The Perfect Pedicure: The Best Treatments For Feet, Nails, and Toes

The lazy, hazy, crazy days of summer are well underway, which means sandal season is in full swing. And, while you may have treated yourself to a pampering pedicure to compliment your flip flops and slides, how much attention have you paid to the rest of your feet?

Despite all of the time and attention we devote to caring for our face and bodies, the area south of the ankle is often an afterthought — that is, if you think about it at all. "I see patients daily who come in with issues with their feet," says Washington Square Dermatology's board certified cosmetic dermatologist Samer Jaber, MD, who is also a clinical assistant professor at the Icahn School of Medicine at Mount Sinai in New York City.

From dry skin and odor to visible veins and cankles, the feet are just as prone to wear and tear as the rest of the body — and they are just as much in need of TLC, too. For those dealing with foot problems that even the prettiest toenail polish color can't distract from, there are cosmetic treatments and medical procedures to address everything from premature aging to funguses and to get your feet in tip-top shape before Labor Day.

The Concern: Premature Aging

When was the last time you remembered to put sunscreen on your feet? If the answer is 'never,' you're not alone. But, in addition to the skin cancer threat, it may be aging you. As with any other area of the body, foot skin can show signs of aging (think: crepiness, sun spots, wrinkles, and more) if it is not looked after. Fortunately, there are plenty of remedies — from topical medication and skincare to lasers and fillers — for those looking to turn back the clock.

Topicals

Whether you're practicing a 12-step K-beauty skincare routine or keeping things minimalistic, you are likely using products formulated with brightening, exfoliating, and clarifying active ingredients on your face. So why not extend that same thinking to your feet?

The skin on the top of the feet is relatively thin, so it can absorb products well, but the tougher skin of the heels and soles is a different story. "Lotions or creams are great for the thinner skin on the surface of the foot but aren’t as effective on the heel or sole," says board certified West Hollywood dermatologist Jason Emer, MD. "I recommend patients use a spray or mousse formula on their feet because these options are more suitable for areas with hardened skin."

In addition to incorporating SPF into your daily foot care routine, Dr. Emer encourages patients to look for over-the-counter products with vitamin C, glycolic acid, and retinoids to improve the tone and texture of foot skin.

• Vitamin C: The powerful antioxidant is a skincare (and foot care!) must for its brightening abilities that even skin tone and fight free-radical damage.
• Glycolic Acid: The alpha hydroxy acid (AHA) is known for its exfoliating powers, which can slough off the dull, dead skin cells on the surface of the skin to reveal more youthful skin below.
• Retinoids: The vitamin A derivative boosts collagen production and increases cell turnover for plumper skin.

Laser Treatments

Lasers can treat cosmetic skin concerns from head to toe, and Dr. Emer uses Aerolase, in particular, to treat a number of foot conditions. "Lasers can be used to treat feet that are showing premature signs of aging," he explains. "We use them to treat visible veins, skin discoloration, sun damage, as well as for laser hair removal on the foot area."

Fillers

Not just for the face, hyaluronic acid-based fillers can be injected on the top of the foot to create a plumped, youthful look where tissue may be losing its natural volume due to the aging process.

Additionally, they can be used to disguise the appearance of bulging veins or tendons in the area. It is not uncommon for people who work out regularly to lose fat on their feet (your running regimen doesn’t just have you choosing between your ass and your face), which can make tendons appear more visible over time. "We use fillers to cover tendons in the feet," says Dr. Emer. "Belotero®, in particular, tends to give a softer result."

Foot Facials

Though a bit less spa-like than your typical trip to the nail salon, medical pedicures can provide relief for patients dealing with an array of foot and nail issues, and they are often coupled with additional treatments at a dermatologist's office.

Dr. Emer, for example, offers a "foot facial" that incorporates microdermabrasion to soften and brighten skin — a professional take on the tried-and-true foot scrub. And one of his current go-to treatments for feet has an aquatic twist. He applies exfoliating fish enzymes to gently dissolve dead skin cells and leave the foot smoother and more youthful.

When it comes to treating calluses and other stubborn skin, Dr. Emer will sometimes employ an ultrasound machine to help serums and other topicals penetrate deeper for better and faster results.

Cankle Definition

One of the most difficult areas to tone is the space between the calf and the ankle (a.k.a. the ‘cankle’), which is visible when wearing strappy sandals or heels.

A before-and-after look at one of Dr. Emer's calf liposuction patients.

Dr. Emer recommends liposuction or liposculpt to patients looking for a more defined calf and ankle, and the same approach can be used on the upper calf as well for an overall slimming effect (as seen in the before and after photo above!).

The Concern: Itchiness, Funguses, and Odor

While cosmetic treatments are available to those looking to improve the appearance of their feet, the nitty-gritty of foot care is a little less glamorous — but no less important. From fungal infections like onychomycosis that thicken nails to itchy rashes caused by eczema or other skin conditions, dermatologists can treat these concerns with a mix of professional and at-home remedies.

For Itchiness

Foot itchiness is generally caused by a fungus (think: athlete's foot) or a skin condition like eczema. “For most patients who come to me with a fungus issue, a simple treatment with a prescription antifungal cream twice a day for two weeks is all they need,” says Dr. Jaber. In the case of eczema, a patient will likely be dealing with flare-ups on other parts of the body, too, and a dermatologist will be able to get to the root cause and triggers (be it stress, food sensitivities, or more) for longer-term management.

For Thickened or Yellowed Toenails

Toenails are not immune from funguses either, and fungal nails can be treated with laser therapy, topical treatment, oral medication, or some combination of the three. Regardless of which approach you choose, however, patience will be key.

"Nail funguses often come back after treatment, and the treatment process, when taken orally and with topical application, is long," warns Dr. Jaber. "It takes three months of antifungal medication and a year of topical medication for a full course." Results from lasers, meanwhile, will not be visible until the affected part of the nail grows out, which could take months.

But, not to fret, there are some easy ways to help prevent fungal infections. For starters, Dr. Jaber recommends keeping closed-toe shoes (think: sneakers) clean and dry and using an antifungal powder as a precaution. And, in case you needed another excuse to reach for your sandals, open-toe shoes are ideal for thwarting funguses.

For Odor

Sweaty feet (especially in the heat of summer) are hard to avoid, but the moist environment is the likely culprit behind some of the most common foot concerns. "Usually foot odor is caused by sweaty feet, which encourages a bacterial or fungal infection," explains Dr. Jaber, who recommends keeping smells at bay by "making sure footwear is breathable" and "taking shoes and socks off" upon getting home from work to dry feet out.

While a dermatologist can prescribe a topical antifungal, antibacterial, or a prescription-strength antiperspirant depending on the cause of the odor, at-home remedies — like tea tree oil-infused warm water soaks — can sometimes do the trick as well.

The Takeaway

The oft-neglected feet deserve just as much time and attention as the rest of the body, and taking a bit of TLC could have you well on your way to the perfect pedicure — no matter the season.

To prevent premature aging, Dr. Emer and Dr. Jaber both encourage patients to apply sunscreen to the tops of the feet daily when footwear (like sandals) leave them exposed. Rashes, odor, and discolored nails, meanwhile, can be treated with prescription medication and other professional procedures performed at a dermatologist's office. Last but not least, those dealing with foot pain caused by bunions, ligaments, and more should consult a podiatrist.