599 Sir Francis Drake Blvd #207

Greenbrae, CA 94904


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Hello Marin...

Tune in to hear from our doctors, Dr. Anthony Fedrigo and Dr. Oendrila Kamal about the latest and most up-to-date information about all things related to foot and ankle and sometimes life in general.  


By Foot and Ankle Specialists of Marin, Feb 16 2016 07:20PM

Part One:

Winter is well under way in most parts of the country, although in California right now we have a high of 72 degrees! But in the rest of the country, winter can be especially hard on your feet. At Foot and Ankle Specialists of Marin, we don’t see as many of the common summertime injuries such as puncture wounds, plantar fasciitis and other barefoot trauma, but we do see increased fungal infections and cold induced tissue trauma during winter.

With cold weather many people wear thicker socks and warm boots. This leads to increased moisture in the shoe and sock which translates to moist skin. The human foot has more sweat glands per square inch of skin than any other part of your body. Your feet are designed to perspire. Whether you notice it or not, feet perspire. When there is more moisture against your skin, there is more fungal and bacterial growth. These microorganisms are responsible for a whole host of problems, as well as most of the odor from our feet and other parts of our bodies. Unfortunately you can never cleanse your body entirely of these organisms. Dermatophytes (Derm=Skin, Phyte=”Plant” or fungus) are a group of 4-6 different fungal species that live on ALL human skin. You can never avoid these organisms. They are always present in low numbers on our skin. We never really know they are there until we get some type of skin or nail change that alerts us to their presents.

One of the easiest way to avoid fungal infections of the foot is to keep your feet clean and dry. Athletes Foot, or Tinea Pedis, develops when the feet are in a moist environment for a prolonged period of time. During the winter we often see more athletes foot than in summer. The reason is not only the warm socks and boots, but also from wearing socks to bed at night. Many people have very cold feet and it is difficult to sleep when your feet are cold. The simple solution is to sleep with socks on. As a side note, having cold feet does not necessarily mean poor circulation. As long as you have strong pulses in your feet, the coldness is not likely from circulatory compromise. Your Podiatrist can further assess this and we will discuss more cold feet conditions below. Sometimes cold feet are just cold feet. Unfortunately sleeping with socks on leads to more perspiration during the night, and more fungal growth on the skin. You may not notice it the first few night, but after a couple of night of wearing socks, you may start to notice redness and itching between your toes or on the soles of your feet. Patients will often wear the same pair of socks for several nights in a row. People believe that since you are not wearing the socks in your shoes, the socks don’t get that dirty. True they may not get dirty, but you keep increasing the fungal load in the sock every night. Then when you put your foot into the sock with a high fungal load, you get a massive exposure to a large amount of fungus. Often people will wake up at night with extreme itching and redness on their feet.

So, the obvious solution? Don’t sleep with socks on. If you need to warm your feet before you go to bed, put a clean pair of socks on before you get in bed so your feet have time to warm up. Then before you go to bed, remove the socks and put them in the dirty cloths hamper. If you develop some redness, itching or peeling skin on your feet and toes, start using an antifungal cream right away. Fungal skin infections, when treated early, clear easily since we make skin rapidly. In about a months the skin you are looking at will be replaced. That is why most over-the-counter antifungals recommend treating your skin for about 6 weeks. Patients always ask if they need to treat their athletes feet since it doesn’t really bother them, and often times it doesn’t even itch. Well the reason I recommend treating athlete's feet is because the breakdown of the skin from the fungal infection can lead to a secondary bacterial infection. Bacterial infections are much more invasive and aggressive, often leading to deep space infections and wound formation. If this occurs you need to get medical treatment immediately and start an antibiotic to prevent a worsening infection.

Dr. Fedrigo

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