Unless they hurt, most people rarely think about their amazing feet. Hidden by socks and often encased in shoes, feet are made up of 26 bones, 33 ligaments, 19 intrinsic muscles, and 10 muscles that originate in the leg and connect into the foot. There are hundreds of other fibers and the whole structure is covered by skin. The foot is a critical component of human mobility, yet most of us walk around with little regard for inner workings or how to keep feet, and the skin covering them, healthy.
Skin is the largest organ of the body. It regulates body temperature, provides cushioning, acts as an organ of elimination, and is our primary immune system shield. When the skin becomes compromised, the biggest risk is infection, which happens when an outside microbe gets inside our body, and our immune system needs to fight the microbe off. Infection can be localized and contained, like an ingrown nail; or it can spread and cause cellulitis, a common bacterial skin infection affecting the skin’s deeper layers. While we are fortunate enough to have antibiotics available to fight off infections, taking care of your skin is the best act of prevention.
Petroleum, silicone, dimethicone, and alcohols are sealants and drying, and not well absorbed by skin.
The skin on our feet harbors a very helpful microbiome that protects us. Therefore, skin should never be sterilized by using harsh chemical cleansers or extremely hot water because sterilization removes that protective microbiome layer. Skin should never be dry, flakey, blistered, peeling, or callused because that compromises its integrity. Like leather, skin baked in the sun or not properly cared for can crack, tear, and fall apart.
At FootCare by Nurses we see a lot of compromised skin on feet. Some skin issues are caused by limited blood and lymph flow (circulation) or chronic disease. Some are caused by shoes that are slipping and toes that are gripping in shoes that don’t fit well. But most of it results from not knowing how to take care of the skin on one’s feet and legs.
Skin health happens from the inside and the outside. The foods, vitamins, and minerals that we eat and our activities directly impact the health of all our organs, including the skin. Processed foods high in sugar, salts, and artificial ingredients are known to cause health issues. When sugars are high because of conditions such as diabetes, yeasts and fungi flourish, often seen as fungal infections and tinea pedis, also known as Athlete’s foot. When skin health is not optimal, the resulting flaking, cracking, and fissures are possible entrances for microbes to pass through the skin barrier. This is avoidable.
Skin breakdown happens fast, but if caught early and treated, an adverse outcome can be prevented. It is one of the reasons those with chronic diseases need to inspect their feet often.
Skin health is also affected by our activities. If you are lying in bed or sitting a lot, legs tend to swell and the skin over bony prominences can become easily compromised. Skin can also be compromised by friction.
Callusing is the result of our skin trying to protect us. Almost every callus/corn is related to friction caused by the foot moving in the shoe. The friction warns the skin and enhances blood flow which encourages growth of skin cells. When a callus or corn becomes hard, it feels like a rock or a thorn and can become painful.
Skin protection is about three things: eating well, caring for the skin, and choosing a shoe and socks that fit and are secured, so there’s no rubbing, slipping, or friction. Making sure the heel is in the heel cup, that the pattern of the insole matches the shape of your foot, is a good start. If it doesn’t, the shoe will never fit well. The socks you choose should protect your feet by keeping them dry and warm and wicking away excess moisture—we love merino wool.
Skin care from the outside is about using oils and lotions that are skin-friendly. Skin is an organ of our body. It is not a superficial covering like paint or siding. Skin doesn’t really like water. At FootCare by Nurses we have a saying: “If you would not eat it, it’s not ok to put on your skin.” Petroleum, silicone, dimethicone, and alcohols are sealants and drying, and not well absorbed by skin. In fact, they often exacerbate issues. Sealing in moisture can be harmful. Skin cells are supposed to shed but when sealed they build up. Maceration (skin breakdown from prolonged moisture) can also happen, especially in web spaces between the toes. This should be avoided; you don’t want skin to open up to infection.
In our hard water New England environment, a rinse of ½ cup of vinegar and a tablespoon of salt in a spray bottle filled with water, applied post shower, is an amazing skin conditioner. The goal is to tend to the skin, not eradicate its protective mechanisms.
Natural oils are well tolerated by skin. Coconut oil, shea butter, sesame oil, avocado oil, and even Crisco are all good natural oils that can provide the skin with nourishment. Many people are afraid that applying oils to their feet will cause slipping or get oil on their socks or sheets, but oils are absorbed quickly, especially after bathing, and socks and sheets can be washed.
Bringing skin care back to natural, edible oils is surprisingly cost effective. A gallon of apple cider vinegar for foot soaking to help balance the pH on your foot’s skin, and a jar of coconut oil, even one of the organic brands, can be picked up at the supermarket for less than $10. You can even add a little essential oil and apply that oil to your legs, arms, and even between your toes as you get into bed. Feet love to be touched, and you will be surprised how well you sleep. But more importantly, you are inexpensively and proactively taking care of the system and parts that are designed to support and protect you.
