Signs of bacterial infection of the skin include pain, redness, draining, swelling, and pitting and sloughing of the skin. In severe infections, malaise, loss of appetite, fever, chills, nausea, and vomiting can occur. It is always safest to have a suspected infection evaluated by a medical professional. Any one experiencing symptoms of infection should seek immediate medical attention.
An ingrown toenail can puncture the skin and cause a painful bacterial infection, commonly on the big toe. In minor cases, soaking the infected toe in warm soapy water twice daily and covering the site with iodine or a topical antibiotic and a bandage can help heal the infection. Check the nail and remove any sharo edges that may be the cause of the infection. For recurrent in fections, a podiatrist may need to care for the nail. See the chapter on nails for more information.
Feet that sweat excessively are especially vulnerable to an infection that may mimic a bacterial infection but is caused by a type of fungus known as yeast. Candida albicans is a common yeast that thrives in warm, moist environments, which makes the skin between the toes an ideal location for infection. White, sloughing skin with surrounding redness is a sign of Candida albicans infection.
This yeast infection is often mistaken for athlete's foot, but is not treatable with some of the more common over the-counter athlete's foot medications. If a suspected case of athlete's foot does not improve after two to three days of using topical antifugal medications, then a b acterial or candida infection may be present. Seek care from a medical professional.
Reference: Great Feet for Life: Paul Langer, DPM
Itching Skin on the Feet
Itching skin is very common. It can be caused by a numb er of things, including certain medications, changes in the blood flow, infections, parasites, allergic reactions, and skin conditions (such as eczema and psoriasis). Most commonly, itching skin of the feet is caused by athlete's foot or, simply, dryness.
Eczema is a condition where dry, itchy patches of skin form on the lower legs or feet. Outbreaks are sometimes also found on the trunk or arms as well. There are a few different forms of eczema, each with its own unique characteristics. The skin lesions may be caused by allergic reactions, nutritional deficiencies, hereditary factors, or circulation changes.
Treatment is dependent on which type of eczema is present. For this reason, you should see a doctor if you think you have eczema
Psoriasis is a hereditary skin disorder that causes skin lesions, swelling, and arthritis. It appears as itchy patches of silvery scales on the elbows, scalp, forearms, back, hands, or feet. It can make wearing shoes and socks uncomfortable and even painful. While 75 percent of those with psoriasis are affected at an early age, 25 percent do not see symptoms until age fifty or later.
Allergic reactions can cause itching, redness, hives, bumps, and blisters. The most common cause of allergic reactions on the skin of the feet are new shoes, new socks, new laundry detergent, or a bandage. In fact, a good indication of an allergic reaction is that often the irritated area has the shape of whatever caused the reaction, such as straps from a sandal. Leather is not usually an allergen, but shoe leather may contain other materials, such as synthetics, dyes, or adhesives, that do cause allergic reactions.
Many socks contain synthetic elastic fibres that can cause or contribute to rashes. Latex and other synthetic rubbers are highly allergenic for some people. In addition to what people put over their feet, what they put on their feet can also trigger or contribute to allergic reactions. Adhesives found in tapes or bandages are allergens for some. And some people are allergic to creams, lotions, powders, and even topical antibiotics. Of special concern are over-the-counter corn and callus treatments. In people with poor circulation, diabetes, or numbness, these treatments can cause severe skin reactions.
Sometimes allergens get on the skin unintentionally. People who are allergic to plants such as poison ivy and poison oak should wash off any oily residue with soap and water as quickly as possible in order to minimize the severity of the skin reaction.
Parasite infestations can be intensly itchy, especially at night. The parasite burrows under the skin leaving a curved track that can be seen in the itching area. Sometimes ther are small blisters present as well. Norwegian or keratotic scabies can produce white scales under and around the toenails and then spread to the surrounding skin. Suspected parasite infestations should be diagnosed and treated by a physician.
Athlete's Foot is an infection of the skin caused by a fungus. Fungus is always living on our skin. Most of the time, this fungus is held in check by our immune system. Occasionally, however, when con ditions are right, the fungus can overwhelm our natural defenses and flare up, by either rapidly reproducing on the surface of the skin or by infecting tiny scapes or tears in the skin.
The most common symptoms of Athlete's Foot are redness with itching. Flaking skin on the bottom of the foot. Some forms of athlete's foot cause moist, white, peeling skin between the toes or small fluid-filled blisters on the arch. Other symptoms including burning and odor. if untreated, athlete's foot can contribute to fungal infection of the toenails and secondary bacterial skin infections. Even with diligent treatment some people are vulnerable to recurrences.
In addition to good foot hygiene, treatment of athlete's foot requires medication. Seventy to 80 percent of athlete's foot infections respond to topical , over-the-counter treatments. A doctor's care may be needed for stubborn cases of athlete's foot(those that do not respond to treatment within one or two weeks). He or she may run diagnostic lab tests to confirm the diagnosis and to decide if treatment with prescription medication is necessary.
Sloughing, or peeling skin between the toes can be a sign of a particularly stubborn form of athlete's foot that involves a bacterial infection as well as a fungal infection. This form is most commonly seen between the fourth and fifth toes. Treatment is the same as that for opther athlete's foot outbreaks: wash and thoroughly dry the feet and apply an antifugal powder on a daily basis.In some cases, placing swatches of cotton or lamb's wool between the toes is also helpful. Keeping the areas between the toes as dry as possible will promote healing.Sufferers should see a doctor if an outbreak does not respond within two weeks. A priscription medication may be required.
Blisters on the Feet
Blisters on the feet can be caused by drug reactions, allergic reactions, or friction (rubbing)-most commonly, the friction created by wearing new shoes. In severe cases, blood will fill the blisters and cause them to appear purple or black. Shoes that are too wide usually cause blisters in the arch or the bottom of the forefoot.Shoes that do not have enough toe length or toe depth will cause blisters on the tops or sides of the toes. Shoes that are too stiff or too loose in the heel will cause blisters on the back of the heels.
Once a blister has broken open or drained, it should be treated as any open sore and monitored for signs of infection. Treat the site with a topical antibiotic and cover with a bandage. If the blister is painful and does not drain or break open, it should be seen by a doctor. Likewise, see a doctor if a blister shows signs of infection (growing redness around the site, presence of pus). To avoid infection, it is best to have a medical professional drain the fluid from the blister. A doctor can also best diagnose and treat a blister that is infected.
If a medical professional is not readily available and the blister is in a place that limits walking ability, you may drain it carefully yourself. keep in mind that a blister that is punctured or breaks open is much more likely to become infected than a blister that remains intact. Blisters that are red or purple in color likely contain blood and should not be punctured. Ideally, you should clean the skin around the blister with iodine or similar antiseptic before attempting to drain it.
Occasionally the blister will require two to three punctures to drain. Drain all of the fluid to alleviate the discomfort the blister is causing you, but do not remove the skin of the blister. Protect, cover, and monitor the site of the blister for signs of infection. Eventually, the blistered skin will dry up and slough off as it heals.
Sweaty or Smelly Feet
Hyperhidrosis is a condition where the sweat glands of the feet and hands are overactive, resulting in excessive sweating. Many thigs, including stress, changes in the weather, illness, and medications, can trigger an episode of excessive sweating. Most often, we don't know what the trigger is.
Socks are important for preventing and treating hyperhidrosis because they can either trap moisture next to the skin or help to evaporate. Contrary to popular belief, cotton is not the ideal fabric for socks, because when cotton gets wet it stays wet. Though soft and absorbent, cotton is not as effective as newer fabrics at protecting the skin of the feet.
Nylon and other synthetic materials can wick, or pull, moisture away from the skin and help it to evaporate. All shoe stores and sporting good stores carry socks that wick moisture from the skin. But wicking socks have their limitations, so even these socks should be changed two or more times a day if the feet are particularly sweaty,
topical skin treatments can also help control excessive moisture. Powders are very effective at keeping the feet cool and dry. Most powders are made from talc or cornstarch, or combination of the two. For those with sensitive skin, corn starch-based powders may be less irritating.
Foot powders that include antifugal ingredients are especially useful for those with sthlete's foot. It is best to apply the powder directly to the feet instead of sprinkling it into socks or shoes.
Some roll-on and powder products contain the antiperspirant aluminum chloride and can decrease sweating when applied daily. They also work well in combination with other treatments described in these chapters. Aluminum chloride products are available without prescription at many stores and pharmacies.
Reference:Great Feet For Life: Paul Langer, DPM