Christelle Ingratta Podiatrist

13/12/2025

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Dry, split heels are more than a cosmetic issue. If left untreated, they can become painful and even infected. Here's what causes cracked heels and how to fix them at home.

Cracked heels are one of the most common foot problems in South Africa, especially in dry climates or when wearing open-back shoes. They often start as rough, dry skin, but can deepen into painful splits that catch on socks or even bleed.

The skin on the heel is thicker than elsewhere on the body. When it gets too dry or lacks support from proper footwear, it loses elasticity and begins to crack. Walking barefoot or wearing sandals all day makes it worse, as the skin is constantly exposed to dust and pressure without protection.

So, what can you do? Soak and moisturise. Start by soaking your feet in warm water for 10–15 minutes to soften the skin. Gently remove dead skin with a pumice stone, no blades or aggressive scrubbing.

Next, apply a thick, urea-based foot cream. These draw moisture into the skin and help repair the outer layer. For best results, moisturise before bed and wear socks overnight to lock in hydration.

If the cracks are deep, painful, or bleeding, see a podiatrist. Open cracks can become entry points for infection, especially in people with diabetes or circulation problems.

Cracked heels may seem harmless, but they’re your skin’s way of asking for care. With the right daily habits and footwear choices, you can restore soft, healthy heels and avoid unnecessary pain or complications down the road.

06/12/2025

Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints, leading to sudden, intense pain, redness, and swelling, often in the big toe. The primary cause of gout is high levels of uric acid in the blood, which can result from certain foods, alcohol, or dehydration. To av...

Read more: https://www.afcdallas.com/component/k2/item/47-preventing-gout-flare-ups

06/12/2025

Peripheral neuropathy affects up to 50% of people with diabetes and is a leading risk factor for foot ulcers and amputations. Early identification is essential to prevent complications. Podiatrists are often the first professionals to detect subtle signs of nerve damage.

Screening methods include monofilament testing, vibration perception thresholds (using tuning forks or biothesiometers), and pinprick or temperature discrimination tests. These tools allow for accurate staging of neuropathy and risk categorisation.

In South Africa, podiatrists in both private and public sectors should conduct annual foot screenings for diabetic patients. Incorporating quick, cost-effective screening tools into practice enhances early detection and supports referral for endocrinology or neurology care when needed.

Education around symptom recognition—such as burning, tingling, or numbness-should be provided to all at-risk patients. Behavioural changes such as daily foot checks, protective footwear, and smoking cessation can all reduce progression.

Podiatrists are front-line defenders against the silent threat of neuropathy. Early identification in South Africa can save limbs and lives.

Source: Tesfaye, S., et al. (2011). Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. https://f.mtr.cool/eharzcrkpk

02/12/2025

Ingrown toenails, or onychocryptosis, are a common and painful condition that can significantly impact quality of life. When conservative care fails, surgical intervention becomes necessary. The most widely used technique is partial nail avulsion with phenolisation of the matrix to prevent regrowth.

International studies have shown that this procedure has a high success rate with low recurrence and complication rates. Phenolisation destroys the nail matrix, reducing the chance of regrowth while minimising trauma to surrounding tissues.

In South Africa, podiatrists are legally permitted to perform this procedure under local anaesthetic. It is one of the few minor surgical interventions within the profession's scope and is particularly valuable in rural and under-resourced areas where referral may be delayed.

Pre-operative patient education, sterile technique, and thorough follow-up are essential for success. Post-operative care includes wound cleaning, dressing changes, and pain management advice.

Nail surgery is a highly effective treatment for recurring ingrown toenails. South African podiatrists can perform this in-practice intervention to alleviate pain and prevent future infections.

Source: Bos, A.M., et al. (2007). Phenolisation in the treatment of ingrowing toenails: a systematic review. Journal of the American Podiatric Medical Association. https://f.mtr.cool/qrupemgryb

21/11/2025

A good pedicure can be relaxing and refreshing, but if done incorrectly, it can cause more harm than good. Here’s how to enjoy the benefits without the risks.

Pedicures aren’t just about pretty toes; they can help maintain healthy nails and soft skin. But there’s a fine line between safe pampering and inviting problems like infections, ingrown nails, or fungal issues.

Start with hygiene. Whether you're visiting a salon or doing it yourself, cleanliness is key. Tools should be sterilised between each use. If you're unsure about a salon's hygiene, trust your gut or bring your own tools.

Don’t cut the cuticles. They protect your nails from bacteria and fungi. Pushing them back gently is fine, but cutting them opens the door to infection.

Clip nails straight across. Curving them at the edges may look neater, but it increases the risk of ingrown toenails, especially if the shoes you wear are tight or pointed.

Avoid sharp scraping tools on calluses. Over-filing can lead to cracked skin or sensitivity. Use a pumice stone or foot file gently and regularly, rather than trying to remove everything in one go.

Be cautious with nail polish. While it's not harmful in itself, keeping nails constantly painted can hide infections or discolouration. Give your toenails a break between pedicures to let them breathe and monitor their health.

A pedicure should leave your feet looking and feeling better, not battling avoidable problems. With the right care and a few smart choices, you can enjoy healthy, well-groomed feet without risking your foot health.

12/11/2025

As a diabetic you may not always know what to look out for in your feet 🦶. What to ask? What to do 🤔? Diabetic foot online recently published this easy diagram.

Have a look.
https://diabeticfootonline.com/2014/12/20/what-to-ask-what-to-look-for-what-to-do-3-minute-diabetic-foot-exam-infographic-bio5-uahealthnet-uazsurgery/?utm_source=facebook&utm_medium=social&utm_campaign=davidgarmstrong&utm_content=facts1&fbclid=IwdGRjcAOA4NxjbGNrA4Dg0WV4dG4DYWVtAjExAHNydGMGYXBwX2lkDDM1MDY4NTUzMTcyOAABHogLH-YHUmWUDzrDsdYnNH122Mq60d0m6it7KcpWPFV_4H1QbKgeSqCtWZ31_aem_tMVgMn-xeGToHXzxttL92Q

As a diabetic you should have a regular foot 🦶screening at your local Podiatrist.

08/11/2025

08/11/2025

04/07/2025

It comes suddenly. One minute you’re fine, the next...searing pain in your big toe. Gout isn’t just painful, it’s disabling. And it loves to strike when you least expect it.

Gout is often described as a burning, stabbing pain, and for good reason. It tends to target the base of the big toe, swelling it up, turning it red, and making even the weight of a bedsheet unbearable.

The cause? A build-up of uric acid crystals in the joint. These needle-like crystals trigger a powerful inflammatory response. Although anyone can get gout, it’s more common in men over 40, those with high blood pressure, or people who consume too much red meat, alcohol, or sugary drinks.

South Africans with a rich, meat-heavy diet or who struggle with hydration may be at higher risk, especially in hot climates where fluid loss can concentrate uric acid in the bloodstream.

Gout attacks are intense but usually short-lived. However, repeated episodes can lead to joint damage, deformities, and chronic arthritis. That’s why managing lifestyle, diet, and hydration is key.

Medication can help reduce pain and control uric acid levels. But prevention is the real goal, staying hydrated, limiting certain foods, and seeing a podiatrist if attacks become frequent or interfere with daily activities.

Gout may come and go, but its effects can linger. If your big toe is throbbing and swollen out of the blue, don’t wait. Proper diagnosis and management can help keep this painful condition under control.

04/07/2025

Onychomycosis, a fungal infection affecting the toenails, is particularly common in elderly individuals due to age-related changes in nail physiology, slower nail growth, and a weakened immune response. The infection often presents as thickened, discoloured, or brittle nails and can lead to pain or secondary bacterial infections if left untreated.

Globally, studies show high prevalence rates of onychomycosis in older populations, often coexisting with conditions like diabetes or peripheral vascular disease. These comorbidities can complicate treatment and require an integrated approach. Antifungal treatments may include topical or oral medications, with varying efficacy depending on the severity and patient adherence.

In South Africa, podiatrists working with older adults need to be vigilant in identifying early signs of fungal nail infections, especially in retirement communities or among patients with reduced mobility. Education on foot hygiene, proper nail care, and regular screenings can significantly reduce the risk and improve patient outcomes.

Access to effective treatments and awareness campaigns targeting elderly care facilities could improve early intervention rates. Incorporating podiatry into geriatric health services can make a meaningful difference in managing chronic foot conditions like onychomycosis.

Given South Africa’s ageing population, proactive podiatric care and awareness of onychomycosis are critical to maintaining foot health and preventing complications in elderly patients.

Source: Epidemiology and Treatment of Onychomycosis in Older Adults – PubMed. https://f.mtr.cool/qeouopcfee

04/07/2025

Achilles tendinopathy is a common overuse injury, often affecting runners, athletes, and middle-aged adults. It involves pain, swelling, and reduced function in the Achilles tendon, typically caused by repetitive strain. Eccentric loading exercises are widely recognized as a gold-standard treatment.

Numerous international studies have shown the effectiveness of these exercises in reducing pain and restoring function. The Alfredson protocol, in particular, provides a structured framework for rehabilitation using heel drop exercises performed twice daily over a 12-week period.

In South Africa, where access to physiotherapy may vary depending on geographic location, podiatrists can play an essential role in prescribing and demonstrating these exercises. Collaboration with physiotherapists ensures that patients receive consistent messaging and optimal care.

Education on load management, footwear assessment, and potential referral for imaging (where necessary) can help manage more severe or chronic cases. Although diagnostic ultrasound is not within the current podiatric scope of practice in South Africa, multidisciplinary partnerships can bridge this gap.

A structured rehabilitation programme using eccentric exercises offers an effective, low-cost treatment for Achilles tendinopathy. Podiatrists in South Africa should consider integrating this into standard care while advocating for broader access to allied therapies.

Source: Eccentric Exercises for the Management of Achilles Tendinopathy – NCBI. https://f.mtr.cool/ldiujvmftv

16/06/2025