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December 5, 2024
Seasonal changes can significantly impact diabetic foot health. In the summer, heat and sweating can create challenges, while cold temperatures and wet weather during the winter present other risks. That's why diabetic winter foot care is so important. Today we'll talk about:
You'll learn all about:
The connection between diabetes and foot health
The importance of diabetic foot care in the winter
Our Foot Specialists' top tips for diabetic winter foot care
The Connection Between Diabetes and Foot Health
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Approximately 800 million adults worldwide have diabetes. It isn’t often immediately recognized as a foot condition on its own, but a serious issue called diabetic foot (a broad term encompassing a wide range of problems) can occur. As a result, foot care should be a top health priority for people with diabetes.
Reduced Blood Flow
People with Diabetes are at risk of developing neuropathy. There are four types, with peripheral symmetric neuropathy (which affects the feet and hands) being the most relevant for diabetes patients.
This condition develops when elevated glucose levels lead to a series of metabolic and vascular changes that impair nerve function. Over time, excess glucose triggers oxidative stress and inflammation, damaging the small blood vessels (microvasculature) that supply the nerves. Without adequate blood flow, nerves are deprived of oxygen and essential nutrients, resulting in their gradual deterioration.
Reduced Sensation
This damage primarily affects sensory nerves, which are responsible for transmitting pain, temperature, and pressure signals to the brain. This progressive loss of sensation makes it difficult for individuals to detect injuries or changes in their feet, such as cuts, blisters, or pressure points. These minor skin issues can turn to diabetic ulcers (open sores or wounds) when ignored.
Reduced Immune Function
Diabetes can also contribute to ulcer formation due to its impact on the immune system. High blood sugar levels over time impair the function of white blood cells, which are essential for fighting infections and promoting wound healing. When blood glucose levels are consistently elevated, it reduces the ability of these immune cells to properly respond to bacteria or other pathogens. This makes it more difficult for the body to prevent wounds that may develop on the feet - including minor cuts, blisters, pressure sores or even calluses - from getting infected. As a result, these small injuries are more likely to become infected, and ultimately lead to diabetic ulcers.
The impaired immune function, combined with poor circulation and reduced sensation, creates a perfect environment for these infections and ulcers to progress, further delaying healing and increasing the risk of severe complications, such as deep tissue infections or gangrene.
Why is Diabetic Foot Care Important in the Winter?
Cold and wet weather can impact everyone's feet, but winter can have a more severe effect on people with diabetes.
Cold Weather and Diabetes: Risk Factors
Low temperatures: Cold air can reduce circulation by constricting blood vessels, particularly in the lower extremities, making it even more difficult for already-compromised vessels to supply the feet with sufficient oxygen and nutrients. This further impairs the body’s ability to heal wounds.
Wet conditions: Snow, rain and sleet getting into your shoes and socks is a recipe for disaster for diabetics. You can develop blisters, sores and infections (which are all ulcer risks) when you let moisture build for too long.
Dry skin: On the other hand, it is also not ideal for your skin to be too dry. By nature, cold air is very dry. Indoor heating makes the air even dryer by extracting humidity. The lack of moisture in the air dries out the skin - including the skin on our feet. This makes calluses form faster and can lead to issues like cracked heels. And since diabetes impairs the body's ability to heal dry skin and cracked heels, the cracks can easily split open, get infected and turn into a diabetic ulcer.
Winter Foot Care for Diabetics
Podiatrists and chiropodists strongly advise individuals with diabetes to take extra care of their feet during the winter months due to the increased risks posed by the elements. If you have diabetes, keep reading to learn the best tips for winter foot care - all recommended by the foot specialists at our Toronto foot clinic.
Practice Skin Care
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Moisturizing your feet regularly is one of the most important steps to combat dry, cracked skin. However, our foot specialists also caution against using harsh creams full of chemicals and fragrances - especially if you have diabetes. Opt for medically respected products with natural ingredients, like Gehwol’s Lipidro and Dermal Therapy Heel Care, that replenish the natural amount of moisture in the skin while also healing cracks.
Only moisturize your feet after thoroughly cleaning and drying. Check out this ultimate guide to moisturizing your feet to master four easy steps. While you're at it, check out the best foot hygiene routine.
Perform Foot Stretches and Exercises
Movement is one of the most effective ways to manage diabetic foot concerns and counteract the impact of cold weather on blood flow. Low-impact cardio exercises such as swimming and walking can assist people in managing blood flow and sensation loss, respectively. Removing the elements of competition and high strain exertion found in other sports, and focusing solely on safety and motion, is a great way to encourage activity.
There are also targeted, low-impact and easy-to-perform foot stretches and exercises designed for people with diabetes. The goal is to stimulate blood circulation as much as possible while still considering any physical limitations. Below are three light exercises you can try from home, and while they may be hard to perform at first, practice makes perfect!
Toe Curls: Sit with your back straight, feet planted, and use a towel to scrunch your toes and pull it toward you, repeating five times per foot.
Figure Eights: Lift one foot while keeping the heel on the floor, move your foot in a "figure eight" motion, repeating five to 10 times per foot in each direction.
Single Leg Lifts: Stand with feet shoulder-width apart, hands on hips, and lift your left foot straight out in front, keeping your leg straight and foot flexed, repeating five times per foot.
To learn more about these exercises, check out the best stretches and exercises for diabetes.
Practice Moisture Control
Keep your feet reasonably dry as much as possible. This may mean changing your socks and shoes several times per day, and thoroughly drying your feet with a towel intermittently. While this can be annoying and easy to forget during the busy winter season, it’s important to stay on top of this with snow, sleet and rain posing an extra risk.
It’s important to not go overboard with too much direct heat penetrating your feet. While cozying up by the fire is safe on occasion, excessive heat can cause even more damage to the nerves. This is due to reduced sensation in diabetic individuals, which makes it harder to notice high heat and burns.
Below are the best ways to manage excessive moisture during the winter:
Wear moisture-wicking socks.
Change socks regularly, especially if they get wet.
Use foot powders and deodorants.
Choose breathable, well-ventilated shoes.
Choose shoes made with waterproof fabrics, like GORE-TEX. This fabric uses a membrane with pores small enough to block water but large enough to allow sweat vapor to escape. This creates a waterproof yet breathable barrier, keeping feet dry and comfortable.
Dry feet thoroughly with a towel after washing, especially between toes.
Avoid tight shoes that trap moisture.
Consider insoles with moisture-absorbing qualities.
Keep feet clean and dry before bed.
Perform Foot Inspections
At-home foot inspections are a good diabetic foot care measure in the winter (and in general) because they help identify potential issues like cuts, blisters, or signs of infection early, when they're easier to treat.
Check for cuts, blisters, or sores: Examine the entire surface of your feet for any visible signs of injury and skin perforation.
Look for changes in skin color or temperature: Check for any redness, swelling, or areas that feel unusually warm or cold.
Check your toenails and between toes: Look for ingrown toenails, cracked toenails and fungal infections,
Try Diabetic Socks
Compression stockings are a great way to enhance blood flow to the legs and feet, but they are not recommended for people with diabetes since they can do the opposite and restrict blood flow too much in the arteries. Instead, ask a podiatrist or chiropodist about diabetic socks and if they might work for you. They have several benefits, which are especially useful in the winter, including:
Antimicrobial treatment which prevents bacterial and fungal growth.
Slightly cushioned footbed for extra comfort and protection.
Loose, non-binding top band which rests comfortably around the ankles or calves, allowing more circulation.
Moisture-wicking and stretchy material.
Smooth toe area to prevent blisters and other skin irritation.
Choose the Right Footwear
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For diabetes patients, wearing proper footwear in the winter is essential for maintaining foot health.
Orthopedic shoes are an excellent choice, as they offer extra cushioning, arch support, depth, elasticity, adjustable straps and ample room to reduce pressure points and prevent blisters or sores.
High-quality winter footwear can also be effective, provided it offers warmth, water resistance, and moisture control properties to keep feet dry and comfortable. Here is what you should pay attention to:
Waterproof materials: As you already know, materials like GORE-TEX help maintain dryness by utilizing a membrane with microscopic pores. These pores are small enough to block water molecules, but large enough to allow vapor from sweat to escape. This technology effectively prevents external moisture, like snow or rain, from penetrating the footwear, keeping feet dry. The breathability of GORE-TEX also ensures that perspiration from the feet can escape, which prevents a buildup of moisture inside the shoe. This combination of waterproofing and breathability is essential for preventing cold and damp feet
Adequate insulation: This is crucial for maintaining warmth in winter footwear as insulation helps lock in warm air and retain body heat. Look for insulated winter shoes and boots that also let you maintain moisture control. And remember to let your feet air out after sweating in your boots all day to avoid excessive dampness.
Non-slip soles: For better traction on icy or slippery surfaces to avoid falls.
Cushioning and arch support: To provide comfort and reduce strain on the feet, especially when walking for extended periods.
Roomy toe box: To avoid friction and pressure on the toes, preventing blisters or sores.
Breathable lining: To allow moisture to escape and keep feet dry, reducing the risk of infections.
Adjustable closures: To ensure a secure fit without restricting circulation, particularly important for those with swelling or neuropathy.
In addition, custom orthotics can provide personalized support, improving foot alignment and alleviating pressure, further reducing the risk of diabetic foot complications.
Visit a Foot Specialist
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Our top tip for managing diabetic feet in winter? Book an appointment with a foot care provider, like a podiatrist or chiropodist, at a foot clinic.
At Feet First Clinic, our chiropodists are trained to:
Offer comprehensive education on how cold weather can affect diabetic feet.
Provide skin and nail care.
Provide wound care.
Offer custom orthotics services: assessments, casting, fittings and follow-up guidance.
Thoroughly inspect your feet and pinpoint potential issues (this can be difficult to fully achieve at home, since diabetes also affects eyesight).
Help you understand what winter boots or shoes you should wear, which you can then browse for at our store. A member of our staff can guide you through our options with a complimentary shoe fitting.
Discuss the benefits of products like diabetic socks, orthopedic slippers, moisturizers, and more, which you can then purchase at our store.
Contact our Toronto foot clinic to learn how a foot assessment can be your first step toward healthier, happier feet this winter!
September 2, 2024
Ingrown toenails can be more than just a foot problem. Quite frankly, they're annoying. They can also lead to significant discomfort and even serious complications if not addressed properly. Many people don’t even fully understand what they are or what “ingrown” really looks like, so recognizing ingrown toenails early is crucial! This will allow for prompt, effective and safe ingrown toenail treatment, which will reduce your risk of infection and help you avoid more invasive procedures.
Recognizing Ingrown Toenails
So, how can you tell if you’re dealing with an ingrown toenail? The first symptoms include pain and tenderness along the side edge of your toenail (the exact location is the called the paronychium, or the soft tissue border around the nail), typically on the big toe. Why the big toe? It is larger and more vulnerable! It withstands the most damaging effects from poor foot care habits (more on that later).
You might also notice swelling, redness, and warmth in the affected area. If the condition progresses, pus may develop, indicating an ingrown toenail infection. Catching these signs early is key to avoiding further issues.
Visually, it may look curved or embedded, or simply like a tiny, strange nail growth attached to the main nail. You may also see skin growing over the nail.
Ingrown Toenails Causes
Ingrown toenails result from seemingly innocent routines that over time, damage your foot health.
These include improper nail trimming — cutting nails too short or rounding the edges (many people do this for aesthetics but it's a big no-no!) which encourages the nail to grow into the skin. Tight shoes that squeeze the toes together (your feet may be wider than you think), as well as injuries to the toenail, are also common culprits. In some cases, genetics may play a role: some people's natural nail shape and growth pattern may make them more predisposed to developing ingrown toenails, like involuted or pincer toenails.
Knowing these causes gives you the upper hand in preventing ingrown toenails before they start.
Preventing Ingrown Toenails
Wherever possible, prevention is always better than cure.
By trimming your nails straight across, wearing shoes that fit properly, and keeping your feet clean, you can significantly reduce the risk of developing ingrown toenails and a corresponding infection.
If you’re unsure how to cut your toenails properly, especially if you have conditions like diabetic neuropathy, seeking help from a chiropodist for a medical pedicure can be a smart choice. People with diabetes need to be extra vigilant about foot care, as their condition can make them more susceptible to complications from ingrown toenails. Click here to see how a deceptively minor laceration can turn into an ulcer.
Regularly checking your feet, especially if you’re prone to ingrown toenails, is also an essential part of care.
Treating Ingrown Toenails
For mild cases in the early stages, soaking your foot in warm water for 15 minutes 2 times a day can soften the skin and reduce swelling. After, you can wedge a wet piece of cotton under the corner of the toenail to help lift the ingrown portion while it heals. But beware—safe ingrown toenail treatment at home requires careful handling to avoid making things worse. And whatever you do, do not attempt to cut the toenail or dig the ingrown portion out.
If there's no improvement in 3 days, or if you're experiencing any pain or irritation, seeking professional ingrown toenails treatment from a Toronto chiropodist is a better idea. For safe ingrown toenail treatment, always see a chiropodist - do not go to a salon. If you try to treat your ingrown toenail at home (or at a salon), you can get an infection and make things worse. Plus, when you do ultimately see the chiropodist, the chiropodist will have to cut the toenail even shorter than they normally would in order to fix the DIY job. This lengthens the healing process.
If the pain is severe and you’re waiting for your chiropody appointment, try the following tips for ingrown toenail relief:
Soaking your feet in warm (not hot) water with Epson salts: The salt is a natural disinfectant and will help clean the wound so that it doesn't get infected and become further irritated.
If there are signs of infection (i.e.: bleeding, discharge), wear a band-aid over the ingrown toenail when you're wearing shoes and socks to prevent bacteria from getting stuck in the wound.
Try over-the-counter pain relievers like Tylenol or Ibuprofen
These can offer temporary comfort before you can address the root cause and follow proper treatment guidelines.
Safe Ingrown Toenail Removal
Safe ingrown toenail removal with a licensed chiropodist is always the best way to go. Most ingrown toenails do not need to be surgically removed: a chiropodist can typically safely remove it non-surgically with sterilized tools in a sanitized, safe environment. They can also cut the toenail in a way to prevent it from coming back.
In severe cases (like if you attempted to fix your own ingrown toenail and it got infected, or your ingrown toenail keeps coming back), safe ingrown toenail treatment may involve a minor surgical procedure from a chiropodist called a total or partial nail avulsion.
August 15, 2024
Whether they're discoloured, cracked, ingrown, curly, or on the verge of falling off, toenail anatomy can be fragile and our nails can do funny things. A less commonly discussed issue is a secondary toenail. Also known as an accessory toenail or petaloid toenail, a secondary toenail is a sneaky little extra nail twin that grows alongside or beneath the pinky toenail. This abnormal toenail growth can be concerning, so it’s natural to have questions.
Signs You Have a Secondary Toenail
It’s important to know the difference between an ingrown toenail and an accessory toenail.
First, ingrown toenails can grow on any toe, whereas a secondary toenail appears on the fifth, smallest toe.
Ingrown toenails are also far more common, and pierce the skin rather than growing alongside the nail.
Secondary toenails are thin in nature and often don’t cause pain, infection or swelling like ingrown toenails do (although it is possible).
Lastly, ingrown toenails form on the side of the nail unit, whereas secondary toenails grow underneath the proper nail.
What Causes a Secondary Toenail?
A secondary toenail is a rare phenomenon.
It often makes an unexpected appearance after trauma or injury to the nail bed. You may notice your nail growing differently after stubbing or hurting it. Chronic pressure from tight shoes or less-than-perfect nail trimming can also coax this extra nail into existence.
Do You Need Surgery For Secondary Toenails?
Studies show that the treatment of choice for this extra pinky toenail is an excision, especially if it’s infected. A partial or total nail avulsion from Toronto’s Feet First Clinic may be the solution you need, but you’ll have to schedule a proper foot assessment to determine the best course of action.
Treatment of accessory toenails targets the original toenail, not the second one. The second toenail should grow properly after the “main” nail is removed.
August 1, 2024
A toenail falling off can be uncomfortable and cause concern about damage to the toenail. The goal is to preserve the toenail's state to prevent further damage.
Fortunately, if you take a few proactive steps, you can reduce the discomfort and promote healing. Here are our six tips for managing a toenail on the verge of falling off.
1. Keep the toenail area clean and dry
Wash the toenail gently and often. We recommend using mild soap and water to keep it clean. Next, pat dry so as not to snag the toenail with a towel.
2. Cut the nail carefully and slowly
Use clean, sterilized nail clippers to remove any dangling or loose portions of the toenail. Cut straight across without digging into the surrounding skin. The goal here is to prevent further snagging or tearing down the road. Improperly cutting your nail may also increase your risk of an ingrown toenail.
In addition to trimming the toenail straight across, you should trim the toenail slowly. Don't over-cut it. Be patient with toenail growth. (It may take months to a year for a nail to fully grow out.) If in doubt, let our toenail specialists in Toronto trim your toenails for you as part of a medical pedicure.
3. Use a non-stick bandage to protect the area
We recommend applying a bandage or non-sticky wrap to your toe. (Adhesive can attach itself to the toenail and be difficult to peel off without grabbing onto it.) A protective layer keeps an otherwise exposed nail bed safe. Replace the bandage regularly and keep the area dry to promote healing.
4. Antiseptic ointment is your friend
Use an antiseptic ointment or petroleum jelly on the exposed nail bed to keep it moisturized and prevent infection. This may help soothe any discomfort from the loose toenail.
5. Choose comfortable and roomier footwear
You'll want to reduce pressure as much as possible to prevent a loose toenail from falling off. Given that we wear footwear so often, finding shoes with ample fit can help prevent further damage to the toenails.
6. Avoid intense activity
Reduce your activity level if it puts excessive pressure or strain on the affected toenail. For instance, running or high-impact sports like soccer could increase the risk of the toenail getting snagged or torn off. Give your toe some rest, and return to physical activity gradually.
July 11, 2024
There's always the right tool for the job. Using each tool for its intended purpose is best, or you risk doing more damage than good. That's why fingernail clippers and toenail clippers exist.
To understand why, it's important to understand the difference between toenails and fingernails. Toenails are thicker, harder, and grow slower than fingernails because your feet and hands serve different functions. Toenails also have a greater surface area.
In this blog post, we explain why you should avoid using fingernail clippers for your toenails and opt for toenail clippers exclusively.
Reduce the risk of bacterial or fungal contamination
For one, separating your nail tools prevents contamination and possible spread of bacteria and fungus. Given how exposed your hands are every day, you wouldn't want to spread any bacteria to your feet.
When in doubt, clean your clippers with 70%—90% isopropyl alcohol.
Fingernail clippers may not work on toenails
When looking at fingernail vs. toenail clippers, the size difference is stark. Fingernail clippers are smaller, narrower, and curved. Toenail clippers are larger, wider, and straight across, as you should trim your toenails straight across. Cutting them with a curved edge increases your risk of ingrown toenails.
If you want more guidance on choosing the tool for your toenails, read our blog post on our top choices for toenail clippers.
Limit the risk of cracking and damaging your toenails
Using sharp, rigid toenail clippers makes trimming easy and more effective. Using fingernail clippers means you'll need to apply more pressure to cut the nail and risk damaging or even cracking the toenail.
If you don’t have the right tools, enough time, or simply the confidence to focus on a nail trim, try a medical pedicure instead. It includes the right nail trimming procedure and includes moisturization, thorough cleaning, and more. Before the nail trim, a chiropodist also examines your feet for other foot conditions.
Prevent ingrown toenails
You'll also notice the curvature of fingernail vs. toenail clippers. Fingernail clippers are curved and meant to follow the contours of your fingernails. On the other hand, toenails are plateaued and should be cut straight across. Using a curved tool on your toenails puts you at risk of jagged edges, nail splitting, or could be a root cause of ingrown toenails.
If you wish, use a nail file to round the edges. This tool is necessary for properly smoothing the edges of the nails. After the trimming, there will likely be some jagged edges, sharp corners, and “spikes.”
March 21, 2024
Foot hygiene and solid foot care tips are your secret weapons for happy and healthy feet! Everyone should practice a clean and healthy foot routine, but those with foot conditions such as diabetes or chronic fungal infections should be extra vigilant. Today we’ll talk about the best foot cleaning practices and how to implement them into your daily foot care routine.
Foot Health Essentials: How to Keep Your Feet Clean and Protected
Foot hygiene is pretty straightforward stuff! But you may make some minor missteps along the way. Take a look below at the best ways to wash, dry and moisturize your feet.
Washing Your Feet
Wash your feet daily with natural, gentle soaps in warm water. Hot water can negatively impact your blood circulation by increasing the size of the blood vessels, so be careful with temperatures. After, pat your feet dry- especially between your toes.
Moisturizing Your Feet
Use lotion on the bottom and top of your feet. This can help you prevent calluses, corns, cracked heels, and more. Natural, fragrance-free and medicinal lotions are your best bet. Be careful to avoid putting lotion in between your toes; it could cause an infection depending on the lotion. Fungal infections also favour wet toes and tend to appear there.
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Keeping Your Feet Dry
Thoroughly dry your feet after washing them. If you get lazy and keep them damp, you are again more likely to attract contagious fungal infections (they love moist environments!).
Invest in products that help manage foot dampness and repel excess moisture. These include moisture-wicking socks (also remember to change your sock frequently!), waterproof shoes and boots, running shoes with perforated holes in the uppers, and various foot deodorant products (creams, powders, sprays). These products are also great for preventing foot odour.
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Toenail Care and Foot Hygiene
Keeping your nails in top shape is an important element of foot hygiene. Follow these nail care tips to protect your nails and keep them clean and strong.
Cut your nails straight across with high-quality nail clippers. Don’t try to shape them during this stage!
Avoid cutting your nails too close to the skin; this will cause ingrown toenails.
Gently use a nail file for subtle shaping.
Don’t cut or push down your own cuticles. They protect the nails and getting rid of them improperly may welcome fungi and increase the chance of a bacterial infection.
Schedule a medical pedicure for professional care and a cleaning of hard-to-reach areas.
