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Feet first

Understanding how to both prevent and treat foot conditions will help pharmacies increase their sales

Foot and leg care issues often require expert advice from a healthcare professional, making this category an important opportunity for pharmacy, as Victoria Goldman explains

Most people don’t start to take notice of their feet until the weather improves, which means pharmacies see a considerable rise in sales of foot care products in the spring and summer months. During warm weather, feet can be more vulnerable to irritation and injury, often triggered by poorly-fitting footwear. Flip flops and sandals can rub the skin, leading to dry, cracked heels, while wearing closed-in footwear regularly in hot weather can encourage foot odour and/or the growth of athlete’s foot.

But foot and leg care shouldn’t be seen as just a seasonal issue. Richard Handford, podiatrist from the College of Podiatry, says pharmacies should be focusing on minor foot problems throughout the year. “Athlete’s foot, for example, can occur at any time of the year, particularly amongst sportsmen and women,” he says. “Dry cracked heels can still occur during the winter as they are not entirely related to climate.”

Research from the College of Podiatry shows that 90 per cent of adults experience some type of foot problem. But only 23 per cent seek professional help and 16 per cent admit to ignoring the problem, hoping it will go away. Many people think of blisters, hard skin and athlete’s foot as minor ailments, yet these common foot care problems can cause a lot of discomfort and embarrassment.

Symptom checks

Customers should be encouraged to come into the pharmacy for foot and leg care advice, rather than simply buying products off the shelf from elsewhere. Some foot and leg symptoms can be a sign of an underlying condition, especially in people with chronic health problems. Unexplained persistent foot pain, for example, could be a sign of arthritis. Tired, aching legs can be caused by poor circulation in the leg veins. Pain in the legs may also be a sign of deep vein thrombosis (DVT), especially in people who have recently travelled long distances or had surgery.

“Any condition that requires customers to seek advice from a healthcare professional is vital for pharmacy, and foot care is no exception,” says Mandeep Mudhar, Numark’s director of marketing. “There are numerous health issues associated with the feet – especially diabetes – which mean that, as a category, it needs to be highlighted within the pharmacy. Pharmacy teams should have a good understanding of the various foot conditions and how they can be treated. They should be aware that serious foot conditions can be an indication of underlying health conditions.”

Diabetes increases the risk of foot complications, so good foot care is an essential part of managing the condition. Customers with diabetes should have a foot check once a year, usually at their annual review. If they suffer from peripheral neuropathy, they may not notice any damage to their feet caused by an injury, or even from shoes rubbing their skin. Most diabetes-related amputations are caused by a ‘foot attack’ – an ulcer or infection failing to heal.

According to Chris Askew, chief executive of Diabetes UK, everyone with diabetes must be provided with information on how to look after their feet properly. “Those who are at an increased risk of foot ulcers must be given information about the care and treatment they need and how to access it quickly,” he says. “Left untreated or poorly managed, diabetic foot ulcers can cause much suffering for individuals, and ultimately pose the threat of an amputation that could have been avoided.”

There are not many OTC foot care products that pharmacists can offer customers with diabetes, so referrals are important. “If any foot conditions develop, a diabetic customer should be advised to never self-treat and to always seek advice from their GP or a podiatrist,” says Mr Handford. “If ulcers or redness develop on the legs or feet then they should be treated within 24 hours by a GP or podiatrist.”

Prevention and treatment

Foot problems often flare up repeatedly , especially if they aren’t treated properly in the first place. To encourage compliance, products need to be easy and quick to use. Customers may prefer a verruca product that’s only applied once a week, rather than daily, or an athlete’s foot treatment that only needs to be used once.

Prevention may be just as important as the treatment itself, especially for seemingly minor problems such as ingrowing toenails, fungal infections and verrucas. “If someone is treating a condition, ask them if this is a regular problem,” says Mr Mudhar. “If it is, suggest a method of prevention to be used regularly instead of simply treating the issue once it arises. Understanding how to both prevent and treat foot conditions will help pharmacies increase their sales and build on great customer service. For example, athlete’s foot is a typical condition that should be treated over the longer term. Many sufferers may not realise this, so the interaction between customer and counter assistant proves extremely valuable.”

Athlete’s foot can often be treated with OTC products, but the infection may return. “Fungal nail infections are extremely prevalent right across the age spectrum,” says Hayley Langdon, Trimb Healthcare’s UK business development director. “Fungal infections also spread easily and are notoriously difficult to get rid of, causing pain and discomfort, so pharmacists need to be able to offer an effective treatment.”

Good foot hygiene (eg, washing feet regularly and drying them properly afterwards) is essential in the prevention of athlete’s foot, but consultant podiatrist Michael O’Neill says that shoes can be a common source of reinfection. “All footwear needs to be cleaned out thoroughly,” he says. “Rinse under cold water and scrub with washing-up liquid until clean, then use surgical spirit or a foot spray inside the shoes. Ideally, replace the insoles inside the shoes regularly as well, especially with trainers.”

Sales advice

According to Mr Mudhar, customers visit pharmacies for advice on foot care, but often don’t ask for it. Sometimes the advice will involve offering preventative tips or simple self-help measures, rather than selling specific products. “Giving advice to people who need it creates loyalty,” he says. “You may not sell them anything whilst giving the advice, but if the advice is sound and relevant, you will probably have brought yourself a long-term customer. This category is about advice-driven sales, but that doesn’t mean you have to wait to be asked for advice before you give it.”

Customers often recognise key foot care brands, but these products may not be the best ones for their needs, medical history or lifestyle. Pharmacies need to stock less well-known brands and products to suit all budgets, and make sure customers at the counter are buying the right products.

Not all customers will ask to speak to the pharmacist, but it’s still important to check the diagnosis is correct. Certain customers will need to be referred to a podiatrist or their GP. “Verrucas and corns are often confused,” says Mr Handford. “But OTC products are effective if they are used properly and with perseverance. Podiatrists can advise on the prevention of ingrowing toenails and treat these in the early stages to prevent them getting worse. If suitably qualified, they can also treat an infection with oral antibiotics and operate to permanently cure them.”

Link selling is a way for pharmacists to generate more sales, as there is significant overlap with other pharmacy categories (eg, first aid, sports, beauty and pain relief). Customers may benefit from products that aren’t sold within the foot care section itself.

“As with many sales, it can be automatic to take payment for the items the customer has self-selected and not ask any questions about their purchase,” says Mr Mudhar. “For instance, if someone picks up corn plasters, we sell them corn plasters. But combination treatments may be required, and there is an opportunity for a link purchase, eg, insole supports to take the pressure off the area. And what about pain relief? Do we even ask if the customer is treating te pain and not just the cause? This is precisely where community pharmacy can add value over and above its competitors – it’s an opportunity not to be missed.”

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