Blisters & skin

Dr. Karpati on Foot Care

•  Foot sweat
•  Foot powders
•  Foot pain
•  Blisters & skin
•  Toenails

1. Question:
My daughter has a small hard blister-like growth on the bottom of her foot. It is transparent and painful if squeezed or pushed on. Thought it might be a wart, but it doesn't look like any pictures that I have seen. Any ideas?

Dr. Karpati's Answer:
Every so often I come across a question that I wish I could answer sight unseen. This is one of them! There are so many different types of lumps and bumps that present on the feet that, without a visual, diagnosis is very difficult. I have seen some warts that appear more "transparent" than others, so it is not out of the question. There are also other lesions such as Porokeratosis that present similarly. Your daughter may have also stepped on something and could have a retained foreign body. Please refer to www.apma.org to find a podiatrist in your area. Your daughter really should have this lesion evaluated.



2. Question:
I have a 5 yr old daughter and she has been suffering severely with dry cracked feet that hurt her so bad she is miserable. I have tried putting Neosporin and clean dry socks on 2 times a day, I have tried covering her feet before bed with Vaseline, then putting clean white socks on her... I have tried Epsom salt, peroxide, that stuff you put on that is a clear coat that is suppose to seal them and also almost everything, please, please help us, my little girl is miserable and I don't know what else to do! I have also tried special expensive creams but her feet especially her big toes and her heels, actually almost her whole foot (feet) have major deep cracks.

Dr. Karpati's Answer:
I am sorry to hear your little girl is suffering from this problem! Do not delay in seeing a podiatrist in your area for proper evaluation as dry, cracked feet may be a hereditary condition verses something of a fungal nature resulting in different treatments. A biopsy of the skin may be necessary for proper diagnosis. Please stop the use of peroxide and Epsom salt as both are VERY drying to the skin and may be exacerbating her condition.



3. Question:
I suffer from Morton's neuroma. What is the best solution for the burning sensation I get?

Dr. Karpati's Answer:
Supporting the foot to control the abnormal biomechanics causing your Morton’s neuroma and offloading the forefoot is the easiest conservative treatment for a true Morton’s neuroma. I recommend Powerstep Metatarsal Pads. This is a pad that helps to offload the forefoot to relieve the pressure under the ball of the foot. Please try this alone as well as in conjunction with an arch support. Your choice of arch support would depend on what types of shoes you wear/activities you participate in. If this does not help, please appoint back to your podiatrist where further evaluation can be performed.



4. Question:
I am a 35 year old woman. I work everyday and my job involves standing for 8 hrs. a day. My feet are very dry and brittle. I use different foot creams. Also my feet are very dark at the bottom, sometimes it looks as though I have leopard feet they have little dark circles on the bottom. What can I do?

Dr. Karpati's Answer:
There are a few products on my website that specifically address your problem with your feet. Please visit www.faant.com and go to the on-line store. On the left side you will see various conditions to choose from. Go to "dry and cracked skin". I really like the Hydrostat cream as I have used the product before. It does not feel greasy. Depending on the amount of dryness of your skin, you might also want to consider the CalleX ointment which may be greasier but even more hydrating. Heel sleeves are also available to wear over night. A combination approach of lotion or ointment during the day and the heel sleeve at night might be best! As far as the little spots are concerned, you did not mention them itching, which could indicate an athlete's foot problem, or growing, which could be a more serious dermatological condition. They are probably nothing to worry about. If they change in their appearance or become painful, however, I would most definitely have them checked out.



5. Question:
I had a corn on my fifth toe. I used Keralite gel and the corn is now gone, but the skin in my toe where the corn was located has become discolored. Is there something I can use to bring the natural color back to the skin on my toe. I don't want to lighten the skin. I just want the natural color to return.

Dr. Karpati's Answer:
I think the best thing you can do is to wait it out. You did not mention how long ago you stopped using it. It may take a long time for your natural color to return. Mind you, skin color is rarely normal from the corn having been there so long, so you may never get the normal coloration back and there is no product that could bring it back.



6. Question:
I have always had the problem of developing blisters on my feet. Especially on my little toe and around my other toes. But really, I have blistered almost everywhere on the top of and on the sole of my feet at one time or another. What causes this, and what can I do about it?

Dr. Karpati's Answer:
If there is itching or dryness, flaking, and redness associated with the blisters, this could represent a chronic athlete’s foot infection. Try using over-the-counter Lamisil cream which needs to be used twice daily for one month. Any less than one month and you may continue to have recurrences. If you have already done this, please go to www.apma.org to find a podiatrist in your area to have this properly evaluated.



7. Question:
I have a blister-like growth on the top of my 2nd toe (right at the cuticle-line of the nail). It's a gelatinous bump that's been there for quite awhile (several months). It's definitely not a blister, but that's what it looks like. If I push on it, it flattens for a minute or so, then puffs back up. I finally got the nerve to stick a pin in it (I know, not the smartest thing). Clear gel-like stuff came out. A little blood too, but VERY little. I squeezed it fairly flat, but after about 10-15 minutes, it was puffed up again like before. It looks like another one might be popping up on the next toe, but is extremely small. I had a medical doctor look at it, and suggested I got to a podiatrist. But I've just been really curious about what it might be. Any ideas?

Dr. Karpati's Answer:
This sound like a mucoid/mucous cyst to me. I know, the name sounds ugly, but this is simply a cyst formed from some fluid that has herniated from the toe joint that lies under the cuticle. Some times a cortisone injection zaps it and sometimes you need surgery to have it removed since they do like to recur.



8. Question:
I have a large blister on the bottom of my heal. I'm not sure of the cause – I run and have been playing pick-up basketball the past couple months. How do I heal this blister and how can I prevent one from coming back?

Dr. Karpati's Answer:
Try to avoid popping the blister if it's not hurting. It should resorb in less than a week. If it is uncomfortable, the safest way to pop a blister is to soak a needle in rubbing alcohol for a few minutes then let it dry, or heat the tip of the needle until it glows red then allow it to cool. Swab your blister with Betadine (you can get this at any drug store), then puncture the blister at the base in several areas and slowly drain out the fluid. Do not remove the excess skin. Apply a thin layer of antibiotic ointment (preferably Bacitracin which is also over-the-counter), then a large non-stick Band-Aid. Keep it covered and change regularly until the area has dried out and no more fluid accumulates. Watch for signs of redness, swelling or pus which indicates infection. If this occurs, please see a podiatrist who may place you on antibiotics.



9. Question:
I have always had clean/soft feet with no cracking anywhere. I noticed over the past few months some itching that comes and goes but mostly cracking in between my toes with peeling skin. It's fleshy pink there. Also I noticed some dark brown spots in the toes area but mostly on the bottom of my feet. They are in clusters. I can feel them as bumps under my skin. Some of them I can actually squeeze out of my skin! Help!

Dr. Karpati's Answer:
Sound like athlete's foot! This stuff is a pesky condition that is rampant during the summer months. Buy some over-the-counter Lamisil and use it twice a day for a month even if your symptoms improve before that. If you see no improvement or your symptoms worsen in two weeks, please follow up with a podiatrist in your area. Do not forget your Summer Soles in your shoes to absorb the sweat, which is a huge culprit in recurrent athlete's foot. Less sweat means less moisture and less chance for the fungus to get out of control!



10. Question:
I have HIV and have been getting black spots under the skin on my feet, along with clear fluid in them. I also have some itching and flaking of the skin. What should I do?

Dr. Karpati's Answer:
I must tell you I am by no means an expert in the various dermatological conditions associated with HIV, however, your symptoms sound very much like athlete's foot. The simplest thing you can do is to try some over the counter Lamisil cream applying it twice daily for one month. You should see a significant improvement in two weeks, but keep using the cream for the whole month. If you see no improvement in two weeks or you resolve this but have chronic recurrences, you should see a podiatrist in your area. You may find one in your area via www.apma.org.



11. Question:
I have been struggling with some little red watery blisters on my feet for about 2 yrs now. They come out and then dry out and go away after a few weeks. They don't itch or smell or anything. I get like 5-6 blisters at once. They look like chicken pox but very tiny. I have been given steroid cream at the doctor's but it has not helped. My spouse has gotten them from me too. Can you give me any advice on what it is?

Dr. Karpati's Answer:
Could be athlete's foot. Try using Lamisil Cream (this is over-the-counter) twice a day for a month to try and get rid of it. Use Lysol Tub and Tile in your shower weekly to disinfect and help keep your spouse blister-free! If this does not work, have your dermatologist or podiatrist do a skin scraping on it to have it evaluated.



Medical conditions are fact-dependent, so in addition to Dr. Karpati's insights, it is important you consult with your personal physician before undergoing any footcare treatment.

Dr. Adriana Karpati is a trusted Summer Soles Advisor and frequently tests Summer Soles products before they are brought to the public. Over the years, she has answered countless footcare and podiatry-related questions – many of which are posted here. Her practice is located in Grapevine, Texas. Her office can be reached through www.faant.com, for medical appointments and established patients only please.