Dr. Melody Chong is back to answer many burning questions about foot care! Learn how diabetic socks can be helpful, what foot problems can be inherited, and more!

Transcript

What are diabetic socks?

Diabetic socks are loose-fitting socks. They don’t bind, so they're not tight. They prevent skin irritation and provide protection. They pull moisture away from the feet so that sweat can evaporate. This means less risk of getting a fungus infection. 

They can prevent smells or odors, which allows the feet to be drier. They usually are seamless. So not having seams along the toes and the top of the socks prevent rubbing and blisters. The concern about blisters and rubbing is that you can get open wounds and ulcers. You don’t want to get these if you have neuropathy (no feeling in the feet) or if you have high blood pressure.

The other good thing about diabetic socks is that they're made of soft kinds of yarn, often bamboo and wool. These kinds of materials are antimicrobial, so they prevent infections and are not harsh on the skin. They don't cause friction, which, again, leads to rubbing and blisters, and open wounds and ulcers.

The other advantage of diabetic socks is they usually stay up without squeezing the calves or causing a decrease in the blood flow. So that is important, too. Another feature of diabetic socks, in addition to being antimicrobial, is they're anti-fungal. So that means they have the ability to prevent infection and fungus (Athlete's foot) in the skin and toenails. The socks usually have silver or copper, both of which are antimicrobial and anti-fungal.

Another feature of diabetic socks is the padding. They have extra padding usually on the pads of the feet and the soles of the feet. This alone can stop injuries from occurring, so they're protective, as well. Another good feature of diabetic socks is that you're usually white. Often diabetics can't feel any wounds or openings in the feet, so just being able to see the color and the blood on the socks is helpful to know to go to the doctor for treatment.

In general, I do recommend them. There are a lot of features I mentioned that are very helpful. They pull moisture away from the feet, they don't have seams, they're made of soft yarns, and they stay up without falling down. Again, they are antimicrobial and anti-fungal, and they have padding. So those are the pluses of wearing them and I do highly recommend them for people who are pre-diabetic or diabetic.

Do you need a prescription for diabetic socks?

No, they're readily available at stores, medical supply stores, and on the Internet, of course. So you don't need a prescription. For the most part, if you do have a prescription, it's not going to be covered by insurance.

What kind of topical treatment for fungus toenails is available?

There are two prescription ones. There's one that's been out for years. It's usually covered by insurance, but it typically is not effective at all. I've had patients use it for many years and then they come to me saying “it hasn’t worked,” “I've been putting it on every day and removing it weekly. It's still not working.” “What other treatments are there for topical?”

There is a newer one out that's somewhat effective, but most patients don't use it because it's very, very expensive. It's not covered by insurance, so that can be very, very costly for a patient. It’s a few hundred dollars. It could be, I think, upward of $500-$800. I don't usually prescribe it because it's considered a cosmetic treatment.

As an option, I do carry an anti-fungal topical in my office and it's much less expensive at the podiatrist's office. It's been very effective, which is why I carry it here, and it can only be bought at the podiatrist’s office.

The advantage is that not only does it help but it has a money-back guarantee through the company. So if you're dissatisfied, call them and they will refund you. However, because it’s effective, I haven't had too many issues where the patients were unhappy with it. So for the most part, topical treatment is very challenging. It takes a lot of effort, meaning you have to put it on twice a day.

On this one, you have to roughen the top of the nails weekly, and then that allows the medication to get in. Sometimes I have patients come in, and I can thin out the nail so that it gets in more effectively. 

What foot problems are commonly hereditary?

Generally, flat feet. Very common. Bunions, hammer toes. Ingrown toenails are often hereditary. Gout can be hereditary. Having high arched feet, as well as flat feet. Those are the most common hereditary problems that you get from your parents or your grandparents.

At what age do chronic foot problems usually start occurring?

That's kind of a tough question. I've had babies that come in with ingrown toenails, and they’re just born with it when they're in their mother's womb. So that's hard to say, but it varies. Also, there's a variable with fungus toenails. Sometimes fungus itself can cause an ingrown nail, for example. Heel pain can occur at any age, as well. There are a lot of variables, like the kind of shoes you wear, and what kind of activities you do.

So, for example, if you're wearing high heels and your parents had bunions, wearing high heels is gonna make the bunion come out sooner. So you might have it at age 20 versus age 40 or 50 or 60, depending on the type of shoes you’ve worn when you were younger. It also depends on the activities you do. If you're more active, these kinds of things occur more often and sooner.

Let's say you're an athlete or you play a lot of sports when you’re a teenager. Because you're active and you're playing sports all the time and your feet are always sweaty, you're more likely to get Athlete’s foot. However, if you take care of your feet, you might not even have Athlete’s foot when you're older. I think more or less, if you're diabetic and your parents have Athlete’s foot, then you are more likely to inherit that sooner. 

So for things like diabetes or gout, you're more than likely to develop that at a sooner age than a later age. On the other hand, if you're prone to getting diabetes due to your parents having it, if you are very good about your diet and exercise, you might not get diabetes at all. So it just really depends on each individual. 

Can nail clippers cause damage to toenails?

So I think if your nails are normal, meaning they’re not really thick or ingrown, then it shouldn't be an issue as long as you cut them straight across for the most part. Just be careful not to cut them too short because you might cut yourself or cause pain. If your toes have fungus –meaning they could be thick, ingrown, hard, or painful– then you could cause damage.

On the other hand, you might not even be able to use a nail clipper on them because they're so hard and thick. In that case, you should see a podiatrist because we do take care of those kinds of nails. We could help you cut them, also known as “debriding the nail.”

Also, if it's an ingrown toenail, I would not recommend using a nail nipper. I've seen people who cut themselves and cause an infection trying to cut out the ingrown toenail. So that's not a good idea. In those cases, you could cause harm. It’s the same with calluses. I've seen patients who try to remove calluses with a nail nipper, which is a little dangerous, too. And then, as patients get older, it's hard for them to see what they're doing down there. So then I recommend you see a podiatrist. Particularly. if you're diabetic, I don't recommend cutting the nails of calluses. Have a podiatrist do it. People with diabetes often lose feeling, can’t reach down, or are in pain. All the above scenarios are things that you probably should avoid doing yourself and leave to a professional podiatrist, not a manicurist. Don't go to those nail salons to have those kinds of toenails cut.

If you have any questions, feel free to call or schedule an appointment. It's always best to come in person. I'll be happy to consult with people of course.

Related Links:

• About Melody Chong, D.P.M.

• Health Education Topics