The fourth toe (ring finger toe) is the one that gets squashed in good-looking shoegear. When shoes come to more of a point in front, rather than a square, the toes take the brunt of this shape. A pointed or “c-shaped last” (the proper name for a curve in front of a shoe) is a good-looking, fashionable shoe. But the toes are not good-looking or fashionable. Closed shoes such as winter boots can put excessive pressure on the pads of those toes. The dark epicenter is blood. Basically, her winter boots are bruising her toes and causing the tips to bleed. I usually see this on the second toe (closest to the big toe), often with runners. The answer to her issue is, as you suspected, a file and some good lactic/salacylic/uric acid cream daily. And invest in new boots!
— Dr. Johanna Youner, DPM, FACFAS, has been in private practice in
New York City since 1996 (www.healthyfeetny.net).