatment options. For anyone with abnormal toenails, I recommend vinegar soaks. Vinegar soaks are not an exact science, but here’s the recipe. Combine ½ cup vinegar with any temperature water in a foot basin and soak for 15 minutes a few times a week. After soaking, use a toothbrush to remove any debris in and around the toenails. Do not scrape or probe underneath the toenails with anything sharp.

Calluses are thickened areas of skin often at areas of friction or pressure. I have a few tips for those as well! Creams containing urea work well to dissolve the dead layers of skin and moisturize at the same time. Excipial cream, containing 10% or 20% urea is available over the counter. For those tougher areas, 40% urea is available by prescription. I usually recommend avoiding devices that use a razor blade to remove calluses and instead recommend more grating type devices. I personally like and recommend one by Microplane.

Hope that helps, and with a head start we can get those feet ready for a pretty pedicure and sandals soon enough!

There are links to the products I recommended below as well as more information on the conditions.

With this and the Dreaming of Summer posts I’ll share in the coming weeks before summer, you’ll be able to not just dream about summer, but get prepared for its arrival!

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