Foot infections

Skin provides a natural barrier, but if that barrier gets broke via a wound, then the area is prone to infection. Due to the warm moist environment surrounding feet, bacterial and fungal infections are common. People with medical complications such as diabetes often have poor circulation, and are most susceptible to foot infections. If an infection doesn’t clear up quickly or gets worse, seek medical attention.

Bacterial infections

Typical signs of bacterial infection include:
- Increased redness, swelling, pain, warmth and tenderness around the area.
- Pus in and around the area.
- Fever.

This inflammatory response is the body’s way of protecting against infection. The immune system is kicked into action. In an attempt to fight off the infection, extra blood is sent to the affected area and that’s what causes the localised redness, swelling and warmth. Inflammatory responses may also occur in areas of the body that are overused or have minor injuries, and are not necessarily associated with infection.

Infected areas can turn nasty pretty quickly, particularly in hot and humid conditions – perfect for pathogens to multiply. Unfortunately, those are the exact conditions that feet are subject to in sweaty socks and shoes, so wounds on feet are particularly susceptible to infection. On bushwalks it’s important to take precautions to prevent any injuries or wounds getting infected, and to seek medical attention if the patient’s condition deteriorates.

Prevention
While it’s impossible to dodge small wounds and cuts entirely, good foot care and maintenance can go a long way to reducing the chance of infection. Appropriate management of infections in the field is important.

Management
- In the field: If skin is broken, clean the area with a saline solution or alcohol wipes or just water if nothing else is available. Apply antiseptic cream (e.g. betadine) and put on suitable bandage depending on size and location of the wound. Monitor the patient for signs of infection such as increased aches, pain and fever. If the condition becomes serious, seek medical attention.
- At home: regularly clean and dress the wound. Monitor and seek medical attention if the wound does not heal.

Yeast infections

Because shoes provide the ideal warm, moist conditions for fungi to thrive, feet are also extremely susceptible to fungal infections.

Common fungal infections include:
- Athlete’s foot – Symptoms: red, itchy patches. White flaking skin.
- Jock itch – Symptoms: rash, patches of redness or bumps.
- Ringworm – Symptoms: itchy, red, scaly patches.

Athlete’s foot, jock itch and ringworm are all caused by dermatophyte fungi, although athlete’s foot can occasionally be triggered by yeast (candida) infections. Fungi feed on keratin, which is a protein found in skin, hair and nails.

Prevention
There are some simple steps to follow to reduce the chance of getting a fungal infection:
- Develop a good foot maintenance routine.
- Wear footwear and socks made from breathable materials.
- Wash feet thoroughly after exercise and change socks.
- Keep toenails cut short and clean them regularly (note that fungal infections can develop underneath toenails).
- Air feet out as much as possible (i.e. use open shoes around the house). When feet are infected, avoid walking barefoot as this can spread fungal infection.

Management
- In the field: Because it’s hard to properly keep the feet clean and dry on a bushwalk, fungal infections are difficult to eradicate. Consider soaking feet in creeks (downstream from any water collection points) for relief, applying antifungal cream (if this is something in the first aid kit) and changing socks regularly to keep feet as dry as possible.
- At home: wash and dry the rash area thoroughly; apply antifungal creams and/or powders; seek medical attention if it hasn’t cleared up within two weeks or gets worse.