Ask the Doctor: What can I do for cracked soles on my feet?

Monday April 22 2019

 

I have deep cracks on the soles of my feet commonly referred to as enkyakya. Is there any medical treatment for this? Byankabya

Dear Byankabya,
Feet have numerous sweat glands (as many as 250,000) that constantly produce about 500mls of sweat. Much as sweat helps to cool us down when we feel hot, sweat also helps to keep feet moist otherwise dry feet would develop cracks or plantar fissures (enkyakya).
These fissures are thought to be a poor man’s disease happening mostly in people who till dry land when they are barefooted hence risking losing the foot moisture to the dry soil. Dry skin is known to crack like a drying mud and wattle house. The obese, those who consistently walk barefoot or those with inactive sweat glands are also prone.

Much as heel fissures may seem harmless and are a cosmetic nuisance, like many foot conditions that compromise the protective function of the skin, heel fissures can become more dangerous if they go untreated and become deep or infected.
This is especially dangerous for people with diabetes or compromised immune systems. Infections here can lead to conditions such as cellulitis (etalo), tetanus and could also facilitate easy entry by fleas that cause jiggers.

Treatment and prevention of plantar fissures requires taking adequate amounts of fluids and soaking the feet in water with salt before and after going out in the fields to dig.
A rough stone can be used to scrub off extra hard skin after soaking the feet in salted water. Wearing gumboots out in the fields is protective, locking out germs and fleas as well as retaining moisture. Avoiding walking barefoot or wearing open shoes or sandals can also help.

I get a burning sensation after sex

Whenever I am intimate with my girlfriend, I get a burning sensation in the penis. She says this might be caused by the fact that she takes pepper and the vagina’s acidity. Is this true or is she cheating? Manly

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Dear Manly,
During sex, the penis releases Cowper gland’s pre-ejaculate (pre-cum), which acts as a lubricant and an acid neutraliser and semen. Precum and the fact that the vagina is not very acidic means that the vaginal acidity is unlikely to burn the penis. That said, a burning sensation during sex could be on the outside of the penis or may come from the urethra.

Pepper, much as it can burn the mouth is digested and does not appear as pepper in vaginal fluids to cause a burning sensation. Therefore, allergy to condoms, vaginal fluids or applications, could be causing the burning sensation. Other causes include infections of Herpes simplex (or even the scars), infections such as candida affecting the fore skin (posthitis) or penile head (balanitis). Though these infections can be mitigated by circumcision, the said allergies may not be.

Sometimes your brain can discern a burning sensation during unwanted sex with a woman just because you have relationship problem with her. Suspecting that she could be giving you an STD alone can cause you to have a burning sensation even when there is no infection.
Sometimes one may not know where exactly the penile burning sensation is originating from, confusing urethral burning with superficial penile burning sensation.

The burning sensation in the urethra may happen during ejaculation and may be due to an STD (chlamydia, trichomoniasis), candida of the urethral opening, prostate infection, urinary tract infection, or damage to the nerves by say diabetes.
Since the causes of your problem could be many, you need to visit your doctor together with your girlfriend for help.

Why do I have difficulty swallowing food?

For the last six years, every time I try to swallow food I suffocate and feel a lot of pain. I was prescribed sleeping pills which did not help. What can I do? Alinda

Dear Alinda,
Difficulty in swallowing (dysphagia) commonly happens when one tries to swallow large amounts of food or food which has not been properly chewed or mixed with saliva.
Many times, people who are anxious or stressed may feel a lump in the throat (Globus pharyngeus), which may cause one to keep taking water or swallowing saliva in a bid to remove the lump. This could be the reason the doctor gave you anti-anxiety drugs you are referring to as sleeping pills.

When dysphagia is longstanding, painful or makes it impossible to swallow with or without food being regurgitated, is associated with weight loss, causes a hoarse voice or frequent heartburn, then it may be caused by a serious medical problem. Here, cancer of the throat, acid reflux from the stomach with wounds and stricture formation in the oesophagus should be investigated. Please visit your Ear, Nose and Throat doctor for further help.

How can I get rid of this infection?
For more than 20 years, I have had smelly white stuff between my toes which have refused to heal despite getting treatment. What can be the long-term solution?
Darius

Dear Darius,
Athletes foot is the fungus infection usually between the first and second outer toes which are warm, moist, hidden (perfect for fungus growth). Anyone including those who are not athletes can be affected by the fungus which is contagious and can be spread through contaminated floors, towels, clothing and shared shoes.

Athlete’s foot, which may cause intense itching and scratching may also be associated with foot odour because both conditions are common in people whose feet sweat and retain sweat for long periods of time. If the condition is not treated, it may spread to other areas of the feet or even the groins and armpits where intense itching can cause embarrassment when scratching is done in public.

A doctor can prescribe antifungal creams and powders to treat the condition but may keep returning if the toes are close and do not allow sweat to evaporate. Also, if one keeps wearing damp closed shoes or damp socks for long periods, they are likely to get athlete’s foot.
Keeping one’s feet dry, especially between the toes, changing socks regularly, wearing light, aerated shoes and not sharing shoes can help prevent the condition.

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