DEAR DOCTOR, I tend to get rough skin under my feet that can only be taken care of with a thorough foot scrub. I would like to know, however, what causes it and how I can avoid rough/dead skin on the feet and keep them smooth. ADAM DEAR ADAM, What is your current age and since how long you have been having this problem of rough skin over the sole? Does it happen only in the dry season or in rainy season as well? Dry and flaking skin is common on the soles, particularly over the heels and sides. There may be associated mild pain and or itching, along with dryness. This part has fewer oil glands as compared to rest of the body. Moreover feet bear the weight of the body and undergo wear and tear due to walking. Lack of moisture due to fewer oil glands is the most common cause for dry skin over this part. The amount of dryness is variable among individuals. Therefore some have this problem only during dry season, while some have it round the year. Exposure to dust aggravates it. Use of soaps containing harsh chemicals causes much dryness of the skin, including those of the feet. Dryness of skin also occurs due to aging, which results in cracking. Closed shoes worn for long, create an extremely hot and humid environment for the feet. The heat draws moisture from the skin, which can lead to dry, thick and or cracked areas of the feet. Nylon socks aggravate the problem. Standing for long hours or wearing ill fitting shoes cause friction over the feet, particularly the soles and can cause dryness, sores and cracking. Certain medications like diuretics used for heart or kidney failure, cause dry skin as adverse effect. Dryness and cracking of the sole and heels and in between toes can be due to fungal infections. In this case, intense intermittent itching may be present along with dryness. Eczema, psoriasis, under functioning of thyroid gland, uncontrolled diabetes, deficiency of vitamin B.complex are other medical conditions that lead to dry skin. Dead cells present over the skin, naturally fall off and are replaced by new cells. This build up of dead skin cells, leads to form flaky patches on the feet and subsequently callosities. Hence the basic thing needed to cure dry and cracking skin is to regularly remove the dead skin from the feet. This can be done by simply soaking the feet in lukewarm water with soap and rubbing with a scrub or pumice stone. Honey or baking soda can also be used. Scrubs or soaps with harsh chemicals should be avoided. Afterwards, a suitable moisturising agent like Vaseline or petroleum jelly can be applied softly over the soles or entire feet. Take care to wear properly fitting shoes and preferably cotton socks. A balanced nutritious diet containing sufficient vitamin B.complex would be useful. Supplements of vitamin B.complex also help. In case of an associated medical condition, there would be other symptoms along with dryness. Any such condition if present, can be diagnosed and treated very well. Dr Rachna Pande is a specialist in internal medicine E-mail rachna212002@yahoo.co.uk
