Feet first - taking steps with the category

As customers bare their feet and legs for summer, pharmacy staff need to be ready to offer advice and treatment for common complaints

Summer is just around the corner and your customers will be turning their attention to their feet and legs as they swap tights and boots for bare legs and sandals. Research by the College of Podiatry found that 90 per cent of women have suffered with a foot problem and a fifth admitted to being embarrassed by their feet. The most common complaints include blisters (55 per cent), cracked heels (45 per cent), verrucas (28 per cent), corns (24 per cent) and ingrown toenails (20 per cent). Yet 19 per cent of women don’t seek help because they think that foot complaints are trivial.

Podiatrist and fellow of the College of Podiatry Lorraine Jones says, ‘It’s shocking how little regard we show our feet. As a result of general wear and tear, most of us will suffer with some sort of foot complaint, but we are seeing a lot of cases that could have been prevented. Foot problems I commonly see are athlete’s foot, verrucas, problems caused by ballet pumps – heel pain and big toe joint problems, ingrown toenails and corns.’

Community pharmacy staff can encourage customers to seek early treatment and give advice on how to keep feet healthy and prevent problems in the first place.

‘Customer confusion as to what the problem is and over what product to choose is a key issue,’ says Mark Pearson, healthcare category marketing director at Scholl. ‘The pharmacist has a crucial role to play in helping customers understand what the problem is and providing guidance on the correct treatment. Clear point of sale in the store will help signpost the foot care area and make it easier for customers to navigate the store.’

Summer foot complaints

Sweaty feet: Ms Jones suggests people alternate shoes to give them time to dry out and wear socks that are at least 70 per cent cotton or wool to keep feet dry and odour-free. ‘Wash feet daily with an anti-bacterial soap – leave it on for a few minutes before you rinse it off. This really helps with foot odour. Try an antiperspirant on feet or a specialist product such as Driclor.’

Athlete’s foot: This fungal condition is more common during summer months because it loves warm, moist conditions. Alternating shoes helps prevent infection. Advise customers to wear flip- flops around public showers and pools. ‘Advise customers to treat the whole foot, not just the patch of skin affected, as fungal spores will be spread across feet,’ says Ms Jones. ‘Check whether your customer has a fungal nail infection, too – if this isn’t treated it can cause a recurrence of athlete’s foot. If a customer has recurrent fungal infections, advise them to get their blood sugar tested for diabetes.’

Blisters: These are common when we start wearing summer footwear, especially without socks or tights. The College of Podiatrists has these tips to pass on to customers:

  • Ensure footwear fits properly
  • Keep feet dry at all times
  • Give feet ample rest – overworking feet increases heat and moisture in footwear, increasing the likelihood of blisters.

‘Pick sandals with shock-absorbent soles and thick, adjustable straps to minimise friction and prevent blisters,’ says Ms Jones.

Verrucas: These are more common in summer months. Avoid walking barefoot in communal changing areas to help prevent them. Customers who don’t have diabetes or circulatory problems can treat them with either salicylic acid or a freeze treatment.

Foot care news

Bazuka is being supported by national TV, press and online activity until September. The campaign explains to consumers why and how they should treat verrucas.

The latest foot care products from Scholl include the Scholl 2 in 1 Corn Express Pen, which promises results in just five days; Scholl Advance Athlete’s Foot Cream, a seven-day terbinafine treatment; and Scholl Fungal Nail treatment, a treatment and protection product.

The corn sector of the market has grown by 24 per cent in the past two years, says Carnation, as prevalence of the condition increases. David Wain, podiatrist at Carnation, has this advice for building a better category: ‘Stock and merchandise by condition category, ensuring there is a robust range to cover all key elements, including corn, callous, bunion, athlete’s foot, blister and odour control. Don’t forget orthotics, which are an important area.’

Carnation’s new PediRoller kit is aimed at helping tired, aching feet. Carnation is working with the choreographer Arlene Phillips to promote the brand and educate the public on foot health. She says that exercising the muscles in the feet is important for everyone, including older people who will benefit from better balance and perhaps less risk of falling. ‘Find the strength in your feet’, says Phillips. Podiatrist Dr Tariq Khan confirms that regular stretching out of the muscles in the feet is beneficial and can help prevent conditions such as plantar fasciitis – throbbing pain of the heel caused by inflammation of the plantar fascia in the foot. This can be the result of standing for a long time, walking or running on a hard surface or weight gain, all putting extra strain on the feet.

Diabetic foot care

Each week in England there are 120 amputations due to diabetes, the majority of which caused by a foot ulcer or infection failing to heal. New figures show the amputation rate is not improving and the gap between the worst and best performing areas of the country has widened, with those living in the worst areas seven times more likely to have an amputation. Up to 80 per cent of diabetes-related amputations could be prevented, says Diabetes UK, and improving foot care is a crucial factor.

‘Pharmacists can help by emphasising the importance of daily foot care to their customers Podiatrist Dr Tariq Khan confirms that regular stretching out of the muscles in the feet is beneficial and can help prevent conditions such as plantar fasciitis – throbbing pain of the heel caused by inflammation of the plantar fascia in with diabetes,’ says Libby Dowling, clinical advisor at Diabetes UK. ‘Ask if they’re getting their annual foot check and whether it’s effective – feet should be examined and tested for sensation. If you’re not doing some active promotion already, talk to your customers with diabetes about their foot care. Refer patients on quickly if they have any problems.’

Top tips for summer

Diabetes UK has this advice to pass on to customers:

  • Ensure new shoes fit properly – much damage is due to ill-fitting footwear
  • Check feet daily for changes/damage, especially in patients with neuropathy
  • Take extra care on beaches and, if patients have neuropathy, wear something on the feet at all times
  • Wash feet daily to avoid infection
  • Moisturise feet, but not between toes, as this could cause athlete’s foot
  • Act on damage immediately
  • Trim nails at least every six weeks and file away sharp edges.

Summer leg care

Research commissioned by Activa Healthcare, experts in leg care, found that 81 per cent of people surveyed said they’d experienced leg problems, including tired/aching legs, swollen ankles or varicose veins. Yet only 36 per cent sought advice from a healthcare professional and just four per cent wore compression hosiery to relieve symptoms. More than half of those surveyed didn’t understand about varicose veins, oedema, leg ulcers or DVT and only one in four knew how compression hosiery works.

Pharmacy staff are in a good position to advise and offer treatment this summer for customers with leg complaints. ‘Pharmacy staff can help raise awareness of leg problems, especially during the holiday season when customers may be going on flights or travelling for long periods, which increases the risk of DVT,’ says Mark Hudston, senior product manager for hosiery at Activa. ‘If customers in at-risk groups come in asking for mosquito spray or malaria tablets, take the opportunity to discuss DVT and how they can reduce their risk.’ To find out more about DVT risk factors visit www.activahealthcare.co.uk/deep- vein-thrombosis.

Activa has produced a free app that pharmacy staff can download to help them recognise common leg problems and work out customer sizes (www.activahealthcare.co.uk/hosiery- selector-sizer). ‘Fitting compression hosiery is a valuable service to offer customers. Correctly measured and fitted Activa hosiery will be more effective than hosiery selected by shoe size. It also allows you time to build relationships and talk about other conditions or concerns they may have while you do this,’ says Mr Hudston.

His top tips for fitting compression hosiery are:

  • Explain what you’ll be doing
  • Start measuring at the top of the leg, working down to the ankle
  • Check skin for spider veins, varicose veins or discolouration
  • Measure in the morning, if possible, before any swelling occurs
  • Measure both legs.
  • Varicose veins

It is estimated that more than six million people in the UK suffer from varicose veins, five million of whom are women. Varicose veins are thought to be a hereditary condition. Veins walls have one- way valves to assist blood flow back to the heart. These valves are particularly important in the legs, but sometimes become ineffective. The damaged valves allow blood to flow backwards, which can lead to problems with aching legs, spider and varicose veins.

‘Wearing compression hosiery at an early stage can prevent leg problems getting worse and stop making legs feel tired and heavy – an early sign of vein problems and potential varicose veins,’ says Mr Hudston. ‘Varicose veins are common in pregnancy. Prescriptions for compression hosiery are free to pregnant women likely to be at risk.’

  • June is Feet For Life Month and each year the campaign aims to raise awareness of good foot health. Find out more about this year’s campaign and get materials to promote foot health in your pharmacy at www.scpod.org.

Comment

Lila Thakerar, Shaftesbury Pharmacy, Harrow ‘This is an ideal category to include as part of health checks and MURs for diabetic patients. Looking after the feet, with correct guidance from the chiropodist, is crucial for anyone presenting a prescription for diabetic medications. Preparations for corns, calluses and comfort supports are great sellers and Scholl remains a popular brand in the market. Customers are more aware of the importance of looking after their feet and legs for both hygiene and comfort. Sales of cracked heel creams have escalated and Flexitol is also a popular brand. We find treatment for athlete’s foot peaks in the summer as people wear trainers more often for outdoor sports.’

Dilip Patel, Mirage Pharmacy, Handsworth ‘Over the years this category has more prominence and customers seem more aware of their foot and leg health. This could be because of an increase in advertising from manufacturers and pharmacies have done their bit to promote the category by having sections in store dedicated to it. Flexitol Heel Balm tends to be very popular, and there are products for corns and calluses and warts. We are also asked for recommendations for stockings and tired legs and rough skin on the feet. Having a dedicated section that is properly merchandised for foot and leg health can improve sales. Generally, it’s about making people become more aware of the fact that pharmacy can offer advice about good leg and foot health.’

Nemesh Patel, AMG Pharmacy, Braintree ‘Leading foot care brands such as Scholl, Lamisil and Compeed lead the way in terms of retail sales in our pharmacy. We find dummy displays of OTC products stimulate awareness and interest and have helped numerous customers with ailments such as fungal nail infections. Excilor is also currently selling well in our pharmacy. I would recommend stocking the key sub- categories and positioning these close to first aid and beauty products such as nail files and pumice stones. There is a clear opportunity for pharmacists in more serious foot care conditions, such as identifying foot ulcers and poor diabetic control that requires referral to a GP. Symptoms such as leg ulcers or cramp can be indicative of an underlying condition such as venous disease or a side effect of medications.’

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