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IMG_2921When we get a foot or toe infection, whether a simple infected, ingrown toenail or perhaps life-threatening pneumonia, it is due to tiny organisms, often called “bugs” or “germs.”

The only way to see these bugs is with a microscope.  Scientists have categorized these bugs into different categories: bacteria, viruses, and fungus.

Within the bacteria category there are “good” and “bad” bacteria.  One of the more common infection-causing bacteria is Staphylococcus aureus, often called S. Aureus or just “Staph.”  The bug can be harmless or it can cause infections—minor or lethal.  The good news is that most strains of S. Aureus can be killed by antibiotics. The bad news is that there is a strain of Staph that is difficult to kill: MRSA.

A True Superbug 

Pronounced “mursa,” methicillin-resistant staphylococcus aureus (MRSA) is one of the worst infections imaginable—a true “superbug.”  But, there is nothing super about it.  It can be just about anywhere: on clothing, countertops, floors, carpets, the health club yoga mat, even the high school football; and MRSA doesn’t discriminate.  It has killed the elderly, babies, toddlers, teenagers and even healthy, strong athletes.  Recently, MRSA has been responsible for closing public schools.

There are different strains of MRSA.  There is hospital-acquired MRSA and community-acquired MRSA. Most people die from hospital-acquired MRSA.

The Staph organism is all around us.  Worldwide, 2 billion people have the Staph organism on them—on their skin, in their nose, even in their lungs—and don’t know it.  It is estimated that 57 million (2.7%) of these people have the MRSA strain of Staph.  People can carry the bug for years without any symptoms.  Usually, these people have strong immune systems.  But, even with strong immune systems, the bug can flare up at anytime or these people can spread the bug to someone else.

According to the Journal of the American Medical Association, in 2007, MRSA will infect 94,000 people and of those, 19,000 will die, and those numbers are rising.  In 2005, the Centers for Disease Control counted more deaths from MRSA than AIDS (HIV).

Our Feet Are At Risk

One of the most common places these bugs, such as MRSA, can attach themselves to us and enter our bodies is through our foot or toes. These infections can start very innocently, perhaps with a simple ingrown toenail, a cut or a nick on your heel or foot.

You might pick up these foot infection-causing bugs while walking across the locker room floor, around a swimming pool, or even on your back porch.  Basic wound care and antibiotics control most foot infections, but not all.

Some people’s feet are more at risk. Those people with diabetes or poor circulation have a higher foot infection risk.

As a practicing podiatrist, I see serious infections in the foot routinely.  MRSA causes the worst of these foot infections.  It is so virulent that it can actually burrow into the bones of the foot and destroy them.  In other cases, it can cause gangrene and result in amputation of a toe or foot, or even death.

In rare circumstances, patients die from MRSA.  I have had to perform life-saving emergency amputations to save lives.  Sadly, of those who survive MRSA, many are left disfigured—be it from scars or amputations of a toe, foot, leg or even a finger, hand or arm.

12 Simple Steps to Prevent a Foot or Toe Infection

What follows are 12 magic, simple steps to protect you and your family’s feet from infection, particularly MRSA. Preventing foot infections is easy once you know what to do.   

1. Wash Your Hands  — Don’t Spread germs to your feet or toes! 

Infections and MRSA can live on clothing, countertops, or just about anywhere.  Our hands are our number one way we pick up infection-causing bugs.  Wash your hands frequently, and especially before you touch your eyes, ears, nose, mouth or feet.  To kill germs, you don’t need fancy antibacterial soaps, just good old fashioned soap and warm water.  Wash your hands vigorously for at least 20 seconds and then dry them with paper towel. 

2.  Check Your Feet Daily  — Catch foot problems early! 

It’s amazing how many people don’t look at their feet, or if they do see a problem or have pain, they shove their foot into a shoe and try to forget about it.  Infections often start as a small red bump or swelling.  It may look like a bug bite or an ingrown hair.  There may not be any pain, but that doesn’t mean that a serious infection or other foot problem isn’t starting.

When examining your feet, be sure to check between the toes, as this is a common area for infections to start.  Also, watch for any blisters, cuts, or open sores.  Toenails that become ingrown are prone to infection; see a podiatrist immediately.

If you have trouble bending over to see the bottom of your feet or heels, have someone check your feet for you or use a mirror to see underneath (read my review of a fantastic scale with built in foot mirror).

Persons with diabetes or poor circulation need to be especially vigilant about checking their feet.

Parents need to check their children’s feet until their kids are old enough to do it themselves.  Children must be educated on the risks of foot infections and encouraged to let their parents know when a problem is starting.  Surprisingly, many times in my podiatry practice, a parent will bring a child in with a severely infected foot, telling me they just noticed it; however, when I question the child, I learn it started months ago.

There are several reasons children don’t tell their parents about foot infections or other foot problems, such as embarrassment, fear of having to go to the doctor or fear they will not be allowed to participate in a certain activity, such as a favorite sport.  The main reason is, however, they just don’t think the infection is a problem.

3.  Be Careful How You Use Your Towel around Your Feet

Towels are a breeding ground for bacteria and scientists have recently proven that towels have spread infection and MRSA to your feet.  As a result, it’s important not to share your towel with others.  If you wipe down equipment at the health club, do not use the same towel on your body or face.  The same applies to a towel that you’ve used on your feet; don’t use it on the rest of your body or face.

Once a towel has touched the floor, whether in a locker room or the home bathroom, consider it infected.  Never reuse a damp towels that has been in your gym bag, unless you wash it thoroughly first with hot water and soap.  At home, bacteria can breed quickly in damp, dirty towels, so be sure to wash them often.  When washing towels, the water temperature should be a minimum of 40 degrees if you are using bleach or at least 60 degrees without bleach.

4.  Wash Your Feet Everyday

Some people think standing in the shower is washing their feet.  That isn’t enough.  In fact, that could make matters worse.  If warm, dirty water pools in the bottom of the shower it could breed more bacteria and lead to an infection in your foot.  Feet need to be lathered with soap and scrubbed with a good brush or a loofah. (Again, this tip is very important for persons with diabetes or poor circulation).

5.  Keep Your Feet and Toes Dry

After washing your feet, be sure to dry them well, especially between the toes.  Moisture, especially between the toes, is a breeding ground for bacteria.  To prevent moisture from accumulating, put a little foot powder, talcum or cornstarch between your toes.

6.  Wear the Right Socks on Your Feet

You need to wear socks that wick the moisture away from the skin of the feet and toes.  Moisture acts as breeding ground for bacteria and fungus.

Sock technology is quite sophisticated these days and many athletic socks wick moisture away from the skin quite effectively.  Do not wear 100% cotton socks.  Cotton offers good cushioning for your feet, but allows moisture to build up, creating a breeding ground for bacteria.  Cotton-blend socks tend to be better, or wear a wool sock.

It’s important that your socks should fit correctly.  Socks that are too big will bunch up under the toes and create friction and abrasions, possibly causing breaks in the skin that bacteria might enter.  Socks that are too small can constrict the circulation to the toes and cause the toes to become bent and contracted, leading to friction, blisters and potential infections.

7. Don’t Go Barefoot In Infection-Prone Environments 

Bacteria love breeding in damp areas, such as saunas, showers, bathrooms, and locker rooms.  To prevent infections from entering your feet wear sandals or flip-flops–do not walk barefoot.

Keep in mind, that sandals or flip-flops themselves can quickly rife with infectious-causing bacteria if not cared for properly.  Storing damp flip-flops or sandals in a dark gym bag, particularly with sweaty clothes, could make them more dangerous than the locker room floor.

Always, dry your flip-flops and sandals thoroughly before putting them away.  The best way to dry flip-flops and sandals is to set them in direct sunlight.  When that isn’t possible, dry them with paper towel and wash your hands afterwards.  A good additional step is to spray your flip-flops once a day with an antibacterial spray, such as Lysol. Be sure to let the Lysol dry before you wear them.

Whether at home or the health club, I recommend you have two pairs of sandals.  This way you can let one pair air out each day, and always be wearing a dry, clean pair.    

8. Go Barefoot When Not In an Infection-Prone or Dangerous Environments

There are few safe places to go barefoot.  But, the more you can air out your feet, toes and heels, the better.  Bacteria like moist, dark areas, and shoes and socks create the perfect breeding ground around your feet.  At night in bed is a good time to let the air at them.

9. Take Care of Your Shoes

Shoes and particularly athletic shoes can be loaded with infection causing bacteria, fungus, and yeasts.  In fact, old running shoes often have 100 times more yeasts and molds than a recently flushed toilet bowl. The best way to kill germs in your shoes is with the SteriShoe UV Sanitizer.

Like flip-flops, air out your shoes everyday and spray the insides with an anti-bacterial spray, such as Lysol, and have two pairs so you alternate wearing them each day.  If the insole is removable, spray underneath it.  Some shoes have washable insoles, and in those cases, wash the insole regularly.

Try to buy shoes comprised of breathable materials.  Avoid shoes that contribute to moisture build up, such as shoes made of certain kinds of plastic.

Also, be sure your shoes fit correctly.  Tight-fitting shoes can crunch up the toes leading to abrasions and potential areas of infection.  Loose shoes allow the foot to slide, possibly causing friction areas and blisters that can let bacteria enter the feet.  Parents need to check their child’s shoe fit frequently; kids don’t always tell mom and dad when they’ve outgrown their shoes and they are becoming too tight.   

10. Take Care of Your Toenails

You should cut your toenails regularly and straight across.  Do not round the nails at the corners.  On the big toe, you should leave a tiny bit of nail protruding to help prevent ingrown toenails.  The toenails on the big toe tend to get infected more often than the other toessnails. Be careful not to cut nails too short or they become ingrown and possibly infected.

After cutting your nails, use a nail a file to smooth rough edges.  Leaving a jagged edge can cause the nail to catch on your sock and become split or cracked, creating an area for infection to set in.  It is a good idea to use a nailbrush to remove debris that accumulates under the toenails.

If you go for pedicures, make sure the salon adequately sterilizes their instruments.  Improper disinfection of salon whirlpools and instruments have spread infections. (Read my article on having a Safe Pedicure).

11.  Take Care of Your Skin of Your Feet

The skin on your feet should feel smooth.  Dry, calloused skin can crack and fissure, allowing infectious-causing bugs to enter. Use hydrating creams and lotions on dry, calloused skin.  The most common places for dry, calloused skin is around the heels and balls of the feet.

 12.   Seek Help Promptly for Foot Problems

Foot infections or other foot problems can be more serious than they appear.  Sometimes, diabetics, due the sensation in their foot diminishing, can develop an open wound and infection, and not feel any pain.  Because it doesn’t hurt, these diabetics oftentimes they believe it isn’t serious and let infections fester too long before seeking medical care.

Occasionally, patients will try to treat their foot problem or infection themselves.  As a podiatrist, I see the cases where these home remedies did not work.  Many of these patients went on to lose their toes, feet, or legs.  Most of these amputations were preventable, if the patients had sought medical treatment sooner.

The bottom line is: when you see a foot problem or infection, immediately seek medical care from a podiatrist or other qualified physician.

Conclusion: Foot and Toe Infections in the Feet Are Preventable and Treatable

Now you have the 12 magic tools to help prevent MRSA and other infections in the feet.  Use them.  Pass them along to your friends and family–especially if they are diabetic, prone to foot problems or have poor circulation.  Infection-causing germs, such as MRSA, does not hyave to cause gangrene or amputation!

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