Foot problems in the elderly - Caidr
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Foot problems in the elderly

Written by Caidr's team of doctors and pharmacists based in UK | Updated: 04.04.2022 | 4 min read
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For those of advancing years, 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, so you may be at higher risk of dry and cracked skin, or skin 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 footcare, with either a podiatrist (also known as a chiropodist) or even at your local beauty salon, to keep your tootsies in tip-top condition.

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. Surgery for aesthetic reasons is only done privately.

Corns and calluses

Corns and calluses are often used interchangeably but they are slightly different. Corns are hard lumps and calluses are patches of thick, rough skin. They happen over time from repetitive friction of your feet rubbing against shoes. Although some think they can look unsightly, they do not cause serious problems. 

It’s best to buy supportive equipment and footwear to reduce any friction. 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. Your GP 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. 

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 toes involves leaving the toenail to grow out and you should avoid cutting it. Try this technique to keep it clean, soften the skin and relieve pain: soak your foot in warm water with potassium permanganate crystals multiple times a day. 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

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 the infection.

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, ie most one nail is affected, or multiple nails are 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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