BLOOMINGTON - Summer is brutal on feet as people are more active outside and may be wearing improper shoes and, sometimes, no shoes at all.

But there are things you can do to reduce your risk and to treat warm-weather foot problems.

"We see more athlete's feet, fungus of the feet and nail fungus during summer," said Dr. Carl Cortese, a podiatrist for 35 years with Cortese Foot and Ankle Clinic in Normal, Bloomington, Pontiac and Clinton.

Dr. Henry Sherman, a family practice physician with a focus on sports medicine, sees more blisters "because people start new jogging programs without wearing the proper footwear." Sherman recently joined Carle Clinic-Bloomington.

According to the American Podiatric Medical Association's recently released 2007 foot ailments survey, about 45 percent of Americans suffer from foot pain. About 54 percent of them said the pain prevents them from performing routine activities.

Here are some common summer foot problems and how to reduce your risk:

Keep them clean

Cortese sees more foot and nail fungus, largely because people slip on dirty shoes to work outside. Many people wear old shoes to work in their garden and lawn. Many of these sweaty, dirty shoes aren't cleaned and are kept in damp, dark garages. Fungus soon grows, Cortese said.

Replace the shoes if they are beaten up, he said. If the shoes remain in good condition but are dirty, wash them in the washing machine with Clorox and let them dry in the sun.

Always wear socks with the shoes to reduce skin contact with fungus and to reduce friction that may lead to blisters.

Keep them covered

Some people go outside this time of year without shoes. They risk getting bitten by a bug or stepping on a foreign object, such as a nail or broken glass, Sherman said.

When going outside for just a few minutes, Sherman recommends wearing something - such as flip-flops - on your feet.

If you're on a beach, wear sandals or water shoes, which also will prevent discomfort from walking on the hot sand at mid-day, Sherman said.

Remember sunscreen

Don't forget to apply sunscreen to the top of your feet. People often forget to apply sunscreen there, Sherman and Cortese said.

When spending a day on a sailboat, wear deck or boating shoes, Cortese said. They reduce the risk of sunburn and of toe and foot injury while boating or on the dock, Cortese said.

Care around crowds

Wear pool shoes or flip-flops in public showers and locker rooms, the doctors suggested. The humidity combined with the variety of people who uses these areas mean the floors may be a hotbed for fungal growth. That can lead to athlete's foot, and viruses, which may lead to warts.

A virus may find its way through an opening in the skin, causing a wart. People whose resistance to viruses is low are more susceptible to warts, Cortese said.

Flip-flop flaws

Remove flip-flops when leaving the shower room, locker room, beach, pool deck or yard, the doctors advised.

People who leave on flip-flops are at risk of falling if the back of the shoe gets caught on something, and are at risk of arch pain because flip-flops provide no arch support, Cortese said.

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Common foot problems

Athlete's foot

• Flaky, dry, cracked, itchy skin.

• Caused by warm, dark, humid environment that encourages fungal growth. May be contracted in locker rooms, shower rooms, dressing rooms and hotel rooms.

• Reduce your risk by inspecting your feet for unusual growths; keeping shoes and socks dry; washing feet with soap and water and drying regularly, including between the toes; changing shoes regularly; and wearing flip-flops in public showers.

• Consider moisturizing skin (but not between the toes) with over-the-counter topical medications, such as Lotrimin AF.

Calluses or corns

• Painful thickening and buildup of skin that forms at points of pressure, over bony prominences or on the bottom of the foot.

• Caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe. Also caused by heredity, tight stockings or a tendon imbalance.

• Reduce your risk by avoiding tight-fitting shoes, socks and hosiery, and instead wearing supportive shoes with a roomy toe box and a low heel. Use an over-the-counter cream (not a medicated callus/corn remover pad).

• Ask a podiatrist or your doctor about Pedinol's Ureacin-20 Cream or AmLactin Moisturizing Lotion.

Blisters

• Painful, fluid-filled lesions.

• Caused by ill-fitting or stiff shoes, wrinkled socks, excessive moisture or foot deformities.

• Reduce your risk by keeping feet dry and wearing socks with properly fitting shoes.

• Do not pop a blister. Treat a mild blister with soap and water, cover with an antiseptic ointment and a protective dressing, and use padding such as moleskin to reduce friction. If the blister becomes large and painful, carefully open a corner of the blister closest to the bottom of the foot with a sterilized needle, drain, apply antibiotic cream and cover with a bandage.

Fungal nails

• Thickened, discolored, loose or deformed toenails.

• Often starts in the skin as athlete's foot, then spreads to the nails. May also be inherited or caused by a medical condition, such as diabetes, arthritis, cancer and psoriasis.

• Reduce your risk by trimming toenails straight across, keeping shoes and socks dry, washing and drying feet daily, changing shoes regularly, and wearing acrylic or cotton socks.

• Ask a podiatrist or doctor about Novanail by Hathor Rx, a nail lacquer that is painted onto an infected nail to treat the nail fungus at its source, or Keralac Gel, a quick-drying gel that treats thickened nails, psoriasis and nail fungal infections.

Warts

• Painful thickening of the skin. A hard, flat, elevated surface, often on the sole of the foot.

• A virus causes warts, which typically invade the skin through small cuts and abrasions.

• Reduce your risk by avoiding walking barefoot, changing your shoes daily, and keeping your feet clean and dry.

• A podiatrist may treat warts by using laser treatments or Duofilm, a liquid salicylic acid wart remover.

Foot odor

• Sweaty, smelly feet that do not itch nor appear to have a rash. The medical term is bromohidrosis.

• Caused by increased bacteria on the skin and closed shoes that allow bacteria to grow.

• Reduce your risk by keeping shoes and socks dry; washing feet daily with soap and water and drying thoroughly, especially between the toes; changing shoes regularly; and wearing socks that wick away moisture.

• Rub cornstarch or spray antiperspirant directly on the soles of the feet and spray Lysol into shoes.

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Proper footwear ensures good workouts

By Paul Swiech | pswiech@pantagraph.com

Some people start exercise programs in the summer and by August are paying for that if they aren't using the proper footwear for their activity. Ill-fitting shoes can lead to blisters, calluses or corns.

"Wear the proper shoe for each sport," Dr. Carl Cortese said. Whether you are running, or playing tennis, basketball or another sport, talk with someone knowledgeable about the sport and shoes to select footwear that works for the demands of sport, said Cortese and Dr. Henry Sherman.

For example, tennis players need shoes with good traction to grip the surface during rapid starts and stops; absorption to protect the joints; and lateral stability to provide protection during all the lateral movement.

Basketball players need shoes with good traction, stability and a high top to reduce the risk of ankle sprains during jumping, rapid starts and stops.

Runners need shoes with good shock absorbency and a firm heel to help the body absorb the shock of hitting the ground; a studded sole to grip the ground; a buildup inside the shoe for arch support and to reduce the risk of shin splints; a flexible mid-sole for help with uneven terrain; a well-padded tongue and high-rounded toe box so the toes won't blister; and padding at the heel to reduce the risk of Achilles' tendon.

People who run daily should have two pairs of running shoes and should alternate them, Cortese suggested.

Replace running shoes every 300 to 500 miles.

When buying any shoes, go later in the day after your feet have swelled, and wear socks you normally would be wearing with those shoes, Cortese and Sherman said.

Many foot problems are a result of wearing poorly fitting or worn-out shoes, they said.