Podiatrists manage the health of patients' feet on a daily basis and one of the keystones of this management, is the use of moisturisers. But why do we recommend this?
Almost every person will experience dry skin during their lifetime (Flynn et al, 2001) and this can be on any part of the body. Some people have no issues with this, whilst others can have a chronic problem which can be debilitating and affect an individuals daily activities.
Layers of the skin
In order to understand how the skin is affected by dryness, it's useful to have a quick peak at the layers of the skin. In basic terms the skin has two layers: the dermis and the epidermis.
The dermis is the deeper of the two layers and contains small blood vessels, nerves and hair follicles. The epidermis is the more superficial layer, and is the one which becomes dry and in some cases itchy. Cells (corneocytes) in the this layer are designed to move from the deeper epidermis to the more superficial, changing as they age and being replaced by younger cells. This layer is often affected by conditions which cause dry skin such as psoriasis.
Sweating, friction from footwear, shearing and torsional forces in the skin itself can all lead to a reduction in the moisture content of the epidermis.
So what happens if the skin stays dry?
In the majority of people there may be no issues at all. Their normal control of the natural skin moisturisers may be enough to prevent problems. In those individuals where this process is impaired, cracks in the skin can occur which are painful and increase the potential for infecting organisms such as fungus and bacteria. Not a nice thought and more common than you would imagine.
So what do we do about it?
Well, on the whole there is a simple solution to dry skin - use a moisturiser! Sounds simple doesn't it?
Any moisturiser applied to the skin will provide an increase in skin hydration and water content and this helps the corneocytes to swell, reducing the chance of invading organisms and maintaining the skins elasticity and resistance to stress and shear. They also reduce moisture loss from the skin by occlusion.
In a study looking at aqueous cream and CCS cream applied to the feet, Baalham et al (2011) found that both creams hydrated the skin, but it was CCS which hydrated the skin significantly more and they recommend the use of CCS over aqueous cream in dry skin conditions of the feet.
So what can we take from this?
My basic advice to patients is to moisturise. Use whatever you feel comfortable with and what you have access too, but be aware that for more serious levels of dry skin, a moisturiser containing an ingredient such as urea may be much more appropriate.
I use CCS in my clinic and apply this to my patients feet after treatment and have for many years found it greatly beneficial. It's important to also note that there are other creams containing urea out there, with difference concentrations, perfumes and packing and it is down to individual preference.
At the end of the day, it's best to moisturise your feet!
If you have any questions, comments, or wish to enquire about an appointment then please get in touch.
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Flynn TC, Petros J, Clark RE & Viehman GE (2001) Dry skin and moisturizers. Clinics in Dermatology. 19:387-392.
Baalham P, Birch I, Young M & Beale C (2011) Xerosis of the feet: a comparative study on the effectiveness of two moisturizers. British Journal of Community Nursing. 16(12): 591-597.