Foot Problems in the Elderly
As we get older it can become more difficult to care for your feet for a number of reasons. Firstly, you may have joint and dexterity issues in reaching your feet and using tools to maintain care, such as clipping toenails. Secondly, you may have medical conditions that put your feet at risk, such as a lack of feeling in the nerves in advanced diabetes, which might cause infection, or poor circulation putting you at risk of chilblains, eczema and ulcers.
Components in skin that keep it stretchy, plump and well-nourished reduce with age, which means you may be at higher risk of dry and cracked skin, or have skin that’s more likely to tear or ulcerate.
We’ve put together a list of common foot problems for you to be aware of, but it may be worth investing in regular foot care, either with a podiatrist (sometimes also known as a chiropodist) or even at your local beauty salon, to keep your toes and feet in good condition.
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Bunions
Bunions are hardened lumps that occur on the side of your big toes. They may cause your big toe to point outwards towards the other toes. Bunions can become painful, especially when walking or with shoes. In this case, you can try simple measures such as avoiding tight shoes, taking simple painkillers like paracetamol or ibuprofen and using an icepack.
Feet may be more comfortable with pads to cushion bunions while out and about, and you can buy these from your local pharmacy.
Your GP may refer you to a podiatrist, or you can refer yourself. They will consider specially made supports to help with the pain, such as insoles (orthotics), toe spacers, and toe supports (splints).
Bunion surgery is the only cure for bunions but actually doesn't prevent bunions from recurring. Bunion surgery is not usually done on the NHS, unless under certain circumstances, such as significant pain or affecting the way you walk and surgery for aesthetic reasons (because of how they look) is only done privately.
Corns and calluses
The terms corns and calluses are often used interchangeably but they are in fact slightly different from each other - corns are hard lumps whereas calluses are patches of thick, rough skin. They happen over time from repetitive friction of your feet rubbing against shoes and although some people can think they can look unsightly, they don’t cause serious problems.
It’s best to buy supportive equipment and footwear to reduce any friction and this can be in the form of thicker socks, insoles or corn pads, available from your local pharmacy. Wide comfortable footwear is also important to give your foot that space to move. You can try to soften them at home with warm water and then moisturise and file them down with specific equipment.
If you have diabetes, heart disease or poor circulation, you should see your GP who may refer you to a specialist for advice regarding your condition or refer you to a podiatrist.
If there are any signs of infection, your GP may offer antibiotics, or they may suggest that you see a podiatrist for removal either by cutting them out or trying alternative treatments.
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Ingrown toenail
An ingrown toenail is where your nail grows into the skin alongside the toe, causing you pain, especially when walking or standing. It can lead to an infection, which you will recognise by every stronger pain, swelling, redness, pus and possibly feeling a bit unwell in yourself.
Management of ingrown toenails involves leaving the toenail to grow out and so you should avoid cutting it while this happens. Soaking your feet in warm water with potassium permanganate crystals can help to keep it clean, soften the skin and relieve pain. Symptoms can also be helped by wearing comfortable, wide-fitting shoes, or open-toed sandals, if weather permits.
You should see your doctor if you have diabetes, as this can worsen foot problems. You may even have direct access to a podiatrist, who may be able to help with an ingrown toenail. If there are any signs of infection, your GP will need to give you antibiotics.
If you still require treatment for your ingrown toenail you should see a podiatrist. With some local anaesthetic injection, they can either cut away part of the nail or the whole nail.
Fungal toenail infection
A fungal toenail infection is recognisable as the nail (or nails) turning yellow/brown, and thickened, crumbly and soft. You can manage this in several ways: firstly, try some treatments from your pharmacist such as antifungal nail cream or nail lacquer. You have to be patient with this as it can take up to 12 months to cure the infection. Keep your nails as short as possible to help clear the infection and avoid the other nails catching it.
For hardened nails, it's worth using nail softening creams – persist with this for several weeks to soften the nails and then scrape away the fungus.
With severe fungal infection, (more than one nail is affected) or if home treatments haven’t helped, book an appointment with your doctor or a podiatrist. They will take nail clippings and send these to the laboratory for confirmation. If this shows up a fungal infection, you may be prescribed oral antifungal tablets that need to be taken for at least three months before a view. Toenails often require at least 6 months of treatment.
These medications have side effects, so your doctor will need to check your medical history and do some baseline blood tests before they can start you on them. A podiatrist will also be able to soften, trim and remove the fungal area from the nail.
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