Diabetes Forecast

Summer Tips for Keeping Feet Healthy

Treat your tootsies right this summer with these skin-care tips

Orbon Alija/iStock

Sunny skies and days at the beach may tempt you to play fast and loose with proper foot care. After all, how much harm could be done swimming without taking precautions? Is going barefoot really such a sin? Keep reading for the answers to questions about how to hit a healthy stride in any situation this summer.

Can I skip shoes on the beach?

It depends. People without any foot complications can generally spend the day barefoot on the beach, but it’s smart to discuss this with your health care provider before you hit the sand. And no matter what, stay vigilant. Even people without diabetes need to be watchful while walking around barefoot at the beach, where rocks, shells, and other sharp objects may hide in the sand.

For people with a loss of sensation in the feet due to diabetic neuropathy (nerve damage), foot covering is crucial. “Neuropathy can lessen your ability to detect a harmful object,” says podiatrist Bruce Pinker, DPM, a fellow of the American Professional Wound Care Association in White Plains, New York.

Why does that matter? Diabetes can weaken the immune system, especially when blood glucose isn’t well managed. That makes it more difficult to fight off minor infections, so even small cuts are at a greater risk of becoming difficult-to-treat wounds. “Even if you have an injury on your foot that is a few days old, you risk exposure to bacteria on a sharp object or a surface you walk on,” says Pinker. “That may cause a potentially dangerous infection.” And without pain to alert you to the presence of the wound, an infection can spin out of control quickly, which could ultimately result in the loss of a toe or foot.

It might be convenient to slide into flip-flops, but these leave your feet exposed to potential injuries. If they slip off, you could accidentally step on a wound-causing object. Flip-flops also make it easy for objects to come between your foot and the shoe, increasing your chances of cuts and scrapes.

Whenever you head outdoors, slip on sandals, sneakers, or your favorite summertime footwear that is secure on your foot, is enclosed enough to protect your skin, and has arch support. If you like sandals, pick a pair with an ankle strap to lessen the odds your shoe might slip off while walking.

What precautions should I take when swimming?

Before you dive in, give your feet the once-over. If you spot any cracks, cuts, blisters, or other wounds, stay out of the water. Pools, lakes, rivers, and oceans can harbor potentially dangerous bacteria that can cause a foot  infection if introduced to an open wound, says Said Atway, DPM, a podiatrist at The Ohio State Wexner Medical Center in Columbus.

But let’s say you’re days away from a long-planned, once-in-a-lifetime Caribbean vacation and you have a wound that isn’t quite healed. Do you still need to steer clear of the water? It depends. Discuss it with your health care provider, who may give you the go-ahead to use a waterproof bandage.

If your feet are free of nicks and scrapes, keep them healthy by wearing water shoes any time you’re in the water. Not only will they protect your feet, but they’re made of a material that dries quickly and drains water, reducing your chances of getting blisters once you’re back on land.

How often should I do a foot check?

You’ve maintained healthy feet all summer—way to go! But that doesn’t get you out of daily foot checks. “Look for any changes in color or condition of the skin, like blisters, cuts, and redness,” says Bradley Levitt, DPM, a podiatrist specializing in diabetic foot care in Virginia Beach, Virginia, and contributing editor for the medical journal Diabetic Foot & Ankle. As a reminder, keep a mirror near your shoes and hold your foot above it to check for trouble spots.

And be sure your health care provider does a thorough foot exam at least once a year, as recommended by the American Diabetes Association’s 2019 Standards of Medical Care in Diabetes. In addition to checking for  new wounds and monitoring the healing of existing wounds, your doctor will check for redness of the skin, which could point to a bacterial or fungal infection; indications of peripheral artery disease, such as decreased pulses in the arteries supplying the feet, cold feet, or a loss of hair growth; and numbness and burning, both signs of neuropathy. “The development of neuropathy is not like a light switch,” Levitt says. “It can be a slow, progressive process, and you might not notice subtle changes a doctor will detect during an annual foot check.”

Can my feet get sunburned?

Absolutely! And if you take sulfonylureas (for type 2 diabetes) or certain blood pressure meds, you may have an increased risk of burning, says Susan Bard, MD, a dermatologist at New York–Presbyterian Hospital/Weill Cornell Medical Center. “People with diabetes often have hypertension [high blood pressure], and some diuretics used to maintain healthy blood pressure can have the same effect [on sunburn risk].” 

One of the easiest ways to show your feet (and the rest of your body) some summer loving is to slather sunscreen on them any time you’re outdoors, even when you’re wearing sandals.

While it’s important that everyone apply SPF to their feet, it’s especially important if you have diabetic neuropathy. “You might not feel the stinging or irritation caused when skin is overexposed to the sun,” says Atway. “Along with damage that causes premature aging, sun spots, [and cancer,] this can lead to sunburns that may ultimately result in blistering of the skin.” And just like blisters caused by improperly fitting shoes, those blisters may open, causing a wound that raises your risk for infection.

To make sure you’re covered, apply sunscreen 30 minutes before you go outside and reapply every two hours—more often if you’re sweating or swimming. Be sure to avoid covering wounds or ulcers with sunscreen (or any lotion). Doing so could cause painful burning and irritation. And, yes, you need to use sunscreen on cloudy days, too. Damaging UV rays are still present, says Bard. If dry skin is an issue, pick a sunscreen that doesn’t include moisture-zapping alcohol.

What can I do about dry, cracked, or scaly heels?

Winter isn’t the only season that does a number on skin hydration. Summer can be equally brutal, thanks to moisture thieves such as the sun, chlorine, and salt water. Poor circulation can also contribute to dry skin.

The fix is relatively easy. “Apply a cream specially formulated to moisturize the skin, preferably after bathing, when your feet are clean and towel-dried,” says Levitt. But skip those with medicating ingredients (such as hydrocortisone), which are used to treat eczema or other issues, unless suggested by your doctor. And no need to invest in creams specifically for people with diabetes. Any moisturizer will do the trick.

Never apply lotion to the skin between your toes. “Those areas are warm and naturally moist,” says Levitt. Rubbing lotion in the area between your toes can create an excessively moisture-rich environment that’s ideal for the development of fungus. And people with diabetes already have an increased risk of fungus. “Should the skin break down from an advanced fungus growth, bacteria can get into your bloodstream and cause an infection,” says Levitt.

Once you’ve taken all of these precautions, there’s only one thing left to do: Have fun!



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