With winter well and truly here, we find ourselves bidding farewell to sandals and embracing cosy merino socks. However, for podiatrists like us, the arrival of winter also means an increase in patients seeking help for specific foot problems that arise due to the colder temperatures. To help, here are our valuable podiatry insights into the top five winter-specific foot problems we often encounter, along with practical tips to keep your feet safe and protected.
Raynaud’s Phenomenon
The first condition we tend to see is called “Raynaud’s phenomenon” or syndrome. Raynaud’s affects both the feet and hands, and it is triggered by cool temperatures. If you experience Raynaud’s, you’ll notice that certain parts of your feet, particularly the toes, turn stark white, resulting in patchy discolouration. Other areas may turn red or blue or purple, and you may also feel extreme coldness and numbness in your feet.
Raynaud’s occurs when the blood vessels in your feet constrict, limiting blood flow. Interestingly, stress can also contribute to the onset of Raynaud’s symptoms. As normal blood flow returns, you may experience sensations of heat, tingling, throbbing, or swelling in your feet.
What can you do? The key is to keep your feet warm and dry. When your feet are warm, the blood vessels widen, promoting circulation and preventing episodes of Raynaud’s.
Dry, Cracked Skin
Did you know that the soles of your feet lack oil glands? This means that they are prone to drying out, especially in colder temperatures. Dry skin reduces sensitivity in our feet and makes us more susceptible to calluses and cracks, particularly on the heels.
What can you do? The solution is simple: moisturise daily. Regularly applying moisturiser is crucial since your feet cannot naturally keep the skin moist. You don’t need expensive skincare products; your regular moisturiser will suffice to keep your skin smooth, supple, and healthy. If you notice a significant callus build-up, consider having it reduced by your podiatrist. The same applies to any cracks that form in the heels.
Fungal Nail And Skin Infections
Fungus thrives in warm, moist, and dark environments—just like the conditions found in our enclosed winter shoes and warmer socks. Spending all day in these environments, combined with increased rainfall and foot sweating, creates the perfect breeding ground for fungal infections.
However, fungal infections don’t simply materialise; you must come into contact with fungal spores. Whether it’s at a friend’s house, your local gym, or a swimming pool, if you pick up the infection, there’s a higher chance it will spread faster than in summer when going barefoot or wearing sandals allows your feet to dry out.
What can you do? After every shower or when removing your shoes, thoroughly dry your feet. If your shoes get wet, let them dry completely before wearing them again, and ensure your feet are dry too. Wash and dry your socks thoroughly, paying attention to the spaces between your toes. Consider using sprays or powders on your feet or in your shoes to maintain a dry environment and discourage fungal growth. If you notice signs of a fungal nail infection (discoloration or patches on your toenails) or athlete’s foot (bubbles in the skin, dryness, itchiness, or redness), seek treatment from a podiatrist who can provide the appropriate antifungal care. The earlier you address a fungal infection, the easier it is to treat and eliminate.
Ingrown Toenails
Colder temperatures often mean thicker socks, which, combined with snug-fitting shoes, leave less room for your feet. As your toenails grow, they may press against the skin due to the restricted space, significantly increasing the risk of developing ingrown toenails.
What can you do? Keep your nails trimmed straight across the nail, avoiding cutting into the sides. If your toes feel uncomfortable and cramped in thick socks, opt for thinner socks made from warm and durable materials like merino.
Amplified Effects Of Diabetes On The Feet (Sensation And Blood Flow)
For individuals with diabetes, the impact on nerves and blood vessels gradually diminishes sensation and circulation in the feet. Colder temperatures can amplify these effects, similar to what occurs in Raynaud’s phenomenon. Consequently, it is crucial to diligently monitor your feet during this time, ensuring you don’t sustain any unnoticed cuts or wounds that could lead to infection.
What can you do? Make it a habit to check your feet daily, examining both the top and bottom. If necessary, use a mirror to inspect the bottom of your feet. Keep your feet protected and warm at all times, even indoors by wearing socks and slippers. Avoid exposing your feet to direct heat, such as open fires or hot water bottles, as decreased sensation may prevent you from feeling potential burns. Regularly moisturise your feet to maximise your sensation. Additionally, ensure you have your annual diabetic foot health check to stay informed about your foot health status and understand the specific precautions you should take.
Need Help Caring For Your Feet?
Our experienced podiatry team is here to help, and leave you feeling great on your feet. Book your appointment online here or call us on 09 523 2333
There’s a lot that comes to mind when we think of diabetes, and for most people, the risks to their feet and ingrown toenails are not one of them. Yet as podiatrists that specialise in treating ingrown nails, seeing a diabetic with ingrown nails, particularly if they’ve had more than one in the past, rings some big alarm bells for us. Here’s why.
Background: The True Impact Of Diabetes
Diabetes is a whole-body disease that interferes with the way the body removes the sugar from our bloodstream after we eat, leaving high concentrations of sugar in the bloodstream. This becomes dangerous as it produces toxins that negatively affect all body organs and systems, including our vision, heart, kidneys – and the circulatory system and the nerves in your feet and legs, all the way down to the toes.
Specifically, diabetes impairs a person’s ability to fight infection, supply enough oxygen and nutrients to their cells, efficiently heal wounds, and feel what is happening to and around their feet. This occurs because two key processes are disrupted:
Regular, healthy sensation (feeling)
Our nerves are responsible for our ability to feel, detecting everything from a feather being moved across our toes, to standing on an uncomfortable pebble in our shoe. As diabetes can damage the nerves, our ability to feel can fade, become mixed up, and may eventually be lost altogether. This is called peripheral neuropathy.
When we can’t properly feel what is happening around our feet, this makes us vulnerable to sustaining damage, even something as simple as a scrape or a blister from our shoes, and not knowing it has occurred. This means that we can’t take the right measures to look after the wound and protect our feet, leaving them vulnerable to further damage, infection, the wound turning into an ulcer, and more.
Circulation
When diabetes damages the blood vessels and impairs your circulation, your tissues aren’t able to receive the blood flow they need to thrive and carry out their essential cellular processes most efficiently. This means that when you sustain a wound, it will take longer for the body to heal, leaving it open and vulnerable to picking up an infection. If an infection takes hold, it is more difficult for your body to fight, exposing you to a range of potential problems.
Together, impairments in both sensation and circulation are some of the key reasons why 34% of people with diabetes are expected to develop a foot ulcer in their lifetime, approximately half of which become infected, and 15% of which then require an amputation.
What Does This Mean For Your Ingrown Nails?
It means that if you have diabetes:
- You’re at risk of not being able to detect when an ingrown nail starts, as well as when it becomes severe, because your ability to feel pain is disrupted.
- Without pain telling you to care for your toe, you may also miss an infection, which may then spread.
- Aside from being absolutely not recommended for those with diabetes, attempted home treatments for ingrown nails are far less successful because we can often tell when the entire nail spicule is removed from deep within the skin from the feeling of relief and notable pain reduction – something that can be disrupted in diabetes, meaning you may think you successfully removed the ingrown spicule but only part was removed, and part was left behind. This can be very dangerous.
- You may have difficulty healing and closing the wound left from your ingrown nail because of the effects of poor circulation and reduced blood flow to the toes.
- Together with the above, attempted home treatment can worsen the problem because it deepens or widens the wound, making it even more difficult to heal. Additionally, any time you have an open wound, it is susceptible to infection.
- You may continue to struggle with complications from repeated ingrown toenails if you don’t apply effective and ideally permanent treatment to stop the ingrown nail for good.
Having Diabetes Means You Must Take Extra Care With Ingrown Nails
The bottom line is that having diabetes means that you must take extra care of your feet and ingrown toenails to reduce your risk of significant complications like infections or worse. This is where our podiatry team works extensively with people with diabetes to give them the confidence that their feet are safe and progressing well, as well as provide permanent treatment solutions for troublesome, recurring ingrown nails that can solve the problem for good.
Diabetes New Zealand has a formal recommendation for having your feet and ingrown nails cared for by a podiatrist to best support your foot health. You can book an appointment with us online here.
Care Tips For Diabetic Feet
To help you best support your foot health at home, here are a few tips from our podiatrists:
- Wash and dry your feet thoroughly every day, including drying well between the toes to prevent moisture from becoming trapped
- Check your feet daily by holding them up against a mirror if needed, and check the top, bottom and sides of the feet, including between the toes. Look for marks, spots, cuts, swelling or redness that is not normal.
- If you notice anything out of the normal with your feet, book in with a podiatrist or a GP promptly
- Ensure you have good, supportive shoes that minimise your risk of damage to the feet
- Check your socks – ideally, these should be cotton with no elastic in the tops, as they will absorb sweat and reduce pressure at the top of the sock line. There are also seamless diabetic socks available
- Book your diabetic foot assessment every year
- If you have difficulty trimming your toenails, or if you get corns or calluses, consider having podiatry nail and skin care every 6-12 weeks, during which your podiatrist will also be able to check for any warning signs related to your diabetes
