Diabetes can damage the nerves and blood vessels in your feet. This damage can cause numbness and reduce feeling in your feet. As a result, your feet may not heal well if they are injured. If you get a blister, you may not notice, and it may get worse.Check your feet every day. Inspect the top, sides, soles, heels, and between the toes. Look for:

• Dry and cracked skin
• Blisters or sores
• Bruises or cuts
• Redness, warmth, or tenderness
• Firm or hard spots

If you cannot see well, ask someone else to check your feet.Call your doctor right way about any foot problems. Do not try to treat them yourself first. Even small sores or blisters can become big problems if infection develops or they do not heal.Wash your feet every day with lukewarm water and mild soap. Strong soaps may damage the skin.

• Check the temperature of the water with your hands or elbow first.
• Gently dry your feet, especially between the toes.
• Use lotion, petroleum jelly, lanolin, or oil on dry skin. Do NOT put lotion between your toes.

Ask your health care provider to show you how to trim your toenails.

• Soak your feet in lukewarm water to soften the nail before trimming.
• Cut the nail straight across, because curved nails are more likely to become ingrown.
• Your foot doctor (podiatrist) can trim your nails if you are unable to.

Most people with diabetes should have corns or calluses treated by a foot doctor. If your doctor has given you permission to treat corns or calluses on your own:

• Gently use a pumice stone to remove corns and calluses after a shower or bath, when your skin is soft.
• Do NOT use medicated pads or try to shave or cut them away at home.

If you smoke, stop. Smoking decreases blood flow to your feet. Talk with your doctor or nurse if you need help quitting.Do not use a heating pad or hot water bottle on your feet. Do not walk barefoot, especially on hot pavement or hot sandy beaches. Remove your shoes and socks during visits to your health care provider so that they can check your feet.

Shoes and Socks

Wear shoes at all times to protect your feet from injury. Before you put them on, always check the inside of your shoes for stones, nails, or rough areas that may hurt your feet.

Wear shoes that are comfortable and fit well when you buy them. Never buy shoes that are tight, hoping they will stretch as you wear them. You may not feel pressure from shoes that do not fit well. Blisters and sores can develop when your foot presses against your shoe.

Ask your doctor about special shoes that can give your feet more room. When you get new shoes, break them in slowly. Wear them 1 or 2 hours a day for the first 1 or 2 weeks.

Change your broken-in shoes after 5 hours during the day to change the pressure points on your feet. Do not wear flip-flop sandals or stockings with seams. Both can cause pressure points.

Wear clean, dry socks or non-binding panty hose every day. They will help protect your feet. Holes in socks or stockings can put damaging pressure on your toes.

You may want special socks with extra padding. Socks that move moisture away from your feet will keep your feet drier. In cold weather, wear warm socks, and do not stay out in the cold for very long. Wear clean, dry socks to bed if your feet are cold.

Foot problems include athlete’s foot, plantar warts (verrucae), corns, smelly feet and infected toenails.

• Athlete’s foot is a fungal infection — also called tinea pedis. It is contagious via direct contact, wet floors and shared footwear.
• Plantar warts (verrucae) are flat warts in the sole of the foot. They are forced under the skin and may occur in clusters. The surface is greyish and crumbly, and they may contain small black points that are swollen blood vessels. Plantar warts are also contagious via wet floors. Like other warts, they will disappear on their own, but this may take up to 2 years.
• Corns are areas of hard skin that build up on parts of the foot that are subject to pressure or friction, such as on the little toe.
• Smelly feet are usually caused by excessive perspiration and an over-growth of fungi and/or bacteria.
• Infected toenails are commonly the result of a fungal infection, a condition known as onychomycosis. Toenails affected by onychomycosis are often brittle, discoloured or yellow.

What can you do to care for your feet?

Here are several steps you can take towards healthy feet.

• Wear thongs in public showers such as in camping grounds and gyms to help prevent you from contracting athlete’s foot.
• Wash your feet twice daily and dry them thoroughly, particularly between your toes. Use a clean towel.
• Change your socks daily and wear cotton, not synthetic, socks.
• Wash your socks and towels at a high temperature (hot cycle on washing machine).
• Wear well-fitting leather shoes that allow your feet to ‘breathe’ (synthetic shoes tend to increase the amount of perspiration) or wear open shoes or sandals to allow air to circulate freely.
• Bleach your shower/bath area.
• When applying corn or wart medication, make sure it does not get on the healthy, unaffected skin.

When should you seek medical advice?

All of the above conditions can be treated: some by medications that are available from pharmacists, while others, particularly fungal nail infections, can require prescription medication from your doctor. You should also seek medical advice if:

• you suffer from diabetes, as you may lack some feeling in your feet and that can lead to complications such as ulcers;
• you are elderly, as you may have poor circulation;
• you have a mole or dark-coloured spot on your foot; 
• there is bleeding.

Here is a list of quick questions to help you check the health of your feet.

1. Do you have pain in your feet?
2. Are you on your feet all day?
3. Do you have skin or nail problems (ingrown or discoloured toenails, corns, skin rashes, areas of hard skin) on your feet?
4. Do you have any sores on your feet that are not healing?
5. Do you have foot odour?
6. Do you have a foot injury?
7. Do you have health problems such as diabetes or arthritis?
8. Do you have numbness, tingling or burning in your feet?
9. Do your feet have poor circulation - are they unusually pale, blue or red?
10. Do you trip or fall often?
11. Do you have problems finding shoes that fit comfortably?
12. Do you have lumps or bumps, bunions or misshapen toes?
13. Do you regularly wear heels that are 5 cm (2 inches) or higher?
14. If you have answered ‘yes’ to any of these questions, see a podiatrist or your doctor for diagnosis and treatment.

Diabetic conditions affecting the legs and feet

The feet and legs are common sites for complications in people with diabetes mellitus and for this reason good foot care is very important. An injury to the foot or leg can be painful, but in people suffering from diabetic neuropathy (nerve damage) the sensations are dulled and minor injuries often go undetected and untreated, potentially leading to more serious damage.

Loss of temperature sensation is also a significant risk factor for injury in people with diabetes. This can result in a person being unaware that the bath water they are stepping into is scalding them. They may also be at risk of developing severe burns after sitting too close to a heater.

Special attention is needed to prevent circulatory disorders and infections that commonly occur in the lower extremities of people with diabetes. Areas with poor circulation heal badly and, if left unattended, such injuries may develop into ulcers or even become gangrenous.

Do not ignore pain in the feet or legs as this may indicate a problem. Corn plasters should not be used as they may cause foot ulcers.

Good foot care

Good foot care is vitally important for people with diabetes. Every day, wash your feet in warm (not hot) water. If you notice a callus forming, you can try to gently remove it (for example, with a pumice stone). However, once formed, calluses should only be treated by professionals. After washing, apply a moisturiser to your feet, but avoid moisturising between your toes. When you cut your toenails, cut straight across and file down any sharp edges.

Always wear shoes and socks, and choose your shoes carefully. Shoes should be large enough to be comfortable, but not large enough to be slipping off. They should have resilient (but not soft) insoles, and be smooth on the inside, with no rough areas.

Check your feet each night, looking for:

• dry, scaly, red, itching or cracked skin;

• areas where something has been rubbing on your feet;

• blisters;

• cuts or abrasions;

• corns or calluses;

• infections;

• thickened or discoloured nails;

• blueness or any swelling; and

• any red, hot or swollen areas.

If your vision is poor, get someone to check for you.

Any breaks in the skin need to be treated straight away, so see your doctor or podiatrist. Also, try to work out what might have caused the problem so that you can prevent it happening again. If one of your feet is hot and swollen, check it again the next day — see your doctor if it remains hot and swollen.

Your feet should also be examined regularly by a doctor, diabetes specialist or podiatrist. Your doctor or podiatrist can advise you on foot care and also on the selection of appropriate footwear.

Corns and calluses

Painful areas on the feet can be a great source of misery, making walking uncomfortable. Sufferers are often reluctant to take regular exercise.

Among the most common causes of sore feet are calluses and corns. These are raised areas of local thickening of the surface layer of the skin. This layer is known as the keratin layer. When it becomes thickened the condition is known as hyperkeratosis.

Calluses and corns are usually found in places where there is friction or pressure. They are usually the result of badly fitting shoes, but can also occur if your feet are abnormally shaped. They are sometimes found on other parts of the body where friction occurs, for example, on the fingers of guitar players.

Calluses are bigger than corns and are usually found on the bottom (sole) of the foot, either around the heel or around the front of the foot at the base of the first and fourth toes — places where pressure occurs.

Corns are smaller and often have a central core, or ‘plug’, of keratin, which can be seen. The top of the fifth toe (where it gets squashed by tight shoes) is the most common site for a corn. Sometimes they are found between the toes, where they can be extremely painful.

Treatment of corns and calluses

The best way to treat corns and calluses is to remove the hard keratin on a regular basis. This can be done by ‘shaving’ with a sharp, preferably sterile, blade. This is best done by a doctor or podiatrist. For those who prefer the do-it-yourself approach, a pumice stone can be used to do the job. Various preparations are available to help soften the areas of hyperkeratosis. These usually contain salicylic acid, which is present in corn plasters.

Although the discomfort of calluses and corns is often easily fixed, the problem will inevitably come back if the underlying problem, usually wearing the wrong pair of shoes, is not corrected. If changing shoes does not help, seeing a podiatrist may be helpful.

Children’s feet are not the same as adults’ feet. Babies' and toddlers' feet are soft and pliable because the bones are not yet completely formed. This means their feet can be more easily damaged than the feet of older children e.g. by shoes that are too tight. Here are some tips for taking care of your child’s feet.

Shoes and socks

Toddlers do not need shoes indoors when they first start to walk. Letting them go barefoot or wearing socks alone helps their feet   grow normally and encourages their toes to develop a grasping action.

• Feet grow rapidly during childhood. Check that your child’s shoes fit properly every one to 3 months up to the age of 3 years, every 4 months between 3 and 5 years and every 6 months for children aged over 5.
• Make sure children wear fresh cotton socks daily and that they air their shoes overnight — this can help reduce skin problems.

• When choosing shoes for children, there should be about 1 cm ‘growing room’ between the longest toe and the end of the shoe. The shoe should also fit the foot’s natural shape, especially around the toes.

• Always have both of your child’s feet measured for length and width. Note that a child's left and right foot are unlikely to be exactly the same size.

• Never "hand down" shoes from one child to another.

• Uneven wear and tear on the heel of a shoe may indicate a foot problem that should be checked with a doctor or podiatrist.

Walking problems

• Flat feet are common in children, but are not necessarily a problem. Arch development will likely stabilise by the age of 6 or 7 years. However, take your child to a doctor or podiatrist if flat feet are causing pain or affecting your child’s walking or other activities.

• Most toddlers who walk with their feet pointed inwards (in-toeing or "pigeon toes") or with their feet pointed outwards (out-toeing) and those who appear to have bow legs, will be walking normally by the time they are 2. Take your child to a doctor or podiatrist if these walking patterns persist beyond the age of 2 or you are worried.

• Children walking on their toes can also be just a phase, but the Australasian Podiatry Council says it is "not normal" and recommends review by a podiatrist.

• Knock knees are normal in children aged 2 to 7 years. If the condition causes the foot to roll or be painful, orthoses (orthotics) may be advised.

• Signs that your child may have a problem needing investigation include frequent tripping and falling, withdrawing from sport and recreation, or lagging well behind other children during sport and play.

Athlete's foot is a common infection caused by a fungus. It most often affects the space between the toes. Symptoms include itching, burning, and cracked, scaly skin between your toes.

You can get athlete's foot from damp surfaces, such as showers, swimming pools, and locker room floors. To prevent it

• Keep your feet clean, dry, and cool
• Wear clean socks
• Don't walk barefoot in public areas
• Wear flip-flops in locker room showers
• Keep your toenails clean and clipped short

Treatments include over-the-counter antifungal creams for most cases and prescription medicines for more serious infections. These usually clear up the infection, but it can come back.

Each step you take involves a complex network of bones, muscles, tendons, and ligaments. This, combined with all of the weight they carry, explains why feet can have problems. To keep your feet healthy

• Examine your feet regularly
• Wear comfortable shoes that fit
• Wash your feet daily with soap and lukewarm water
• Trim your toenails straight across and not too short

Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling or numbness could be a sign of diabetes. Swelling might indicate kidney disease, heart disease, or high blood pressure.

Good foot care and regular foot checks are an important part of your health care. If you have foot problems, be sure to talk to your doctor.

A simple wet test can tell you if you have flat or high arches, and how to choose your running shoes accordingly.

A simple wet test can tell you if you have flat or high arches, and how to choose your running shoes accordingly.