The sweat glands of the feet produce moisture, fats, and oils which moisten and lubricate the skin, making it soft and supple. With age, and especially with the onset of vascular and neurologic problems such as those that accompany diabetes mellitus, the number of sweat glands and the amount of secretions decline. The skin tends to become dryer and thinner, lose some of its hair and elasticity, and itch.
Itching induces scratching, and scratching the feet may break the skin, permitting bacteria commonly found on the feet to cause infection. Also, dry skin is brittle and cracks easily. The cracking of chapped skin also opens a path for bacterial infection. Heel fissures are a common problem among the elderly, especially when the blood supply is inadequate. Deepening of the normal skin creases can lead to cracking and the likelihood of both pain and infection.
Treatment of dry skin aims to replace lost moisture, fats, and oils by application of an emollient skin cream. The cream should be rubbed in well over all parts of the feet except between the toes. In severe cases, the feet should be soaked for five or ten minutes in lukewarm water, then patted almost dry before cream is applied. The remaining dampness will help to moisten the skin and allow the cream to penetrate faster.
Although many good creams are available, it should be kept in mind that price is not a reliable index of quality. Also, because of the variability of the human skin, a product that works well for one person may not be satisfactory for another. Thus, several trials with different brands of cream may be necessary before one is found that is adequate. Use of petrolatum (petroleum jelly) and lanolin should be avoided as these are basically greases. When applied, they coat the skin but do not replenish moisture or oil. While greasy skin appears to be soft and supple, removal of the coating will reveal skin as dry as it was before the grease was applied.
The heels should be generously covered with skin cream because of their tendency to crack easily as a result of persistent dryness. Occasionally, heel fissures may require additional therapy, including bath oil soaks, protective petrolatum gauze dressings, and heel cups.
If, after several weeks of regular applications of cream, the foot has failed to respond satisfactorily, a professional examination is in order. Many skin conditions such as dryness, scaling, and peeling may be more than just dry skin. A break in the skin in particular is a sign to consult a podiatrist or physician without delay, because it may be associated with circulation changes which reduce the amount of blood reaching the foot and render it more vulnerable to infection. Such infection is much more easily prevented than treated.
The skin between the toes -- toe webs -- is usually moist, no matter how dry the rest of the foot may appear. It is important to keep the toe webs as dry as possible at all times, and this is most easily done by daily use of foot powder. Ordinary cornstarch is best because it absorbs more moisture than the talcum powder used in commercial preparations. It is also much less expensive.