WINTER FEET – LOOKING AFTER YOUR FEET IN COLD WEATHER

ADVICE FROM OUR PODIATRIST, George Hill

Staying warm when it’s cold outside can be a challenge. Especially when it affects our body’s circulation; our feet and hands can suffer especially. In cold weather, it is a natural response to prioritise the heating of our vital organs. This is so they remain at their optimal temperature for full functionality. This means having cold feet is normal when the temperature drops. Nail growth slows down and skin will often become drier because nutrition to these tissues is affected.
In response to this temperature change, small blood vessels temporarily constrict. As a result, you may see a change in the colour of your skin, which could look pale, blanched and waxy at first, before becoming bluish. This is because the oxygen in the blood has been used up by the tissues. The skin is also cool to touch. Returning to warm conditions usually remedies this and the skin becomes pink and warm again.
However, in some individuals, this response is exaggerated and prolonged. This condition is known as Raynaud’s phenomenon and can be inherited. The same response will occur but much more readily and will last longer. Meaning the colour changes are much more obvious. When the skin is deprived of oxygen for long periods of time, some injury occurs to the soft tissues. This can make fingers and toes numb while they remain cold. When the blood vessels do finally relax and blood returns to the area, fingers and toes can throb and burn, turning bright red with inflammation. Eventually, things return to normal but repeated episodes of this can lead to dry, devitalised skin and changes in nail shape and texture.

Chilblains occur for much the same reason. These are painful, itchy swellings that often occur on the tops of small toe joints but can occur in other bony areas too, such as the back of the heel. Tightly fitting footwear can add to the misery by constricting blood flow further and rubbing on the painful skin. Chilblains are not caused by using hot water bottles, as commonly thought, they are a cold injury to Winter Feet, The attempt to relieve the intense itch by scratching merely worsens the problem, often causing further damage. Itching tends to break the skin and causes sores which can sometimes lead to infections.
Preventative action should reduce the likelihood of chilblains developing, but if they do, an antipruritic (anti-itching) cream or ointment can be obtained from pharmacies, and menthol-based products can also be very soothing.
If the skin becomes broken, antiseptic creams such as Savlon help the skin to heal and prevent infection. Cover with a gauze pad after applying, which can be secured with finger bandage or held in place with a cotton sock.
In the aftermath of chilblains, the affected skin is often dry, thin and rough, so use a moisturising cream to restore normal texture.

Cold feet at night can keep you awake or disrupt sleep.
What can be done to help? If you are susceptible to cold extremities, it is important to keep yourself generally warm. Listen to the temperature forecasts and dress accordingly. As well as suitable outer clothing, trousers, tights or socks will help to keep the whole limb warm. Fibres such as wool or bamboo are good insulators and several light layers, rather than one thick layer, traps more air and heat. Remember to wear roomier footwear to allow for thicker socks without compressing the skin.
Footwear should have a good rubber or composite material sole, to insulate against cold pavements – adding insoles of cork or lambswool can improve insulation and comfort. The sole should have good grip for traction on slippery pavements.
Keep active – this improves circulation, and have plenty of hot drinks and food throughout the day.
At home, a warm (not hot) foot-bath will help. Dry with a rough towel and apply a cream or lotion with a massaging action. Some preparations include ingredients such as capsaicin or ginger, to stimulate circulation. Afterwards, put on loosely-fitting, warm socks or slippers to maintain the effect. If the feet are warm before going to bed, they are likely to stay warm. Bed socks in wool or cashmere can be very helpful. Water bottles or gel pads should not be over-heated, as sensation can be unreliable in cold feet.

People who suffer from eczema will find that cold weather tends to make the skin even drier and more cracked. Use plenty of ointment to keep the skin well hydrated and wear hose to help trap moisture and warmth. Silk is a good choice of material and is thin enough to wear under a thicker, outer sock.
In severe cold weather, you may find you get recurrent problems in your feet. Consult your GP who may advise a prescription drug to relax the constricted vessels and thus improve blood flow to the extremities.

Book Your Winter Feet Podiatry Appointment

For more information about podiatry at Fleet Street Clinic

Botswana is one of the greatest safari destinations.

The Okavango Delta offers exceptional opportunities to view wild creatures and birdlife. Elephants roam freely and herds of buffalo crowd around the winding waterways the river. The stark and desolate landscape of the  Kalahari desert can be found in the south with the longest unbroken stretch of sand there is. Whatever your itinerary, ensure you follow our top travel tips.

Vaccines

All travellers should ensure they are up-to-date with their routine vaccinations including measles, hepatitis A, typhoid, diphtheria-tetanus and polio (DTP). You may want to consider getting vaccinations for rabies and hepatitis B as well. Both these diseases are classed as high-risk in Botswana. We would advise you to speak with a travel nurse ideally 4-6 weeks before travel. At this appointment, you can discuss where you’re going and what you plan to do. They can then advise you of all the recommended vaccinations you should consider.

Find out more information about our travel and wellness vaccinations.

Malaria

There is a high risk of malaria throughout the year in the northern areas of Botswana including the Okavango Delta, Chobe and Moremi. There is a low risk of malaria in the rest of the country including the central Kalahari, Gaborone and Gemsbok. Individuals travelling to hight risk regions are advised to take anti-malarial medications to prevent the disease. As well as taking precautions against mosquito bites. The mosquitoes that spread malaria predominantly bite at night. For that reason, it is essential you sleep under a mosquito net.

Insect prevention

All travellers need to take extra precautions against insect bites. Mosquitoes, ticks, mites and lice are able to spread diseases such as African tick bite fever, dengue fever, filariasis and myiasis. Travellers should wear good insect repellent with at least 50% DEET and try to cover up with long loose clothes. You can add extra protection to your clothes by treating them with an insecticide. We would recommend using a permethrin spray.

See our Ultimate Bug Kit.

What about Yellow Fever?

The is no risk of Yellow Fever in Botswana. It is therefore not recommended that travellers get vaccinated. Travellers may require a valid Yellow Fever Certificate if they are entering Botswana from a country that has yellow fever, or who have transited through a country with a risk of yellow fever.

First Aid Supplies

Areas of Botswana can be remote, and access to medication and first aid supplies can be limited. Packing a good basic first aid kit is a good idea to help treat minor injuries and illnesses. Basic items such as anti-histamines, pain relief and medicines to treat upset stomachs are useful. Likewise, pack small dressings, plasters and antiseptic cream to treat minor scrapes and scratches. If you take prescription medication to ensure you pack sufficient for your trip and carry a record of the medication with you.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | October 2019