Foot problems affect an estimated one in three adults in the UK at any given time, according to the College of Podiatry. As highlighted in a recent BBC programme exploring why so many people experience foot conditions — from bunions to verrucas — the feet are often the first place where circulatory and neurological issues manifest.
Yet foot health remains one of the most under-consulted areas of pharmacy practice. Community pharmacists, accessible without appointment across England's 13,147 registered branches, can treat many common foot conditions over the counter and identify the warning signs that require onward referral.
Corns and calluses
Corns and calluses are areas of thickened, hardened skin caused by repeated pressure or friction. Calluses are broad and flat (typically on the ball of the foot or heel), while corns are smaller, deeper and often painful — usually forming on toes or between them.
Pharmacy treatment
| Product | How it works | Notes |
|---|---|---|
| Salicylic acid plasters/pads (e.g. Compeed, Scholl) | Softens keratin to allow gradual removal | Apply daily, avoid surrounding healthy skin |
| Salicylic acid liquid (e.g. Bazuka) | Same mechanism, more targeted application | Use the applicator precisely |
| Pumice stone / foot file | Physical removal of softened skin | Best used after bathing when skin is soft |
| Moisturising heel balm (urea-based) | Prevents callus recurrence | 10–25% urea formulations most effective |
Red flag: corns and calluses in patients with diabetes or peripheral vascular disease should NOT be self-treated. These patients are at high risk of foot ulceration and infection. Pharmacists should refer directly to the diabetic foot team or podiatry service.
Bunions (hallux valgus)
Bunions are bony deformities at the base of the big toe, causing the joint to angle outward. They are more common in women and have a strong genetic component, though ill-fitting footwear accelerates progression.
Pharmacy cannot reverse a bunion, but can help manage symptoms:
- Bunion pads and spacers: silicone toe spacers and protective gel pads reduce friction and pressure
- Pain relief: ibuprofen gel applied topically, or oral paracetamol/ibuprofen for acute flare-ups
- Footwear advice: wide-fitting shoes with a deep toe box; avoid pointed toes and high heels
Referral to a GP or podiatrist is appropriate when the bunion causes persistent pain affecting mobility, or when the toe deformity is progressing.
Cracked heels
Cracked heels (heel fissures) are one of the most common foot complaints at the pharmacy counter. Mild cracking responds well to emollient-based heel balms, particularly those containing urea at concentrations of 10–25%.
| Severity | Pharmacy management | Referral needed? |
|---|---|---|
| Superficial cracks, no pain | Urea-based heel balm + pumice stone | No |
| Deeper fissures with mild pain | Intensive moisturiser + heel sleeves | Monitor for infection |
| Bleeding fissures or signs of infection | Clean, dress, advise GP | Yes — infection risk |
| Cracked heels in diabetic patient | Do not self-treat | Refer to diabetic foot team |
Ingrown toenails
Ingrown toenails (onychocryptosis) occur when the nail edge grows into the surrounding skin, causing pain, swelling and sometimes infection. Mild cases can be managed in pharmacy:
- Soak the foot in warm salt water for 15–20 minutes daily
- Gently push the skin away from the nail edge using a cotton bud
- Place a small piece of cotton wool under the ingrown edge to redirect growth
- Keep the nail trimmed straight across — never rounded at the corners
If the toe is infected (red, swollen, discharging pus), refer to the GP for antibiotics and possible nail surgery.
Verrucas
Verrucas (plantar warts) are covered in detail in PharmSee's dedicated verruca treatment guide. The key pharmacy message: most verrucas resolve spontaneously within two years, and treatment is only necessary if they are painful or spreading.
When foot problems signal something bigger
As the BBC programme noted, foot problems can be early indicators of systemic disease. Pharmacists should be alert to:
- Peripheral neuropathy (numbness, tingling, burning in feet): common in diabetes, B12 deficiency and chronic alcohol use
- Peripheral arterial disease (cold feet, poor wound healing, intermittent claudication): cardiovascular risk factor
- Gout (sudden, severe pain in the big toe joint): metabolic disorder requiring medical management — see PharmSee's gout management guide
- Fungal nail infection: covered in PharmSee's fungal nail treatment guide
Any patient presenting with unexplained foot numbness, non-healing wounds or sudden colour changes should be referred urgently.
Sources
- College of Podiatry, Foot health statistics (2024)
- BBC News, "Dr Chris asks: Why do so many of us have problems with our feet?" (15 April 2026)
- NICE Clinical Knowledge Summary, Corns and calluses (2023)
- PharmSee pharmacy register data, April 2026 (13,147 registered community pharmacies in England)