Wednesday, 17 March 2010

On footcare - Some advice from a Podiatrist

Disclosure - I received a complementary treatment and checkup at The Shah Clinic in Highgate while researching this post.

Ah, feet. The most neglected body part, give or take a few internal bits and pieces. We spend most of our time ignoring our feet, hiding them in shoes and socks, walking around on them all day or pouring them into torturous high heels, then perhaps bewailing how gnarled and unsightly they become as a result. Not many of us have a close relationship with our feet, but we'd be pretty lost without them, and with proper care, they can be as much of a pleasure as they are a necessity.

When I found myself in conversation with Podiatrist Vas Shah recently, it quickly became clear that we had much to discuss. Feet are an important but often overlooked health concern, especially for those of us who are obsessed  interested in beauty. I had plenty of questions about foot care, and I felt sure that plenty of people reading the blog did too.

I arranged to meet Vas at his Highgate clinic for a treatment and a bit of a Q&A about a beauty addict's most pressing footcare concerns...

Settling ourselves in a local Highgate cafe (OK, it was actually a branch of Cafe Rouge, but the scenery was nice), we began the interview.

LBR: A lot of salons offer pedicures as part of their treatment range. Are pedicures good for feet? What should I look out for when choosing a salon?

VS: A key concern with pedicures is hygiene. Our feet are very succeptible to infections because they are kept inside shoes where air can't circulate and moisture builds up. Where there's moisture, you get bacteria and fungi multiplying. That also applies to foot baths at salons, and bottles of polish that get dipped into with the same brush in between clients. (Nail polish doesn't kill bacteria and fungi.) A good salon should have excellent hygiene practices and clean everything between clients. Ideally, footbaths should have a disposable insert that is thrown away between clients. As there is no accreditation or legislation to enforce good hygiene practice in beauty salons, be careful when choosing one. Bad hygiene can risk your health - if the same instruments are used from one client to another without proper sterilisation, you can potentially be exposed to a whole range of infections. Pedicures are also very superficial. Visit a Podiatrist every few months and then go for a pedicure if you wish. The best advice I can give is always to go first thing in the morning, because everything at the salon should have been cleaned at the close of the previous day.

LBR: Should we paint our toenails? And is it true we should cut them "straight across"?

VS: Unfortunately, nail polish actually degrades the nail surface, creating tiny holes in the nail. Again, because feet are enclosed and moisture builds up, this can increase the risk of fungal nail infections, so polish on toenails isn't recommended. Try and give your nails a break in the winter months when they’re not on show.

LBR: Oops...

VS: Doctors often recommend cutting toenails straight across because this prevents ingrown toenails, but not everybody's nails are naturally suited to the "straight across" shape. The important thing is not to leave any sharp edges that could dig into the skin around the nail and grow inwards. A gentle curve is OK if that is how your toenail is shaped naturally.

LBR: Another common practice is to exfoliate calluses from the feet. Is it good to remove dead skin, or should it be left there to protect the foot?

VS: Exfoliation is definitely a good idea because dead skin cells can harbour infection. If you're using a foot file or a pumice stone to exfoliate your feet that's great, but don't be tempted to do "DIY" dead skin removal using anything like a knife or clippers. It's very easy to damage your feet that way. A lot of people do this!

LBR: A lot of us wear high heels, and we know they're probably not the most healthy footwear choice. What's the best way to minimise the negative effects of heels on our posture and our feet?

VS: If you wear heels and you are experiencing pain in your feet, you can visit a Podiatrist for a biomechanical assessment to determine which areas of the foot may be taking damage. Your podiatrist can prescribe individually fitted orthotics [inserts] that will fit into your shoes and help support the foot more. If you wear heels to work, it's good to kick them off under the desk if appropriate at your workplace. Some people wear trainers along with their suits while they're travelling to and from work, and that is also kinder on the feet than walking in heels. There is a precription treatment that involves injecting silicone into the balls of the feet to give more support to older people whose fatty tissues have depleted and want their heels to be more comfortable, but it's quite a new procedure at the moment.

LBR: A question close to many readers hearts... how often should we be buying new shoes? Or is that like asking "how long is a piece of string"?

VS: Maybe a bit like that! It depends on your shoes, and how much you walk around. Obviously high heels wear down very quickly because the heels take so much pressure. But for flat shoes, you can check the wear at the back of the shoe. The heel naturally strikes the ground on the outside first, so over time the heel of your shoe will wear unevenly, sloping outward. If you can see that  happening, it's time to replace the shoes, because otherwise the slope will affect your knee and hip joints, putting you out of alignment.


With my brain stuffed with foot-related facts, it was time to adjourn to the clinic (a beautiful restored period property) lie back in the treatment chair and let the man himself take a look as I bared my sole(s). I found myself actually kind of self-conscious - which I think goes to show how infrequently we subject our feet to any level of scrutiny.

The treatment started with a visual inspection, and Vas was able to affirm that my feet hadn't succumbed to any obvious infection (more through luck that judgement on my part). After positioning my feet on a disposable sheet and cleaning them with an antiseptic spray, he cut my toenails with large metal clippers, ensuring that my big toenails were filed and trimmed into a shape that wouldn't allow them to become ingrown.

He then unpacked a small ultrasound machine and tested the circulation of blood to my feet. A small hand-held sensor and conductive gel provided a loud rendition of my heart-beat, pushing blood through the two major arteries in each foot - one that goes across the top of the foot, and the other going around the side of the ankle into the sole. Vas told me I had a triphasic pulse - a good sign, as it means the walls of the artery are elastic and healthy.

Next, Vas tested the functioning of the nerves across the surface of my feet using an implement with two difference surfaces. With my eyes shut, I was called to tell which one was which as Vas placed it on various bits of my feet. Tickly! Again all was well.

The next stage was a removal of the hard skin from the soles of my feet. Using first an expertly-wielded scalpel and then a small drill with a kind of sanding attachment (again tickly, but painless), Vas returned my hard callused soles to the kind of smooth perfection they hadn't had - oh - probably not since I was in high school. I couldn't believe how much smoother they were, and they felt good too, almost as though the hard skin had never been there.

The treatment concluded with an application of specialist moisturising cream. I was interested to learn that feet do in fact need a special moisturising regime, rather than just regular body lotion. I always thought foot creams were mostly a marketing trick, but it turns out that the skin on the soles of our feet is up to 4 times thicker, they do need a more powerful product than the rest of the body. Vas used ClearZal Silk Smooth on my feet. It's a white aloe vera cream that dries non-sticky and contains urea for extra moisturising power. Not too expensive either at around £7 per tub. It's available from The Shah Clinic, and you can also buy it online.

The treatment I experienced costs £45. When compared to a beauty treatment, that seems pretty good value considering the level of care provided, especially since you get a trained Podiatrist (Foot and Ankle Specialist) treating you rather than a beauty therapist. The Shah Clinic operates in three locations - The Summit, Highgate (where I was), at the Jarrolds Aveda salon in Old Street and at the "Stress Exchange" at London Bridge. Vas also does home visits in the London area.

If you fancy getting your feet MOT'd for presentability, any fungal nail infection treated, and a foot health check into the bargain, I thoroughly recommend Vas's service. To enquire about appointments, contact Vas via The Shah Clinic website. You can also find him on the usual social media sites (Facebook and Twitter - search "Shah Clinic").


  1. Wow, I didnt know you could get treatments like that! I'm in dire need of one :X

    I never thought about pedicure hygiene in terms of using the same nail polish and brush from client to client, I guess I just assumed bacteria couldn't survive in nail polish. And I cant cut my nails straight across or they grow inward D:

  2. Well - you can! A shame you're not in the UK but there are podiatrists in Aus as well. In fact I found this link - Australian & NZ Podiatry Accreditation Council, which regulates Australiasian practitioners.

    I was surprised that nail polish doesn't kill pathogens as well. It seems like it's potent enough to kill most things, especially from the smell, but apparently not.

  3. My name is Nitin from Toronto. I am interested in your writing. Some of your posting are good, I can say, best. Can you please tell me how to subscribe to your blog post online?

  4. Hi Nitin, thanks for reading. You can subscribe to our updates using RSS, email notifications or via Google Friend connect. See the links in the sidebar for more info.

  5. foot massage machine is the best solution for winters. It works like doing manicure,pedicure and crack healing.It very useful,trust me!

  6. In about your seventh paragraph, you mentioned how nail polish can actually create little holes in your nail which can attribute to the risk of fungal nail infections. Is there a nail polish you can buy that you won't have to worry about something like this? I've been watching out for my foot health lately, especially after my older sister had some infections around her nails and big toe area. It's quite remarkable how many things can go wrong with your foot health when you're not looking! Great article with helpful ideas, thanks!


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