The first thing to do is to determine is this dry skin.... or athlete's foot?
If your skin is always dry, no matter how often you apply, or whatever you seem use on your feet, it could be athlete's foot (a fungal skin infection) masquerading as dry skin. It doesn't have to be itchy. It doesn't have to have the pinprick red rash, or an erythematous (red) border. Sometimes, athlete's foot just looks like... dry skin. I will write another blog about this, but if you would like to do a little experiment - try applying a broad-spectrum antifungal (e.g. clotrimazole 1%) every day for a week, and see whether the dry skin improves. Better still, make an appointment with a podiatrist. For convenience, I offer video calls for patients who cannot come to clinic.
Treating Dry Skin on the Feet
If it's not a fungal infection, dry skin can be caused by lots of factors including: -
age
diet
going barefoot
genetics
environmental causes, such as air conditioning, central heating, prolonged submersion in water
medicines
medical conditions such as type 2 diabetes, menopause and hypothyroidism
detergents
washing too regularly and harsh chemicals
skin conditions such as psoriasis, venous eczema, dermatitis
To treat dry skin on your feet, you should identify whether any of the above causes could be contributing to the dry skin, make adjustments if you can and then moisturise, moisturise moisturise.
Wash Your Feet
The water should be not too hot, not too cold and you must dry your feet thoroughly. Soaps are generally quite drying, so ensure to wash this off and if you like a long soak in the bath, ensure you moisturise your skin afterwards.
Exfoliate
A pumice stone can be really handy in removing dry and/or callused skin. Do this carefully; ideally after a shower or bath so that the dead skin can be gently rolled away by sweeping of the pumice across the skin. If you are too vigorous, you can damage or irritate the skin, impairing the skin's natural protective barrier.
Moisturise
'What moisturiser should i use?' is one of the most common questions I am used in clinic. The best moisturiser is the one you will actually use! Ideally, a foot cream containing urea (as this is a humectant, so helps to draw moisture into the skin and enables better absorption of the other beneficial products in the cream), however if you find these products too thick or gloopy, any moisturiser will help improve skin vitality - and perhaps just treat yourself once a week to an overnight application of an urea-containing foot cream (if you pop a sock on to help with absorption - even better) or slather your feet in vaseline, then wrap cling film around the feet and allow this to soak in for as long as possible (preferably overnight). Glycerin, shea butter, jojoba oil and hyaluronic acid are other good ingredients to keep an eye out for.
Ingredients to Avoid in Moisturisers Don't use olive oil! Somewhat counterintuitively, olive oil can damage skin integrity and therefore negatively impact the skin's natural barrier function. Although wheatgerm has great emollient properties, it can cause sensitivity for folks with a gluten intolerance and may contribute to migraines in people who are prone to them. Salicylic acid has many benefits and is often found in hard skin treatments, such as heel balms and foot peels. Typically this is pretty safe, but skin sensitivity can be caused with repeated use.
Steroids should only be used short term where there is an itch or irritation, as these can thin the skin in the longer term. Sodium lauryl sulfate is snuck into so many products, a classic example is aqueous cream (which should only be used as a wash product, and not left on the skin). It strips the skin of it's natural oils, and will thin the skin over time. Bad news.
Drink Water and Eat Fat
Dehydration can cause your skin to become dry, as can a diet lacking essential fats, such as omega 3 and 6. Very low fat diets can cause the skin to be prone to rashes, dry and cracked. Stressed?
Stress can have a significant impact on the skin, such as causing rashes and inflammatory conditions such as eczema.
Footwear Sweat is our natural moisturiser, so if you are often barefoot or wear backless slippers or footwear, sweat evaporates from the skin and dries it out.
Shoes with thin hard soles, such as brogues or Oxfords, coupled with dry skin compounded by long walks on hard surfaces (such as pavements) will cause cracks (fissures) in the heels, as when the skin is dry it is less elastic and therefore will split open in response to repeated pressure from ground forces (being squashed). Simple foam or gel heels pads popped in the shoes can make a big difference.
This can happen at home too.... Carpet over Parquet Floor
It's really common in my clinic to find patients aged 50+ with dry, cracked heels who are mostly padding around on hard tiles or wooden floors at home. The answer? Moisturise! And wear slippers/cushioned footwear (flip flops and sliders are typically ok here) at home to offer some shock absorbency.
Prevention of Dry Skin
It is important to continue to moisturise regularly even when the skin has improved in order to maintain vitality, bolster skin integrity and help prevent problems later.
Not Getting Better?
Get a Diagnosis If you've made the changes above and your skin is not improving, or is getting worse, see a podiatrist, GP, or a dermatologist, who will be able to identify other conditions that may be causing the dry skin.
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