Written by Sara Mateen, DPM and Jane Pontious, DPM, FACFAS

With the warmer weather approaching, our patients will be trading in their winter boots for summer sandals. Before we all can enjoy the sunshine, along with some return to normalcy, we should consider educating our patients on a few things for proper foot care. 

Summertime means lazy beach days or hanging poolside with a good book, but to prevent pedal issues, proper foot care is a must for the summer season. 

FOOT PROTECTION 

Barefoot
Green grass and cool creeks are inviting during the summer. This is why it is important to caution patients that walking barefoot outdoors can increase the risk of foot injury or infection such as viral warts, fungal infections, or aquatic-type infections. 

Sandals
Patients should avoid prolonged-wearing of flip-flops during warm summer days. The thong portion of the flip flop in between the hallux and second digit can create friction and subsequent blister formation, particularly with our high-risk diabetic patients. Help patients choose sandals that are comfortable and have the necessary arch support.

Closed-toed shoes
There are 250,000 sweat glands in each foot. Patients should also avoid wearing closed-toed shoes in the summer for prolonged periods where sweat build-up can occur. This creates a dark and moist environment, the perfect breeding environment for bacterial and fungal infections. Remind patients to take their shoes off periodically to dry them out and prevent these infections from occurring. If patients need to wear closed-toe shoes, recommend they wear synthetic or acrylic socks to decrease perspiration. These fibers allow for better moisture evaporation than socks made from cotton or wool. Also, shoes with mesh fabric can be beneficial for the aeration of their feet during hot and humid days. 

New shoes
Inform patients to check their old shoes and maybe splurge on buying a fresh and supportive pair. Old shoes can cause pressure areas and blister formation, especially in warmer weather, so out with the old and in with the new!

FOOT CARE

Self-pedicure
A new season means a new chance for self-care. Inform patients that performing a self-pedicure can help remove dry skin and promote self-relaxation. Nail polish should not be left on the toenails for too long as this can cause nail breakdown and discoloration. 

Exfoliate and moisturize
Another important factor to having healthy feet is exfoliation and moisturizing. With winter officially over and springtime transitioning into summer, many people have dry skin build-up from the cold weather. Properly exfoliating and moisturizing the feet with a pumice stone removes rough patches on the soles of the feet, especially the heels. Purchasing a foot scrub can leave feet healthy and glowing.

Reduce swelling
After a hot day, a patient’s feet may be swollen or sore. You can recommend cold water soaks to help with the swelling as well as elevation of the feet. Patients can put their feet in cool water for about 5-10 minutes and pat them dry with a towel. 

SUN PROTECTION

Sunscreen
One of the most important points to educate patients on this summer is the application of sunscreen to the feet. Patients will typically protect their face, arms, body, and legs, but tend to neglect their feet. To be the most effective, sunscreen should be reapplied often and especially after swimming. 

Self-inspection
Feet are just as exposed as the rest of the body in the summer and malignant melanoma can go unnoticed. Early detection is crucial. Patients are at greater risk for developing melanoma if they are fair-skin with blonde or red hair, have a history of sunburns and blistering before 18 years old, and those with a history of several moles at a young age. Remind your patients to use the ABCDEs of melanoma for self-inspection: asymmetric, border, color, diameter, and evolution. If our patients have any suspicious lesions, we need to recommend they visit their foot and ankle specialist right away. Educating patients on prevention by repeat-edly applying sunscreen to the feet (both the dorsal and plantar portions), as well as inspecting their feet daily, is key. 

SAFE TRAVELS

With so many fun summer activities to do, whether at home or on vacation, patients should be mindful of a few things for safe travel. 

Hydration and swelling
During those smoldering July and August days, remind your patients to drink lots of water. It is so important for them to stay hydrated for their overall health, but also to prevent lower extremity swelling caused by excessive heat. If patients are experiencing swelling, continue hydration and cold water soaks for 5-10 minutes to reduce the swell-ing when they get home from a long day. 

Travel footwear
When patients are traveling, they should consider having a pair of slippers or flip-flops for their hotel room to prevent any bacterial or fungal infection from the room. 

Recreational activities
Summer activities will vary whether patients are at the beach, lake, or river. Educate patients on proper shoe gear if they plan to do any specific activities that will require different grip strengths (such as rock climbing) or just simply lounging at the pool. 

Water gear
Adventure-seeking patients may want to consider packing protective water shoes for their vacations. Remind patients to dry out the shoes after wearing them to prevent a bacterial or fungal infection from water saturation. 

Injuries
Patients who get a foot or ankle injury should seek medical attention from a podiatric physician right away to prevent further injury or infection. This is especially important if it involves any skin abrasion, laceration, or even a simple ankle sprain. Suggest preparing a first aid kit with sterile bandages, lotion, sunscreen, aloe vera, blister pads, pumice stone, anti-bacterial cream, and any type of anti-inflammatory medication. An emergency kit can be extremely helpful during outdoor activities and hard to come by on an adventure, so it is important to prepare ahead of time.