Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2001;64(5):803-804

Caution: If you have blood vessel disease in your feet or have diabetes, talk to your doctor about any foot problems. Your feet need special care.

Athlete's Foot

If the skin between your toes is itchy and cracked, you may have athlete's foot. Athlete's foot is a fungal infection in the skin. Several antifungal creams can be bought over-the-counter. Terbinafine (brand name: Lamisil AT) works most quickly, usually in 1 week. Other creams will take about 4 weeks of treatment to get rid of fungus from the skin. Tea tree oil may relieve itching but does not get rid of the fungus that causes the problem.

Warts

Warts on the soles of the feet are called plantar warts. Because the skin on your foot's sole is thick, warts there are harder to get removed. Treatment will take several weeks. Paint-on wart removers (brand names: Duofilm, Wart-Off, Compound W, and others) are effective. Each evening you should rub the wart with a pumice stone or emery board. Then apply the wart remover, let it air dry completely and then cover the wart overnight with a piece of waterproof adhesive tape. It usually takes 6 to 12 weeks to get rid of a plantar wart.

Calluses and Corns

A hard callus may form where there is excess pressure on the foot. You can thin and smooth the callus with a pumice stone or emery board. On the toes, reactions to a pressure point are called corns. Between the toes, a corn may soften and be very painful. Toe sleeves or toe spacers may relieve pain from hard or soft corns. Better-fitting shoes can help keep calluses and corns from forming, or keep them from coming back after treatment. (See “Guidelines for Proper Shoe Fit,” below.)

On the ball of the foot, a lump or callus may form because of too much pressure. A metatarsal pad, placed in the shoe so that it rests just behind the lump, often helps to relieve the pain.

Plantar Fasciitis or Heel Pain

Pain in the heel is often caused by strain on the tissue that supports the arch where it attaches to the front of the heel bone. This problem is called plantar fasciitis. Stretching exercises, anti-inflammatory medicine and steroid injections may be part of the treatment plan. Sometimes a ready-made arch support or cushioned insole may help.

In older people, the normal fat that pads the heel can become thin. This may cause heel pain. Heel cups that cushion the heel often relieve the pain.

Guidelines for Proper Shoe Fit

Well-fitting shoes can prevent some foot problems and help relieve others.

Proper-fitting shoes do not need to be “broken in.” Shoes should feel comfortable right out of the box.

Shoes should be fitted on both feet while standing. It's best to do this at the end of the day when your feet are the most swollen.

There should be a space of 1/2-inch between the end of the shoe and the longest toe. In athletic shoes about 1 inch of space is needed.

Check the shoe's width. The joint between your foot and your toes should be in the widest part of the shoe. Those joints should not be squeezed.

The heel of the shoe should fit snugly and not slip when you walk.

Shoes should be snug but not tight over the instep. A shoe that laces will allow for adjustment across this area.

Heel cups, arch supports or insoles will change the fit of shoes. If you plan to use them, try on your shoes with these inserts in place.

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