I enjoy answering your questions about loot conditions you encounter at the pedicure chair. So that I can best answer your questions, include a complete description of the skin or nail condition, including color and tex­ture of the affected area, and any other information about the client in general (i.e., arc they diabetic, have poor cir­culation, or had injuries to the feet or toes). A photograph, though not necessary, helps me answer your questions properly and complete­ly. My goal is to deliver profession­al service to the nail professional.

Q: How do I use a pumice stone to reduce calluses on the feet?

 A: The American Heritage Dictionary defines pumice as, "a light, porous, glassy lava, used in solid form as an abra­sive and in powdered form as a polish and an abrasive." The key element of this definition is that pumice is light, porous, and abra­sive. These qualities let us remove dead skin from the feet by rubbing the stone over the areas we want to exfoliate. Too much rubbing, though, will break the skin, creating a portal of entry for an infection to begin. But if you rub too little, you really have not done anything for the client in the way of reducing the amount of callus.

As noted in the definition, a true pumice stone is of volcanic origin. There are other man-made materials that can be substituted for a pumice stone — such as ceram­ic abrasive objects — which I have seen marketed for removal of dead skin from the loot. A pro­fessional should probably ha\e a variety of stones of different coarsenesses to use. Rough-surfaced stones will reduce thick, tough calluses, while a smoother-surfaced stone reduces and smoothes thin, dry skin surfaces. The actual use of the pumice stone or any other method of re­moving dead skin is an art learned through practical experience.

Before reducing a callus with a pumice stone, use an exfoliating cream. II there are areas that need to be further reduced, first soak the feet in water containing a loot soak treatment to soften the callus. If the callus is thick and rough, you may need to use a very coarse stone first, then change to a less abrasive stone to finish the job. Use the stone as you would a nail file, being careful not to scrape the surrounding tissue. Learn to use your sense of touch in determining how much callus you have removed so that you stop before injuring the under­lying live skin. I rub my thumb over the area I am working on to determine whether I have removed enough callus to make my patient comfortable. Remember that cal­luses are nature’s way of protecting healthy skin. If too much of the protective laver is removed, your client will experience pain when she resumes her normal activities.

 Q: Can pumice stones be sani­tized? Do you recommend foot files over pumice stones?

A: A pumice stone can be washed, but because pumice stones are porous, it's almost impossible to remove all the debris. For your purposes as a nail profes­sional, the stone needs to be disin­fected. Theoretically, immersing the stone in a disinfecting solution for a period of time would disinfect it, but because pumice stones are so porous, organic material (skin) will build up and become packed in the nooks and crannies of the stone. It is almost impossible to remove this material.

One of the disadvantages of the various types of disinfectants is that the biocidal activity (ability to destroy living organisms) of each of them is decreased in the presence of organic matter. Therefore, as the nooks and crannies of the stone be­come more and more packed with organic material, the' disinfectants will not work properly, allowing bacteria and fungus to be passed from client to client.

For this reason, I recommend that technicians use foot files in­stead of pumice stones. There are various files on the market that are easily sanitized and disinfect­ed. Some of them can be im­mersed in the disinfecting solu­tion for long periods without harm to the file.

In my opinion, they work as well, if not better, than pumice stone's. Use them in the same manner as you would a stone. Your clients will appreciate you using an instrument that can be cleaned and disinfect­ed properly.

 Q: What causes skin on the heels to crack, and what do you recommend to use on this condition?

 A: Excessive callus buildup on the heels is caused by fric­tion and pressure on the skin around the heel. People who frequently wear sandals or open-heeled shoes experience this prob­lem more than others. The more the dead skin builds up and hard­ens, the more likely it is to crack. The cracks usually follow the skin folds or lines. Those are the areas where the skin actually gives or moves the most. II the crack ex-tends through the callus into the living tissues, it becomes quite-painful to walk.

Some callus or thickened skin around the heels is normal and protects the living tissue. If this normal buildup is removed, the skin around the heel may become painful. Many of my patients ask me to reduce the calluses on their heels. In most instances I will only lightly sand the area and advise) the patient to use a moisturizing cream to keep the skin hydrated and soft. One patient came to me after a pedicure because her pedicurist had removed calluses from her heels with a blade. Her heels were painful and in some areas the skin was actually breaking down because   the   normal   protective layer of callus had been removed. It appeared to me that she had not needed any callus reduction on her heels. A little sanding with a foot file followed up with regular use of a good moisturizing cream would have been a better service. As I discussed earlier, knowing how much callus to remove is an art   learned   through    practice.  Learn to recognize what is the normal amount of callus for protec­tion and remove only the amount necessary to reach that point. 

If a client has a crack on her heel, try to remove as much of the callus along its edges as pos­sible with a loot file. This helps reduce the pressure along the crack and allows the underlying skin to heal. There is no cure for this problem, but it can be con­trolled through frequent pedi­cures, wearing shoes that support the heel, and using a hydrating cream daily.

Some people will form tremen­dous amounts of callus around the heels no matter what they do. In those cases I recommend you work with the client's podiatrist to keep her comfortable. The podia­trist will reduce the callus with a surgical blade to an acceptable level. Follow-up pedicures on your part will help keep the client com­fortable for longer periods of time between visits to the podiatrist.

Q: How do I choose a good hy­drating cream that clients can use between pedicures?

A: You need to look at the client's skin. Is it soft and pli­able, or dry and cracked? Soft, pliable skin types may respond to a hand cream. For those with dry or cracked skin, I recommend a petrola­tum-based cream with aloe vera, essential oils, vitamin E, and natural fragrances. There are a number of these on the market you can choose from. Retail the lotion to your clients and encour­age them to use it daily. If the client has severe calluses, have her apply a liberal amount of the product before going to bed, and then have her wear hosiery to bed. Doing this once or twice a week, in addition to the daily applications, will really help the condition.

 I have had a few clients who refuse to get pedi­cures, claiming they have a foot odor problem. I tell them that pedicures can help that, but they still refuse. What advice can 1 give them on getting rid of foot odor so that 1 can get them in the pedicure chair?

A: Claiming foot odor as an excuse for not wanting a pedicure may be only that, an excuse. But for our purposes, let's assume the client is really embarrassed by her foot odor.

Offensive foot odor (the med­ical term for this condition bromidrosis) is caused by excessive perspiration. Sweating helps reg­ulate body temperature and elim­inate some body wastes. Sweat is composed of water, various salts, and amino acids, as well as lactic acid and urea. When sweat is ex­creted, it creates an excellent en­vironment for bacterial growth. Excessive perspiration (called hyperhidrosis) enhances the over­growth of bacteria, which feed on the various elements within the sweat. The waste products formed after the bacteria ingest these elements causes the offen­sive odor. To control the odor, the excessive perspiration and result­ing overgrowth of bacteria must be controlled.

Promote the pedicure, not as a beauty service, but as a healthy, hygienic service that can help clients reduce offensive foot odor. Explain to clients the cause of their foot odor and how the prod­ucts you use when performing pedicures, such as the disinfecting foot soak and exfoliating cream, will help to reduce bacterial growth. Removing dead skin and other debris, which they would have a difficult lime doing them­selves, reduces foot odor as well as enhances foot health.

Impress upon your cli­ents that a pedicure is only one part, but a necessary one. of the care needed to reduce their foot odor. Ex­plain to them that between pedicures they need to use products daily on their feet that will continue to re­duce the bacterial growth as well as help to keep their feet dry. You need to have products such as an­tibacterial soaps, foot pow­ders, and an antiperspirant that you can retail to the client for use between pedicures. Finally, stress the importance of follow-up pedicures as a necessary step in keeping the odor under control.      

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