Remember that scene in Shallow Hal where Jason Alexander’s character dismisses a beautiful woman because her second toe is longer than her big toe? For most of us, the size and shape of our toes is part of our genetic makeup, but they can also be a cause of embarrassment thanks to pop culture references like this one and modern beauty ideals. It’s no secret that when it comes to feet, some people love them, and others are repulsed.
“There are a lot of people who are really unhappy with the appearance of their feet,” says Miami podiatrist and cosmetic foot surgeon Abraham Wagner, DPM. “Though cosmetic foot surgery is considered taboo, it’s an explosive trend right now.” These expert-approved products, treatments and procedures can help us put our best feet forward this season.
5 Common Concerns
From cracked heels to bunions, these are five frequent concerns patients express to their doctors, and how to treat them.
01: Dryness + Cracked Heels
What it is: Dry skin and calluses on the feet that can lead to cracking of the skin
Why it occurs: According to New York podiatrist Emily Splichal, DPM, part of the problem is dry weather; the other part involves the shoes we wear. “In the winter, people tend to get calluses because of the stiffness of boots,” she explains. “In the summer, sandals put pressure on the skin on the back of the heels in an unusual way. It’s a high-stress part of the foot that we strike every time we walk, so calluses are very common.” As the dry heel becomes thicker, the risk for cracking increases. “If the crack is deep, it’s called a fissure, which is an actual break in the skin that bacteria can enter,” Dr. Splichal says. “It’s painful and it can become infected.”
How to treat it: Having a regular foot-care routine (exfoliating and hydrating) is important to prevent these issues rather than treat them, Dr. Splichal says. “I tell patients to hydrate their feet every day, like they do their face and body. I like occlusion, like wearing a heel balm with a sock on top at night. I also like the VOESH Pedi in a Box ($18) as a weekly ritual. If the dryness is more severe, I often recommend topical products that contain urea, which helps exfoliate.”
02: Toenail Fungus
What it is: A fungal infection that Dr. Splichal describes as a yellowing on the nail, or a pattern you don’t recognize. “Many people see white and think it’s fungus, but it tends to be more yellow.”
Why it occurs: “What predisposes you to fungus is an injury to the nail,” says Dr. Splichal. “For example, if you often wear heels that squeeze your toes, and your foot is at an angle so you’re also sliding into the nails, it will create micro-trauma that can increase risk for infection. It’s also common for fungus to spread to other toenails.”
How to treat it: Dr. Splichal says the fungus sits under the nail plate—it’s not in the nail itself—so it can be very difficult to treat. “I’d compare it to mold in carpet—it’s really tough to get rid of—so you have to be really persistent. Most over-the-counter nail fungus medications cannot penetrate nail polish, so you’d need to take a nail polish ‘holiday’ to treat it, and even then, they may not work. Some doctors will use lasers, but I’ve always had mixed results. Therefore, I prefer to treat the fungus systemically with antifungal oral medications.”
03: Long Toes
What they are: Some people have one toe that is longer than the rest, several toes that are longer than their big toe, or toes that are all longer than desired.
Why they occur: Genetics
How to treat them: For those who are bothered by their toe aesthetic, Dr. Wagner performs toe-shortening surgery (aka a “toe tuck”) to shorten all the toes to make the overall size of the foot smaller, or just shorten a single toe that sticks out from the rest. “It can be done under local anesthesia without pins, screws or plates, and the patient can walk afterward,” he says. “Swelling can take up to six months to resolve, but the results are permanent. This can be a life-changing procedure, but it is very, very specific and there are only a few doctors I’d trust to do it. I’ve even had married patients who won’t show their feet to their partner, but finally feel comfortable doing so after this surgery.”
What they are: Thick layers of skin that can be hard or soft, and are usually seen on the tops and side of the toes
Why they occur: Dr. Wagner says they develop because of bone pressure against the skin, like a hammer toe. Other causes are arthritis and wearing poorly fitting shoes, or putting excess pressure on certain toes.
How to treat them: Though corns can become tender, they’re generally harmless, so most people just let them be, or they use corn-removal pads at home. “These pads should not be on the market,” says Dr. Wagner. “Ninetyfive percent of the patients who come to see me for corn removal have darker skin types and have used these over-the-counter ‘remedies,’ only to find that they burn the skin. Once the skin is burned, it turns white. Because of the contrast on darker skin, the patients think it looks ugly. Plus, the corns eventually come back.” In some cases, Dr. Wagner can surgically excise the corn lesions under local anesthesia and stitch up the skin. “Results can be seen immediately, though there may be a few months of swelling.”
What they are: A bony bump that forms at the base of the big toe and is typically present on both feet
Why they occur: They can be caused by genetics, shoes that compress the toes, or underlying medical conditions.
How to treat them: “Patients usually consider elective surgery when the pain of the bunion affects their daily life activity, but some people don’t have any pain—they just don’t like the way it looks,” Dr. Wagner explains. “At our practice, we can remove the bunion using a unique minimally invasive surgical technique that is done under local anesthesia. We use tiny, little keyhole incisions and no pins, screws or plates. The patient is awake and walks out on their own.” The recovery program is critical to ensuring optimal results: “We use very delicate, intricate, splinting techniques via postoperative shoes that the patient wears for four weeks,” he adds, noting that some swelling may last four to six months. “Then the patient does physical therapy, and we follow all the other protocols to maximize the outcome.”
At-home Foot Care
Two tips for keeping your feet happy at home—no salon required.
➊ Incorporate massage. “I teach people to serve their feet every day by doing five minutes of bare-foot stimulation in the morning and evening,” says Dr. Splichal. “They can do that by standing on a golf ball or a lacrosse ball when they brush their teeth. The benefit is that you massage the muscles, stimulate the nerves and improve circulation. Part of healthy feet is good circulation, like what gua sha does for the face.”
➋ Treat your feet. “Don’t wait for summer to take care of your feet—they should look and feel good year-round!” says celebrity manicurist and brand founder Deborah Lippmann. “First, use a scrub—I like my Soul Mission, which heats up as you massage it—and a callous softener. Then use a foot file to remove callouses and dead skin.” Lastly, apply foot cream. “I like my Steppin’ Out cream because it’s not greasy and doesn’t have too much slip.”