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Ward off blisters and warts ...

Skin and nails may be resilient but they're also vulnerable to fungus, friction and damage.

January 01, 2007|Regina Nuzzo | Special to The Times

SKIN and nails of the feet just don't get any respect. When researchers talk foot science, they lavish attention on bones, muscles, tendons and ligaments.

And when athletes trade stories in the locker room, they'll recount the finer points of a plantar fasciitis episode -- but are far less likely to breathe a word about a wicked case of warts or toenail-crumbling fungus.

Embarrassment: That's forgivable. Taking the humble foot wrapping for granted: That would be nothing short of foolish.

Layers of resilient skin offer the first line of defense against infection-causing microscopic nasties, and thick nail armor protects toes' most vulnerable parts from bashing and bruising.

Well-exercised feet endure more abuse than the typical couch-potato foot, meaning that trauma, fungi and viruses are more likely to present problems. Ignore them and you run the risk of their getting painfully out of control and keeping you on the sidelines.

Luckily, prevention and treatment for most athletic skin ailments is simple. And scientists are steadily finding new solutions, using tools such as sock-testing robotic feet and duct-tape home remedies.

Here's a closer look at the top five surface problems of feet.


Cause: "Pure physics," says Dr. Brian B. Adams, director of the sports dermatology clinic at University of Cincinnati and author of a textbook on the subject. Meaning: they're all about friction.

A new shoe that slips and rubs a bit on your heel may feel fine at the store, but after 1,700 steps -- a runner's typical mile -- it can peel away outer skin from the layers beneath. When that happens, fluid rushes into the gap from surrounding tissue, and there's your blister -- painful, and a nice breeding ground for bacteria too.

Treatment: Don't rip off the skin flap. ("There's no Band-Aid as good as your own skin," Adams says.) Soak in warm Epsom salts. Big blisters can also be sanitized, lanced with a sterilized needle and drained, which speeds reabsorption of loose skin and helps keep infection at bay.

Prevention: Also a matter of physics. Get shoes that fit well, says Dr. Carolyn McAloon, a podiatrist in private practice in Castro Valley, Calif. For super-sweaty feet, try rolling antiperspirant along your soles. And for known hotspots, dab friction-reducing petroleum jelly or a personal lubricant such as Astroglide, McAloon adds.

Change socks often, because sweat actually increases frictional drag on the skin. But watch what you're buying.

Recently, biological engineering students at the University of Missouri-Columbia tested 10 brands of athletic socks in the lab using a specially built device: a plastic foot to hold socks against a simulated shoe, a motor to create a slow-motion stepping action, and a humidity chamber to provide a realistic sweaty-foot environment.

All-cotton socks were the worst, the students found, because friction increased as soon as they cranked up the moisture. Price tag wasn't a factor, however: Although an improvement over cotton, expensive nylon blends were no better than bargain brands.

Athlete's foot

Cause: Mold-like fungi eat protein in the upper layer of your skin, then leave their digested remains -- a dense, moist, smelly mess -- to sit around on your foot, interlaced with still-healthy cells.

You can pick up the fungus from clothing, locker rooms, pool decks and showers. But only in warm, moist conditions will it really thrive -- and odds are good you're cheerfully providing that. "A hot, sweaty foot in an athletic shoe is a perfect environment," says Dr. Kelly Cordoro, a dermatology professor at University of Virginia.

Athletes are also more at risk than less active folks, she says, because tiny, unnoticeable cuts and abrasions acquired during sports activity are convenient "ports of entry" for the fungus to burrow into, then spread.

Burning and itchiness aren't always the biggest problems, though. "Think of the skin as the wall and the fungus as a vine," Adams says. Fungi creep between layers of skin and destroy them from within, giving harmful bacteria -- such as Pseudomonas or Staphylococci -- a chance to invade. Healthy immune systems usually can fight them off, but diabetics and other immunocompromised folks are at risk for more serious infections.

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