Something afoot in healthcare

Foot and leg care can be a sensitive subject, but pharmacy teams have the products and advice to make a difference. Victoria Goldman explains

College of Podiatry research reveals that 29 per cent of women and 18 per cent of men suffer from daily or frequent sore, aching feet. Foot and leg care is an important pharmacy category, with links to many other health conditions, such as obesity, diabetes and arthritis. Yet it’s often underestimated as a means of driving customer loyalty, link sales and repeat business, especially during the spring and summer months.

Alison Freemantle, pharmacist from the AAH Pharmaceuticals Careway programme, says that independent community pharmacies play a vital role in helping those suffering with foot and leg care issues. “This is not only for advice and support, but also from a practical perspective,” she says.

“Generally, foot care can be seen as a taboo subject. Encouraging people to think about foot and leg health through education can help to raise awareness, while also making patients feel more comfortable about asking a pharmacist for advice. Pharmacists play an important role in reassuring patients and putting their mind at rest through education and prescribing the appropriate treatment for their condition. This is particularly important for elderly patients who are less mobile and may not be able to easily reach, or check, their own feet. I would always suggest using a mirror to look at their feet if they do have difficulty reaching or looking at them first hand.”

A 2014 survey by Diabetes UK revealed that nearly 20 per cent of patients with diabetes hadn’t had their feet checked within the previous year. Of those who had received a foot check, over 30 per cent weren’t given any foot care advice on how to care for their feet. Yet foot care is particularly important in diabetes management. Without proper treatment, minor skin problems can develop into serious infections, such as diabetic foot ulcers and even the possibility of amputation.

Nearly 20 per cent of patients with diabetes hadn’t had their feet checked within the previous year

OTC options

Pharmacists don’t have many OTC foot care products that they can offer customers with diabetes. However, new Allpresan Diabetic Foot Foam Creams, from Neubourg Pharma UK, are clinically formulated for diabetes patients. They can reduce cracks and the build up of hard skin and calluses, counteract pressure marks, and protect against infection and ulceration.

The Pharmacy in Rockcliffe Court, Darlington, runs a foot health awareness service to encourage customers to look after their feet, especially those with diabetes. “People with diabetes are prone to foot complications, so we are trying to reinforce the idea of good foot care,” says pharmacist Carole Tunstall, who works with AAH services. “We provide foot care advice and leaflets to anyone we flag up as diabetic through their medication or during a medicines use review. We explain about foot care problems, such as peripheral neuropathy, and how to check feet for signs.”

Medicines use reviews provide an ideal opportunity for pharmacists to advise on specific leg health requirements, such as oedema and leg ulcers. Activa Healthcare has free leaflets called, ‘Taking care of your legs’, for pharmacy customers, as well as information on hosiery kits on its website.

“Chronic oedema or long-term leg swelling that doesn’t go down overnight affects many people,” says an Activa spokesperson. “Talk to any customers shuffling in wearing slippers because their feet are too swollen to fit normal shoes. Urge them to see a nurse or GP, as swelling like this is not just uncomfortable but can increase the risk of leg ulcers and even cellulitis. Many people feel puffy, stretched ankles is just part of getting older and they should put up with it. This is not the case.”

Product recommendations

Foot care problems exist all year round, but many people don’t take notice of their feet or legs until the weather improves in the spring and summer months. Customers will often recognise key foot care brands, such as Carnation, Scholl and Flexitol, but may feel daunted by the wide range of products. Pharmacy advice is therefore essential to help customers make the right choice, and staff should keep up-to-date with new product developments.

“Obtain detailed knowledge of what each particular feature within each product does,” says Michael Ratcliffe, training and sales manager at Cuxson Gerrard. “And also look at how this may or may not be of therapeutic benefit to your customer and their reported symptoms. For example, when would a foot cream containing 10 per cent urea be more appropriate than one containing 20 per cent urea?”

Fungal nail infections are often ignored or people don’t know how to treat them properly.

To encourage compliance, products need to be easy and quick to use, such as Excilor Treatment for Fungal Nail Infection, which requires no filing down of the nail first. ClearZal BAC’s new press and TV advertising campaign – ‘Don’t Let Your Nails Force You into Hiding’ – highlights that, unlike antifungal products that only kill 50 per cent of infections caused by fungus, ClearZal clears all of the germs that may cause nail infections due to its additional anti-bacterial properties.

Cracked heels and dry skin can usually be managed with regular use of a moisturiser such as O’Keeffe’s For Healthy Feet foot cream, Lotil Foot Cream or Flexitol Heel Balm.

Hard skin can be removed with a pumice stone or non-metal file in the bath or shower, or by using specialised products such as Flexitol Callus Remover or Footner Exfoliating Socks (which remove unwanted dead skin without filing, grating or scraping). New Scholl Velvet Smooth Diamond Express Pedi is available in three roller types: Regular (for light-normal hard skin); Extra-Coarse (for stubborn hard skin); and Mix (Extra-Coarse plus Soft Touch).

Managing foot pain

According to Cuxson Gerrard, manufacturer of the Carnation range, the average Briton puts up with foot pain for up to five months before seeking treatment. Carnation Fleecy Web Roll can help relieve friction and pressure, which cause pain and discomfort, and is now available in a practical roll.

Foot, ankle, knee and back pain may be triggered by the way in which people walk. Yet a recent Cuxson Gerrard survey found that only one in four respondents had considered wearing foot-shaped orthotics to resolve their pain. Cuxson Gerrard’s Pro-Nation orthotic is a new cushioning insole that fits inside the shoe to disperse impact forces and pressure across the foot. It can help relieve pain when standing, walking and running.

Scholl recently launched new insoles to ease tired, aching feet. The Scholl GelActiv Insoles are ergonomically designed with an optimal balance of cushioning and support for greater comfort all day long. Three types are available – everyday, work and sport – to suit different needs. Foot and leg care products overlap with many other pharmacy categories, such as beauty, sports and first aid. And there may be other beneficial products that are not merchandised within the foot care section itself. Cloud 9 Skin Solutions products, for example, include Body Makeover Cellulite Treatment and Nature’s Miracle Varicose Vein Treatment.

For 2015, running enthusiast and TV presenter Jenni Falconer will be partnering with Nelsons Arnicare Arnica Cooling Gel to position the product as a natural healthcare option to use post-exercise for tired and over-worked legs. New Veet Spawax and Veet Natural Inspirations are set to drive category growth in the female hair removal market.

Beyond foot and leg care

Mandeep Mudhar, Numark’s director of marketing, says that pharmacists should think beyond foot and leg care when it comes to making a sale. “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,” he says.

“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. Also, what about pain relief? Do we even ask if the customer is treating the 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. This category should be displayed next to or near the first aid category. This is where you will find antiseptic creams, plasters, etc, so the link to the category is appropriate.”

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