Pharmacies are stocked full of various products to relieve foot problems. While many of these products are helpful and effective, there are others that are generally not helpful and should be ignored in favor of medical-grade products. This article will discuss several of these product categories, and offer a perspective by a foot specialist as to what may be useful for foot care. To begin, it should be stated that the author favors no specific company or product in this discussion. Products continuously change, and therefore this article simply seeks to discuss general product categories that are related to foot care. These general categories include products for athlete's foot, warts, nail fungus, food support, corn and callus padding, and dry skin. Each category will be discussed separately, and general recommendations for their use will be given. Athletes foot infection is one of the most common foot ailments that one presents to the pharmacy for treatment. This infection is caused by microscopic fungus that invades the skin. It is very common, and difficult to avoid. However, it generally responds quickly to treatment. Numerous anti-fungal medications have been available for years to battle this infection, including tolnaftate, miconazole, and clotrimazole. They generally all work against the different types of fungus that cause athlete's foot infection. Most of the over-the-counter preparations are in cream or spray form. Treatment twice a day is necessary for two to four weeks to completely eradicate the infection, although one major brand containing terbinafine may work in a week. Although the author prefers the cream form, any of these products should do, as long as the primary ingredient is not promoted as herbally based (such as tea tree oil), as there is a lack of scientific proof of herbal effectiveness in skin infections. Infections not fully resolved by these medications may need medical evaluation and possibly prescription level medication. Wart treatment at home is often unsuccessful, and therefore the use of products from the pharmacy for this condition may be unhelpful. Warts are due to an infection by a skin virus, and in general this infection is passed over by the body's immune system. Treatment is designed around irritating the surrounding skin to create inflammation, which eventually attracts the immune system and stimulates an immune response to destroy the virus. Numerous chemical agents, typically containing salicylic acid, are available to use for this purpose. Freezing also causes the same reaction through cold damage. Unfortunately, these is a false perception that these treatments actually kill the virus directly. They do not, as the virus is spread wide and deep beyond the visible wart tissue. The acid and freezing products in the store are generally weak for safety purposes. Although they can be effective for hand warts, the thicker skin of the feet makes these products of limited value. They are helpful when used in conjunction with medical treatment by a podiatrist or dermatologist, but on their own are often too weak to be the primary treatment. Nail fungus cure products have recently exploded their presence in stores, all offering relief from the cosmetically displeasing infection. Unfortunately, there are very few topical nail fungus medications that can penetrate through to the skin surface underneath the nail where the fungus resides, and none of these are available in a retail setting. These products can control fungus in the skin around the nail, but do not treat the nail fungus itself and are generally useless. Shoe inserts are numerous and widely available in pharmacies, with each style having their own role to play. Most of these inserts are made of foam, soft composites, or gel. In all honesty, these inserts provide very little in the way of true structural support, as they mostly collapse and deform when body weight is placed on them. This is even true of the ones that require stepping on a 'scanner' to select an insert. Some brands do have models that use thin plastic plates within the padding for more support, but even this is marginal at best. Overall, these inserts provide increased cushioning within a shoe, which can drastically improve a shoe's comfort level. However, one should not expect much in the way of real arch support. The least helpful of these are the gel inserts, which provide only a little more support than the shoe's own sockliner. Padding is also plentiful, and in general foot pads work well to reduce pressure to corns and calluses. They can be made of adhesive felt, foam, or silicone gel, and come in a variety of shapes and sizes. In general, doughnut-shaped pads work well for calluses under the ball of the foot, while elastic sleeve pads with gel underneath work well for corns on top of the toes. Toe separator pads help reduce pressure for corns in between the toes, and metatarsal pads provide limited pressure reduction under the bones in the ball of the foot. These are all recommended, although the author strongly discourages the use of medicated pads that contain skin-damaging acids. Finally, moisturizers are available in hundreds of brand names and preparations. All of these products generally work the same, although the ingredients may differ. In general, herbs and extracts are filler material and marketing gimmicks, and offer no real improvement in the effectiveness of the moisturizer. The chemical forming the base of the product is what really creates the moisturizing effect, and it needs to be applied twice a day to be effective. Although store labels may differentiate between hand, body, or foot cream, they will all work equally on all surfaces of skin. Most people can benefit from the standard preparations containing water, glycerin, petrolatum, or various oils. More substantial dryness or cracking skin needs lactic acid or urea as the base ingredient, and serious cases need prescription concentrations of these chemicals. As one can see, the wealth of options in the pharmacy for foot care can be confusing. Many products are quite helpful in certain foot conditions, while others are a waste of money. When selecting foot care products, especially medications, look at the active ingredient before purchasing, and look online to compare the experiences of others. When in doubt, call your podiatrist for more information.
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