Sandal Season Foot Care: Preparing Your Feet for Spring in Southern California

In Fallbrook, Temecula and the rest of Southern California, sandal season lasts most of the year. Still, spring is when many people take their first real look at their feet after months in closed shoes. Cracked heels, a thick yellow nail or a bunion that rubs can make you want to keep your toes covered. It helps to deal with them before summer is in full swing.

Cracked Heels: More Than a Cosmetic Issue

Dry, cracked heels are easy to spot once your feet are out in sandals. Dry skin on the feet can be uncomfortable, and it can make infection more likely (Parker and colleagues, 2017). For mild dryness, start with a moisturizer every day. That review found that urea creams (moisturizers that help soften thick, dry skin) were the most studied. The research wasn't strong enough to pick one ingredient over the others, though.

Deep cracks that bleed or hurt need a closer look. In people with diabetes, open heel cracks can let bacteria in. That can lead to an infection or an ulcer (an open wound that's slow to heal). In a 2017 trial, Gin and colleagues treated people with diabetes who had deep heel cracks. Fewer people still had a deep, open crack after using a urea cream than after using a placebo cream. An international guideline on diabetic foot care recommends treating any early warning sign on the foot (Bus and colleagues, 2024). So if you have diabetes, let us treat deep cracks instead of working on them at home. Here's our guide to treating cracked heels.

Toenail Fungus: Address It Now

Toenail fungus (onychomycosis) is the most common nail problem doctors see (Lipner and Scher, 2019). It isn't only about looks. It can cause pain and make everyday activities harder. A 2024 review of 108 studies estimated that about 4 in 100 people have toenail fungus caused by the most common type of fungus. It was more common in older adults and in people with diabetes (Gupta and colleagues, 2024).

Nail fungus often goes along with athlete's foot (a fungal infection of the skin). In a study of 2,761 people with toenail fungus, about a third also had athlete's foot. The authors suggested that infected nails may be a source that spreads the fungus to the skin (Szepietowski and colleagues, 2006).

Treatment takes patience. Toenails grow at less than half the speed of fingernails (Yaemsiri and colleagues, 2010). So even when treatment works, the damaged part of the nail has to grow out. A clear nail takes months to grow in. Starting in spring gives that process a head start. Here's how we treat toenail fungus, including laser.

Bunions and Hammertoes in Open Shoes

Open shoes put a bunion (a bony bump at the base of the big toe) on display. The same goes for a hammertoe (a toe that stays bent at the middle joint). Sandal straps can also rub them. A strap that runs right across the bump can cause redness, blisters or corns. So can a stiff edge that presses on a bent toe. Look for soft, adjustable straps that you can move off the sore spot.

Research hasn't shown that shoes alone cause bunions (Nix and colleagues, 2012). But a shoe or sandal that presses on a bunion you already have can make it hurt. If a bunion or hammertoe hurts in every shoe you own, it's worth an exam. Here's how we approach bunions, including minimally invasive repair.

Choosing Sandals That Support Your Feet

A good sandal does more than stay on your foot. Here's what to look for.

• A contoured footbed with some arch support, not a flat sheet of foam.
• A firm heel cup and a strap around the back of the heel, so the sandal stays in place.
• A sole that bends where your toes bend but doesn't fold in half or twist easily.
• A sole thick enough to protect your feet from hot pavement, rocks and sharp objects.
• Adjustable straps that leave room for a wide foot, a bunion or a little swelling late in the day.

There's research behind the contoured footbed. In a 2015 trial, Vicenzino and colleagues randomly assigned 150 people with heel pain to one of three groups. The three groups got contoured sandals, flat flip-flops or store-bought shoe inserts. People in the contoured sandals were more likely to improve than people in flat flip-flops. They did about as well as the people with shoe inserts. The study was partly funded by a footwear company.

Flip-flops also change the way you walk. In a study by Shroyer and Weimar (2010), people took shorter steps in thong-style flip-flops than in sneakers. They also moved their ankles differently. Flip-flops still have a place, like the pool deck or a quick trip outside. For long walks or a full day on your feet, choose a sandal with more structure.

Pools, Showers and Pedicures

Sandal season means more time at pools, beaches and gyms. Walking barefoot on shared wet floors can expose you to athlete's foot and plantar warts (warts on the sole caused by a virus). A study at a public swimming pool found that both infections were spreading among swimmers there (Gentles and Evans, 1973). Another study looked at young people who used a school or club locker room (Johnson, 1995). Plantar warts were far more common in those who also used the communal showers. Wear sandals or shower shoes on pool decks, in locker rooms and in gym showers. Dry between your toes afterward. If you have diabetes or numb feet, protect your feet everywhere, including hot pavement and sand. The international guideline advises people at risk not to walk without proper foot protection (Bus and colleagues, 2024). Not sure whether a spot is a wart? Here's how to tell a plantar wart from a callus.

Many people get a pedicure before sandal season. Infections can happen, though. In 2000, a nail salon in northern California was linked to an outbreak of boils on the legs of 110 customers. The bacteria were found in the salon's whirlpool footbaths. Shaving the legs with a razor before the pedicure raised the risk (Winthrop and colleagues, 2002). A few simple habits help.

• Don't shave your legs right before a pedicure.
• Skip the pedicure if you have a cut, scrape or open sore on your feet or legs.
• Ask how the footbaths are cleaned between customers.
• Don't let anyone cut calluses with a razor blade.
• If you have diabetes, poor circulation or numb feet, talk to us before you book a pedicure.

Check Your Whole Foot, Including the Soles

Bare feet in sandals are a good reminder to look at your whole foot, not just the top. Melanoma (a serious type of skin cancer) can start on the foot, including the sole and under a toenail. The outlook is good when it's found early. Spots in those places are easy to miss or to mistake for something harmless (Bristow and colleagues, 2010). That can delay the diagnosis. In a 2008 case series, most foot melanomas were on the sole (Bristow and Acland, 2008). A third were first diagnosed as something else.

Have a spot checked if it's new, changing, bleeding or looks different from your other moles. The same goes for a dark streak in a nail that isn't from an injury, or a sore that won't heal. Dr. Patish can examine it and refer you to a dermatologist when needed. And when you're out in the sun, remember sunscreen on the tops of your feet. It's an easy spot to forget.

The Bottom Line

Your feet work hard all year. A little attention before sandal season goes a long way. Moisturize dry heels and treat nail fungus early. Choose sandals with real support, and protect your feet on shared wet floors. See us for cracks that bleed or nails that are thick and painful. Come in, too, for a bunion that hurts in every shoe or a spot you're unsure about. Learn why flip-flops may be hurting your feet. If you have diabetes, keep up with a daily foot-care checklist.