Your feet don’t exactly have a reputation as being the cleanest part of your body. Every time you walk around barefoot, you subject them to the germs of the great outdoors. You stick them into sweaty sneakers on the regular, and honestly, you probably forget to wash them in the shower. So it only makes sense that some seriously gross stuff can happen to them.
Don’t fret—most of the issues that crop up on your toes and feet are (a.) totally normal and (b.) treatable, says Brian Fullem, D.P.M., a podiatrist and author of The Runner’s Guide to Healthy Feet and Ankles.
Here, he outlines some of the problems he sees most frequently and how to get your feet back to looking like they should.
Skin Growing Around Your Nails
When your skin starts to grow around the corner of your toenail, causing redness and discomfort, you’ve got an ingrown nail. There are two main types of ingrown nails, according to Dr. Fullem: those caused by improper cutting and those that just naturally occur. To avoid creating an ingrown nail yourself, always cut your nail slightly rounded (the nail should be the same shape as the end of your toe). And don’t cut down into the corners. “Often times, a sharp edge is left that will grow into the skin in weeks or a month or two, and that can create a bad infection,” says Dr. Fullem.
If it’s just one ingrown that pops up out of the blue, soak it in warm water and epsom salts for 10 minutes and apply antibiotic ointment such as Neosporin twice a day, he suggests. If you get recurrent ingrowns, a podiatrist can clip your nails professionally, too.
Think you might simply be predisposed to them even if you’re trimming properly? A podiatrist can perform a procedure called a partial matrixectomy, which partially removes the side of the nail permanently. (A chemical kills the nail matrix cells, which stops it from growing.) “The area will drain and be slightly sore for a few weeks after the procedure, but the end result, if successful, is the elimination of future ingrown nails,” Dr. Fullem notes.
Thickened, Discolored Nails
If your toenails are looking super thick, gross, and are causing you pain, odds are you’ve got a nail fungus. “Fungus in the nail is known as onychomycosis,” says Dr. Fullem. “It typically develops from micro-trauma from being in the shoes, as fungus normally resides in everyone’s shoes.”
Yes, this sounds gross, but the good news is that fungus is not a threat to your health and won’t spread to other parts of your body, Dr. Fullem says. While there are no lifetime cures for fungus, he notes that every six to nine months, the nail is replaced completely by a new one. However, that new nail can also get infected. “Spraying some anti-fungal spray in your shoes and on your feet may help prevent a recurrence,” he says.
The good news: “There are two newer topical agents which work fairly well, Jublia and Kerydin,” says Dr. Fullem. The bad news: “You have to apply the medicine every day to the nail for up to a year, and most insurances do not cover the medications.” (An eight-milliliter bottle of Jublia, for example, costs about $173, he says.)
Another option is the oral medication Lamisil, which is less expensive than the above-mentioned medicines. While it has a high success rate (up to 70 percent), your body clears it through your liver, so there are some concerns about toxicity. A final treatment option is laser treatment, but it’s not covered by most insurance plans and can cost anywhere from $150 to $1,500, depending on where you live.
Black toenails are a common occurrence among runners and other people who find themselves jumping, stopping, and starting more than the average human. “The nails may jam into the end of the shoes, creating a blood blister under the nail which will give it the black appearance,” says Dr. Fullem.
If you can see some of the skin bubbling at the tip of your nail, sterilize a needle and puncture the blob to release some of the fluid, he says. This should relieve pain, he notes. Can’t do it yourself? Your podiatrist can. Dr. Fullem says he almost always drains blood blisters because of the relief it brings, but says doing so isn’t 100 percent necessary.
Just remember: Don’t take the nail off, he says. Since it’s already likely separated from the tissue underneath, it’s “dead” and will fall off or get pushed out by the nail starting behind it.
When the nail does fall off, Dr. Fullem says, apply antibiotic ointment to prevent bacteria from growing. You can also soak your feet in warm water and epsom salts. “Ideally, the nail will grow back in normally,” he says. “But expect the entire nail to take six to nine months to grow in fully.”
Make an appointment with a podiatrist if you notice any redness streaking up your toe or find yourself in more and more pain. “These are signs of a bacterial infection that may require oral antibiotics,” says Dr. Fullem.
A Weird, Fleshy Growth
Noticing some fleshy bumps on your feet? You most likely have plantar warts. These aren’t really that different than warts anywhere else on your body—it’s just that the medical term for the bottom of the foot is the “plantar side,” says Dr. Fullem.
“Warts are caused by the verrca vulgaris virus and can multiply and spread to other parts of the body—this is known as the Koebner phenomenon,” he says. Like with a cold, you get infected by someone who already has the virus, he says. For what it’s worth, he’s had patients with 50 to 60 warts on one foot. As you can imagine, this can be painful and debilitating.
Unfortunately, most warts don’t respond well to OTC treatment. “In the U.S., all wart medicine is over-the-counter and no more than a weak concentration of salicylic acid, which does not work well on the bottom of the foot due to the thickness of the skin,” Dr. Fullem says. Podiatrists, though, can perform excisions and can also prescribe topical, injectable, and oral treatments, he notes. Dr. Fullem uses a medicine called Canthacur-PS. He also suggests taking 15 milligrams of zinc and 10,000 IUs of vitamin A twice a day. Vitamin A helps your skin turn over faster and may have an affect on the virus, he says, while zinc helps your body with immunity.
Cracked, Bleeding Feet
This isn’t necessarily a sign that you need to use more moisturizer—rather, it’s a hallmark characteristic of tinea pedis, aka athlete’s foot. It’s a fungal infection that can lead to red, peeling, bleeding soles . “Fungus requires three elements to develop in the skin: darkness, warmth, and moisture,” says Dr, Fullem. Think: the locker room of your gym, showers, and tile around the pool.
Don’t notice any progress? Attack the cause of the fungus.“Eliminating the moisture is the easiest to accomplish,” Fullem says. He suggests spraying an antiperspirant on your feet, always drying well before putting on your socks and shoes, and using socks made of Coolmax-type fabrics, which wick moisture away from your feet.