As life expectancy increases and life becomes more fast paced, lifestyle-related diseases have increased, even among younger people. Modernization and technology has led to a sedentary lifestyle, on the one hand, but there are ever increasing demands on our time on the other. It is these changes that pose potential serious health risks.

More demands on our time and an increased tendency to multitask have contributed to weight gain, increased stress, and poor eating habits, all major risk factors for lifestyle-related diseases such as cardiovascular disease, cancer, chronic obstructive pulmonary disease, and diabetes.

Factoring in the Feet

You may ask, “How does all this relate to the feet?” The risk factors linked to today’slifestyle choices not only affect the cardiovascular system, they also havea disastrous effect on our skin. They affect the biochemistry of the skin (e.g., collagen production), its immune system (proneness to infections), as well as the vessels in the microcirculation and nervous system.

Studies have shown that the walking population today — more than ever —has some kind of adverse skin or nail condition of the feet. These conditions may be directly or indirectly related to the lifestyle changes that have occurred in the past few decades.

Even though more people of all ages are having pedicures today, the care of feet is all too often overlooked. In a recent survey, 50% of the participants said they do not wash their feet while in the shower. In fact, they said they do not spend any significant amount of time looking after their feet. The same people surveyed however brush their teeth daily, comb their hair, and have some form of facial care routine. More than half of those surveyed agreed they do not like to show off their feet.

Certain Lifestyle Changes Affect the Feet

Obesity, inactivity, smoking, and poor eating habits contribute to poor circulation of the lower extremities. The skin function becomes impaired and quickly loses elasticity as well as its protective and regenerative function. The skin becomes dry, leading to micro-lesions, which allow a portal of entry for bacteria, fungi, and viruses.


If the client is diabetic, skin care is even more important as minor cuts oreven cracks from dry skin can turn into ulcers or small sores that can become infected very quickly. With diabetics, high levels of blood sugar damage the blood vessels, making them less able to supply the skin with the proper nourishment. In this case the poor circulation interferes with the abilityof the skin to heal and raises the risk of infection.

With diabetic neuropathy, sweat secretion is reduced and the moisture of the skin decreases, with keratosis and further micro-lesions to follow. It is, therefore, extremely important that there is consistent care of the skin in people with venous insufficiency and diabetes.

With today’s lifestyles generating amore obese population, the excess weight also creates orthopedic problems as the structure of the foot is overloaded. This often leads to pronation and changes in one’s gait, which may lead to heel pain and plantar fasciitis. Heel pain has risen to epidemic numbers over the last decade and presents itself in all age groups. In older individuals, changes in gait patterns may also lead to joint and knee problems.

The most common cause of heel pain is inflammation of the plantar fascia, a band of fibrous connective tissue that runs along the bottom of the foot from the heel bone to the toes.

Shoe Styles Play a Role

Flip-flop sandals have become the most popular footwear for summer months. Once upon a time, flip-flopswere cheap, rubber thongs that women wore mainly to the beach. Today they come in many different styles and colors and have become just as popular for men as well.


Better than walking barefoot around the pool or on a beach, flipflops give some basic protection to the bottom of your foot, but these shoes give no support whatsoever to the arch of the foot, nor do they provide heel cushioning or shock absorption. More importantly, the constant foot-slapping of the sandal against the heel causes the skin to become traumatized, which often leads to calluses and dry skin and therefore potential portals of entry for skin infections. Flipflops were never meant to be everyday shoes. But again, lifestyles today have made them the shoe of choice for many.

Of course flip-flops aren’t the only popular shoes that can hurt your feet. With shoes achieving iconic status, women are squeezing into the latest pointy-toed, towering stiletto. It is the individual’s choice to favor fashion over function. However as one ages, the ill-fitting shoe can result in debilitating consequences later in life.

In recent years an alarming new cosmetic surgery trend for feet has begun. Among these radical surgeries are shortening of the toes, narrowing of the feet, injecting the fat pad with collagen or other substances, and other procedures performed solely in the name of vanity in order to fit into those stylish shoes.

Travel and Globalization

As travel becomes less expensive and more available, we have more opportunity to visit tropical countries where our feet are exposed to different germs and infections than we have at home. How often do we see entire families walking barefoot from their hotel room down the elevator through public lobbies to the pool or beach? When we see cases of Norwalk and Legionnaires Disease, it becomes newsworthy, but there are never any statistics as to how many people contract atinea pedis (athlete’s foot or fungus) while away on their vacation.

Many technicians have had a client come in for a pedicure just before her vacation and then return for her next appointment with a change to hernails, skin, or both. As pedicurists, we need to become proactive. We need to recommend protection for the skin of the feet just like we recommends unblock for the face. We owe it to our clientele to educate them in good foot hygiene and healthy foot care habits. By doing so, not only will we encourage self-awareness for their own good, but our profile in their eyes will be raised.

What the Pedicurist Can Do

Most importantly, the pedicurist must learn to give a proper foot evaluation before starting any service. We must look at everything from the type of shoe the client wears, to the skin on the bottom of the foot, the nails, and the lower leg. If we identify poor circulation either by some discoloration of the skin, chronic cold feet, or poor lower limb hair growth, we can make the proper recommendations to the client, sending her to a physician when appropriate.

In order to be able to identify these conditions, the technician needs to have advanced education. Programs such as the ones offered by the  North American School of Pedicuring or the International Pedicure Association can offer several levels of continuing education to keep technicians current.

Younger people think lifestyle-related diseases are not likely to affect them; however, anyone who has been pedicuring for five or more years can attest to the fact that the feet are changing and we are seeing more serious foot conditions in younger clients. Urge your clients to pay more attention to their feet. We are only given one pair for life and, like it or not, our lifestyle will eventually catch up to us.

As Our Feet Age

The skin on the feet not only breaks down and is prone to picking up infections, but it ages like the rest of our bodies. It is a well-known fact that skin loses collagen and elastin as we mature; this is also true of the skin on our feet. As we get older, our feet begin to lose their natural resilience; we lose the fat pads that give us protection. The skin becomes thinner, dryer, and more prone to lesions with less potential for regeneration. Just like on our faces we need to practice proper skincare and add moisture to our feet.

More on Moisturizers for the Feet

Normal moisturizers will not do the trick for feet, says Dr. Johanna Youner, a podiatric physician and surgeon at New York Downtown Hospital. “There is another layer called the stratum lucidum on the feet. One needs both a humectant (moisturizer) and a keratolytic (something to take off the dead skin layers that naturally buildup, particularly around the heel, forefoot and tips of toes),” she says. “Medical-grade moisturizers are available over the counter. Their common ingredient is a gentle acid, such as lactic acid, uric acid, or salicylic acid. This is a necessary part of foot creams that will keep feet protected yet soft.”

Katharin von Gavel is the founder of theToronto-based North American Schoolof Pedicuring.

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