Comprehensive treatment of foot problems and control of penile foreskin infection

Latest Information

• Commonality: At least 80% of people have experienced foot or heel pain occasionally.

Risk factors: Ill-fitting shoes are the most common cause, followed by age, poor hygiene habits, and genetics.

• Affected age groups: All age groups, but certain types of pain-such as pain caused by arch collapse-are more common in people over 40.

• Gender differences: Men and women are equally likely to have foot problems, but men are more likely to have them – mainly because they generally do not pay attention to foot care and hygiene, often buy ill-fitting shoes, and are less willing to see a doctor.

• Request for help: Podiatrist.

Pain between the third and fourth toes may be caused by a condition called Morton's toe or Morton's neuroma. The pain is caused by pressure on the toe bones, which pulls on the nerves that run between them. The pressure often comes from tight and pointed shoes, so you should wear looser shoes and consider using toe support pads-these are available at pharmacies. If the condition is severe, you should ask your doctor if you need cortisone injections or surgery.

Some people have a prominent knot on their big toe called a scrotum. Narrow shoes can easily rub against the scrotum, causing pain. To relieve the pain, you can cover it with a scrotum cover, which can be purchased at most pharmacies.

Another reason for frequent foot pain when changing shoes is plantar warts. These are caused by a virus that enters the skin through tiny wounds or friction points on the sole of the foot and grows inwards. The pain caused by them is like stepping on nails. The virus that causes plantar warts thrives in warm, moist environments, which is exactly what shoes provide.

"Wearing the same pair of shoes every day will make the inside of your shoes increasingly damp," says Dr. Douglas Ritchie, a sports podiatrist and podiatrist who runs a private practice in Hill Beach, California. "Changing your shoes more often promotes healthy skin on your feet." For the same reason, you should also change your socks frequently, ideally twice a day.

Penile foreskin problems

Controlling infection

What trouble can foreskin cause? In short: if there were another civil rights movement, opponents of circumcision could start a war on this issue. "People treat us like cavemen," says Marilyn Milos, a registered nurse and founder of the California-based anti-circumcision organization "No Circumcision." She argues that foreskin problems should be treated medically, not removed.

For most of us, this question is not of practical significance. Nearly 75% of American men do not have a foreskin problem because they do not have a foreskin at all.

Men who manage to retain that small patch of skin on their penis (the foreskin) may find a certain satisfaction in it, believing it to be a natural arrangement. However, they also encounter problems that those without a foreskin don't experience; for example, they may suffer from various infections collectively known as balanitis. Balanitis can cause inflammation or ulceration of the glans penis, usually caused by bacterial or fungal infections living in the moist, warm environment under the foreskin. Men with polyuria are considered particularly prone to balanitis, so those with recurrent balanitis should also be checked to see if they have polyuria.

Phimosis is another problem that plagues those who haven't undergone circumcision. Because the foreskin opening is too small, the foreskin cannot be retracted to cover the glans. Phimosis is usually congenital; in some boys, the glans can protrude beyond the foreskin as it grows larger. Otherwise, it can lead to difficulty urinating and make it difficult to clean the smegma hidden under the foreskin.

"Furthermore, the mixture of urine and smegma can easily lead to cancer," said Dr. Mark Goldstein, director of the Center for Male Reproductive Medicine and Microsurgery at Cornell Medical Center in New York and professor of urology. "Therefore, the incidence of penile cancer is very high in men with phimosis."

Another related problem is paraphimosis, a condition where the foreskin is too tight and cannot be retracted once it is put back in place. The result is that the penis becomes constricted by the foreskin, causing the glans to swell and turn a deep blue. "The patient will experience extreme pain," says Michael Melonny, a dermatologist who runs a private practice in Denver. This condition should be treated immediately to prevent gangrene.

Another study indicates that men who have not undergone circumcision are more susceptible to syphilis and gonorrhea. The bacteria causing both diseases can grow under the foreskin and enter the body; syphilis enters through the skin, and gonorrhea through the urethra. This is no joke.

There is also evidence that foreskin can increase the risk of urinary tract infections. Symptoms include a burning sensation in the urethra and a constant urge to urinate. Infections can occur in the urethra (urethritis), bladder (cystitis), and kidneys (pyelonephritis). Nephritis is quite serious. Dr. Meloni warns, "You can develop a kidney infection that can cause your kidneys to lose function." One study even suggests that men who are not circumcised are more susceptible to HIV infection, which can lead to AIDS.

behavioral check

Gangrene? Penile cancer? AIDS? If these terrible diseases make you want to rush to your nearest urologist for a circumcision, remember, you probably won't get them. Dr. Meloni says that most uncircumcised men "won't have problems." For example, penile cancer usually only affects older men and is extremely rare-perhaps only 1,100 or 1,200 cases out of an estimated 632,000 male cancer patients each year. The problem is that the vast majority of them occur in uncircumcised men.

Urethritis is uncommon among young men and those who are sexually active; infants and the elderly are the primary affected groups. Another worrying finding is that uncircumcised boys are 10 to 20 times more likely to develop urethritis than circumcised boys. However, this risk seems to gradually disappear as they enter adulthood.

Latest Information

• Commonality: Approximately 10% of men who have not undergone circumcision suffer from infections and other conditions.

Risk factors: poor hygiene, multiple sexual partners, and unprotected sex.

• Affected age groups: Usually the elderly or children. However, middle-aged men who do not regularly clean themselves can also develop the disease.

• Gender differences: In reality, women have a clitoris that protects the clitoris, but that's a completely different matter.

• Request for help: Urologist.

There is some truth to the claim that men who haven't undergone circumcision are more susceptible to gonorrhea, syphilis, and even HIV, as the foreskin provides a greenhouse-like environment for the growth of bacteria and other impurities. However, with proper care, these diseases are unlikely to occur.

Using condoms, a simple preventative measure, can establish the first line of defense against syphilis, gonorrhea, and HIV entering under the foreskin.

Dr. Goldstein says he is sometimes "surprised by how dirty people are in this area, even company managers, who are otherwise very clean." If you don't have a foreskin condition, don't wait until you do. Keep the penis clean, Dr. Meloni says: "Usually, simply washing and drying the area is enough to inhibit the overgrowth of bacteria or yeast."

If you have moderate balanitis, you should gently wash the inside of your foreskin frequently, but always consult a dermatologist or urologist to determine the cause of the infection. Dr. Meloni suggests that men with balanitis should retract their foreskin and wash the base of the penis thoroughly with water-"You may also be able to use a mild soap or your fingertips to help clean, but don't be too vigorous, such as by rubbing with a towel."

He said that when drying the genitals, retract the foreskin and use a hairdryer on a low setting, or let it air dry in front of a fan. Then apply medication-such as an anti-fermentation, antibacterial, or antifungal cream. The final step is to "take a piece of gauze, cut a small opening in it, and put it over the penis, making sure the foreskin is always retracted."

If you're going to the opera in the evening, you might not be too keen on this method, but it can certainly make you feel better quickly.

Don't rule out circumcision. If you have balanitis along with phimosis, your problem is much more serious. These patients usually need circumcision, and moderate cases may require local anesthesia. Paraphimosis, of course, requires emergency surgical intervention, generally involving circumcision or at least a dorsal slit to allow the foreskin to return to the glans, thus relieving the constriction. Dr. Goldstein suggests that for aesthetic reasons, complete circumcision is best. "A dorsal slit in the foreskin looks somewhat comical, like a dog's ear, and even the shape of the penis is abnormal."

What we want is for our sexual partners to look at our penis, tilt their heads to one side, and express genuine admiration for it.