Pharmacy Unscripted - Footcare

Question 1

People with which health conditions should be referred when presenting with foot query?

Answer 1

Customers with heart disease, circulation problems or diabetes should be referred to the pharmacist/ doctor. This is because foot conditions can be more serious in these groups of customers.

Question 2

What are bunions?

Answer 2

Bunions are hard, bony lumps that form on the sides of the feet by the big toes.

Question 3

What are the symptoms of bunions?

Answer 3

Symptoms include hard or swollen skin, which may appear red or darker than the surrounding skin and big toes pointing towards other toes on the foot. Customers may also have pain along the side or bottom of their feet, which may be worse when walking.

Question 4

What is the only way to get rid of bunions?

Answer 4

Surgery is usually the only way to get rid of bunions

Question 5

What can you advise patients to help ease any pain due to bunions?

Answer 5

• Wearing comfortable, wide shoes with a soft sole and low heel
• Holding an ice pack on the bunion for up to five minutes at a time
• Taking paracetamol or ibuprofen to help relieve pain
• Trying bunion pads to prevent shoes from rubbing on bunions
• Wearing orthotics, toe spacers or toe supports – these are often advised upon by GPs and podiatrists.

Question 6

What are corns and calluses?

Answer 6

Corns and calluses are hard or thick areas of skin. They are usually not serious but can be tender or painful.

Question 7

What is the difference between corns and calluses?

Answer 7

Corns are small lumps of hard skin, while calluses tend to be larger patches of rough, thick skin.

Question 8

What advise can you give to patients for corns and calluses?

Answer 8

Soaking feet in warm water to soften them, regularly using a pumice stone or foot file to remove hard skin and moisturising feet regularly to help keep skin soft.

Question 9

What ingredients in moisturiser should be used for corns and calluses?

Answer 9

Moisturising creams containing urea can help soften, hydrate and improve the protective barrier of the skin.

Question 10

What should patients be advised to avoid doing to corns and calluses?

Answer 10

Customers should be advised not to try to cut away a corn or callus themselves; this should only be done by a foot specialist, such as a podiatrist.

Question 11

When do fungal nail infections occur?

Answer 11

When feet are warm and damp for long periods of time

Question 12

What kind of treatments are available for fungal nail infections?

Answer 12

treatments available in cream, pen and brush formats and you should advise customers that it can take a long time to treat a fungal nail infection.

Question 13

What are verrucas?

Answer 13

Verrucas are small lumps on the soles of the feet that have tiny black dots under hard skin.

Question 14

What are verrucas caused by?

Answer 14

They are caused by the same virus that causes warts called the human papilloma virus (HPV).

Question 15

Do verrucae go away on their own?

Answer 15

They usually go away on their own, but this can take months or even years.

Question 16

What is the term given for freezing to destroy verruca?

Answer 16

Cryotherapy

Question 17

What can you advice patients with foot verruca?

Answer 17

Should be advised to wash their hands after touching a verruca, change their socks daily and cover veruccas with a plaster when swimming (if suitable according to the directions of any treatment they are using). They should also avoid walking barefoot in public places and sharing towels, socks or shoes.

Question 18

When examining a patient’s foot which symptoms require referral to GP or podiatrist?

Answer 18

• If bunion pain hasn’t improved after trying home treatments for a few weeks or if the pain is preventing them from doing normal activities
• If they have cracked skin that is weeping, bleeding or could be infected
• If they have a very large or painful verruca, or if a verruca keeps coming back.

Question 19

What regular foot hygiene advice should be given to patients?

Answer 19

• Keep feet clean and dry, especially between the toes
• Check feet regularly for cuts or sores, redness, swelling or bruising
• File dry or hard skin using a pumice stone or foot file
• Regularly apply moisturising foot creams to prevent skin from drying out and to improve its texture.

Question 20

What is Onychomycosis?

Answer 20

A fungal disease of the nails

Question 21

What microorganism causes fungal nail infections?

Answer 21

The microorganism that causes fungal nail infections is often the same fungus that causes athlete’s foot. (Dermatophytes). other micro-organisms (e.g. Candida)

Question 22

How does fungal nail infection transmit?

Answer 22

It may already be present on the body or it may pass on for example, in a salon using unsensitised nail clippers or in public showers.

Question 23

How does fungal nail infection usually start?

Answer 23

Usually starts at the outer edge of the nail and then spread into the middle.

Question 24

What does fungal nail infection look like?

Answer 24

The nail becomes discoloured and lifts away from the nail bed. The brittle nail can then break and the pieces fall away. There may also be pain and swelling in the area around the infected nail.

Question 25

Do fungal nail infections go away on their own?

Answer 25

Fungal nail infections are unlikely to get better without treatment.

Question 26

When do topical treatments for fungal nail infections work better?

Answer 26

When they are used early on.

Question 27

What should you inform patients about the length of the treatment?

Answer 27

The treatment is a lengthy process.

Question 28

How long can it take for a healthy nail to grow back?

Answer 28

up to 12 months

Question 29

What OTC options are there for fungal nail infections?

Answer 29

softening creams (e.g. those containing urea), which are applied to the nail so it can be scraped off.

Question 30

How do antifungal nail products work?

Answer 30

They are applied to the nail and work by altering the pH of the nail to prevent fungal growth or killing the fungus.

Question 31

What can you advise patients to prevent fungal nail infections?

Answer 31

• Treat athlete’s foot as soon as they can
• Keep their feet clean and dry
• Dispose of old shoes that may contain fungal spores
• Wear cotton socks
• Wear shoes that allow the feet to breathe each day

Question 32

To avoid catching fungal nail infections, what can patients do?

Answer 32

To avoid catching the infection, customers should wear flip-flops in communal showers and avoid sharing nail scissors, clippers, towels or shoes.

Question 33

When should you refer a patient to GP for fungal nail infections?

Answer 33

Pregnant women and children
Customers with more than two infected nails or a severe infection
Customers who are immunocompromised or have diabetes
Customers who have tried treatment that hasn’t worked.

Question 34

What may GP prescribe for fungal nail infections?

Answer 34

A GP may prescribe antifungal tablets, which need to be taken for up to six months.