One of the challenges with PC is its veritable nature and each person is unique. Please remember just because something works for one PCer it may not work for another. You will have to find out what works best for you. Please discuss any care tips or treatments with your local doctor. This is not to substitute medical advice from your local doctor.

Hand Tools

PC patients use a variety of cutting tools to trim and manage their keratoderma. Some of…

Power Tools

PC patients use a variety of power tools to trim and manage their keratoderma. Some of these products…

Shoes, Socks, & Insoles

Many PCers have to experiment with different types of footwear and insoles to manage discomfort resulting…

Walking Aids

Because walking creates almost constant pain for the majority of PC patients, many PCers have found…

Because walking creates almost constant pain for the majority of PC patients, many PCers have found ways to take pressure off of their feet or use alternative forms of mobility.

Crutches

Folding Ebike

Knee Pads

Many different types of knee pads are available online through Amazon.com and other online stores.

Mini Jazzy

Mobility Scooter

Office Chair

BizChair.com offers a variety of office chairs.

Rollator

A rollator also contains a large basket for storage purposes, along with a canvas seat and back between the handles. This seat allows users to take short rest breaks whenever necessary. The storage area of a rollator is often larger and more stable than the wire basket attachment of a standard walker. Due to its collapsible design, a rollator can also be folded and stored in a car’s trunk or rear seat. Standard walkers can be folded into thirds, but they are not nearly as compact as a rollator.

K16 patient: “It’s like a walker but it has a seat. I took that all over Europe and it was very helpful. I was still on my feet, but my arms shared the pressure and I had a seat whenever I needed it.”

K16 patient: “I’ve been using a rollator, which is a walker type device, but it’s on wheels so you don’t lift, and it has a seat so you can sit and rest whenever you need it. I’ve taken it all over Europe on vacations and it has been a tremendous help — not as much as if someone were pushing me in a wheelchair, but it has been extremely helpful. The nice thing is that the seat lifts up and there is a storage area where I put my cane folded up (for times I can’t fit the rollator) and my handbag, water, souvenirs, all kinds of stuff. Mine is made by Medline but there are lots of different ones. They have brakes on them too so walking downhill isn’t difficult. You do have to remember to put the brakes on before sitting though. It’s so nice when I’m on a tour and the guide wants to talk about a statue for 10 minutes. I just sit and I buy myself some more walking time. It’s even good for buffet lines. I put my tray on my seat so I don’t need help. Just a thought. After using the rollator, I notice that my arms are sore because I’m sharing the pressure from my feet. But it’s definitely worth it.”

Shop for rollators online.

Wellness Mats

Wheelchairs

Results from Wheelchair Survey from August 2014 PC NewsBrief.

PC Type	What factors would you consider in choosing a chair?
PC-K6a	The lightweight ones were the easiest to use and put in and out of a car trunk. As I got bigger I then have to use ones that are stronger and hold my heavier weight. We have always bought them 2nd hand but were like new. I have two right now that are perfect.
PC-K6a	Easy to travel with.
PC-K16	The most important is that it fits you. My son was measured by a ergonomic therapist.
PC-K17	I have never even thought about using a wheelchair, but it certainly would make some of our trips easier and more likely to go in the first place. If too much walking is involved, I’ve normally just stayed home. One factor would be lightweight and easy to load/unload in the car.

PC Type	Do you have a recommended Brand or Style?
PC-K6a	Used
PC-K6a	Transport wheelchair
PC-K16	Walkingbike most of the time and Childrens wheelchair ehen we are going somewhere like a zoo or when he can’t walk.
PC-K17	No

PC Type	Do you have any contacts to get a wheelchair for a reasonable price?
PC-K6a	I bought each of them off craigslist.org  a few years back for $50 & $75!!  each were in mint condition, barely used.  They two are extra wide and heavy duty types.
PC-K6a	Costco with coupon
PC-K16	We have the wheelchair on loan from our community ( our town).
PC-K17	No

PC Type	What is a good price for a wheelchair?	Have you been able to have insurance cover any of the costs of a wheelchair?
PC-K6a	Used $50 & $75	No
PC-K6a	Less than $200	It was reimbursed though my spending account at work.
PC-K16	Don’t know	We don’t pay anything for the wheelchair, we have it on loan from our town.
PC-K17	I’ve seen some advertised in catalogs for about $149 to $199, but I don’t know if that’s a “good” price.	I know MEDICARE can approve wheelchairs if ordered by a physician and it’s NECESSIARY for the health of the individual. I can see where using a wheelchair would make it a very good advantage to PC folks, myself included!  I’d travel more and stay at home less!

PC Type	Other comments or suggestions for a PCer choosing a wheelchair for a first time?
PC-K6a	The one problem with extra wide chairs is getting through doors or down store aisle.  For any medical type needs, I would always check craigslist.org 1st.  People it seems sell these types of items that were family members whose insurance had paid for and now the family members just want to sell them quick.
PC-K6a	I use it most when we travel and at airports. If I don’t take mine I always get a wheelchair at the airport. I also use it when shopping and anywhere there will be a lot of walking.
PC-K16	Don’t be afraid that you step in and out the wheelchair. If people say something about it you explain what you have, they will understand most of the time. And if they don’t they don’t. You have to deal with it.
PC-K17

Many PCers have to experiment with different types of footwear and insoles to manage discomfort resulting from plantar keratoderma. The hunt for the right pair of shoes is a big challenge PCers face.

Many of the products discussed here can be found in online stores such as Zappos.com and other online venues. If you are aware of other online sources for PC-friendly footwear and insoles, please contact us!

PATIENT TIPS & COMMENTS FOR SHOES, SOCKS, INSOLES

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Recently there have been a number of posts about Sketchers Go Walk 3 shoes as some PCers have found that they work well with their PC feet. The comments are below in the Sketchers section.

K6a patient: “I get all my [wicking] socks from REI. The brand I like the best is Wigwam. Here is a link to Wigwam site and the sock I like the very best of all. One of my sons wears these too. We buy these ankle size socks in black and khaki and I think they’re awesome.

Amazon also sells them, but you will have to search for the size you want. They also have several options, and you can get them in groups of three or individually.

That said, socks are very personal. My other son doesn’t like those particular socks because he thinks they’re just a little too thick. We had him pick out about four pairs that felt good to him and he ended up going with an REI brand. In the end, we got him a bunch of those (all in black) for his mission.

With PC, the thicker socks can be nice for padding, but then sometimes they make the feet too hot, even if they are wicking types. If they’re too thin, there’s no padding. I love those Wigmams because, for me, they are right in the middle for padding, plus they remain soft even after many washings — They’re expensive for a reason. Some wicking socks — like the Smart Wools and other wool socks that are good for hiking and sports — are too scratchy and rough to me and don’t feel good against the calluses. So I’d stay away from those.”

K6a patient: “I use extra cushioning in boots and foot powder. With jungle boots (breathable!) and cotton socks, I was able to walk all day.”

K6a patient: “I wear flip flops around the house and where ever else I can. I call them ‘my Lagunas’ (that’s the brand name). I have specially made insoles, but I wear the flip flops around house because they’re just as comfortable but allow my feet to breathe and I can’t stand wearing socks. The sweatier the feet get, the more they hurt.”

K6a patient: “I wear cheap, rubber beach shoes. The best ones are not shaped or molded, just a flat slab of foamy type material and are usually slip-ons, like flip flops but slightly fancier. They work well because they’re flat, soft, and make allowances for hard skin. They are quite thick, so they absorb rocks on the ground and they keep my feet from getting sweaty because they’re airy.”

K6a patient: “I buy my shoes at Eneslow Shoes, located at 470 Park Avenue South @ 32nd St., New York.”

K6a patient: “I wear sandals when on holiday, but most of the time my shoes have to be laced (done up as tight as possible). I prefer a short boot, as they support the ankles and hold the shoe/boot on.”

K6b Patient: “I have PC calluses on both feet, including on my heels, middle, sides, and toes. I find Sketchers really help with comfort — not 100% — but more bearable in daily life.”

Cx30 patient: “I only wear shoes that are soft, cushioned, and made of natural leather. I’ve found that heat is main factor in the pain with my feet, and it also causes my feet to swell, redden, and of course blister. If I wear covered shoes (like sneakers) that have a synthetic lining, my feet generate so much heat from the friction that I can’t walk. One dermatologist suggested I use a biopsy punch (he gave me one) to make small round holes in the instep of shoes and sneakers just above the sole to allow air to flow. “

K16 patient: “Zappos.com is a wonderful source for shoes. They carry many brands and widths, with shoes made for men, women, and children. Shipping and return shipping is free, and the shoes arrive in a couple of days.”

K16 patient: “I have found these socks to be the most comfortable. They have padding! Find them at Dicks Sporting Goods. They are called Experia Powered by Thor-Lo Pads Sock.”

K16 patient: “I wear the Altra Instinct 2.0. I’ve had this sneaker for about a year now, and it’s by far more comfortable than anything else I’ve tried. Though it’s a zero-drop platform (heel and forefoot are at same height, which helps distribute my weight better, reducing any ‘hot spots’), as with all my shoes, I still modify the inner platform of the shoe for best bio-mechanical function. This shoe has a roomy toe box, lightweight and breathable upper mesh, is very flexible (allowing the foot to naturally articulate), and probably above all, has excellent cushioning. This combination of factors allows me to be on my feet pretty much as much as I want, usually with minimal pain.”

??? patient: “Women’s…Clarks, Aerosoles, Geox, Ecco, Gentlesouls, Rockport, Campers, New Balance, Merrells. Men’s…Ecco, Campers, Rockport, Nike, New Balance. Also, Harry’s Shoes sells tip-top shoes. It’s located at 2299 Broadway @ 83rd St. or 165 West 72nd St. in New York. They sell a variety of comfort shoes in many sizes, both men’s and women’s.”

K6a patient “. I wear sandals only all summer and they need to be with smooth (preferably leather) insoles.”

Shoes and Sandals

Abeo – Bandals – Brooks Ghost 5 – Campers – Crocks – Dearfoams – Ecco – Geox – Joya – MBT – Merrell – Nike – Orthopedic – Reiker – Sketchers

Abeo

From The Walking Company:

ABEO® biomechanical footwear™ infuses advanced technology into classic shoe designs and is found exclusively at the Walking Company’s 200 plus nationwide stores and thewalkingcompany.com. When you visit any location of The Walking Company we will utilize advanced scanning technology to digitally analyze your foot in order to help you maximize the benefits of ABEO’s revolutionary footwear.

K6a patient: “In 2010, I discovered The Walking Store, and in particular, a shoe they carry referred to as the Abeo Smart System (generally I have used the sandal form of this shoe). This shoe has made a huge difference for me — I actually couldn’t wear the shoes I used to wear before I started wearing this shoe. I just wanted to pass this along and say that this is the most comfortable shoe I have found to date.”

Bandals

K16 patient: “Bandals fashion flip flops are so comfortable. They have a thick base and are very flexible. The best thing is that you can change the top to match your outfit. I live in mine in the summer, as they really help and being able to change the tops means you only need one pair!”

Campers

K16 patient: “I wear camper shoes. They are very comfortable.”

Camper men’s shoes and Camper women’s shoes have a spirit and personality of their own and present a diverse range of footwear that combines graphic design with imagination and functionality. To the senses, Camper shoes are unique, original and constantly a surprise. From the iconic Camper Pelotas range, the true original in retro sneakers, to the asymmetrical Camper Twins, that are playful and whimsical, Camper men’s shoes and Camper women’s shoes are filled with excitement. Urbanites around the world appreciate the creativity and artistry in Camper men’s shoes and Camper women’s shoes as well as the quality and comfort.

Crocs

K17 patient: “I use classic Crocs (not any other brand) for shoes, but I have to wear with socks. I use cotton socks (likes 100% cotton).”

NOTE: Many PCers use 100% cotton socks. However, extensive research shows that cotton holds water (think about those thick cotton towels) and PCers need to keep that water away from their feet to avoid blistering. While nylon or other synthetics may be worse, the idea of ‘wicking’ socks that take water away is an important concept for PCers.
Crocs shoes are simply the perfect all-purpose shoe designed with total comfort in mind. Roomy orthotic foot beds mold to your soles for a custom fit; ventilation ports keep feet cool; antimicrobial and odor resistant material; slip resistant, non-marking bottoms; and, lightweight Croslite foam washes clean. Pivoting strap allows you to wear as clogs or sandals.

Dearfoams Fireside Sandal Slippers

K6a patient “My mother bought me a pair of Dearfoams Slippers and I love them. They are a game changer for me. With them on I can walk around the room instead of crawling.”

ECCO Sandals

Cx30 patient: “With m plantar keratoderma, I use ECCO sandals, which are European and very expensive, but are wonderfully comfortable and have great cushioned soles and soft Velcro straps. I don’t get the sweating that happens in cheaper shoes. Also, the lining under the foot is like a suede finish, so your foot doesn’t stick and blister like it does on regular leather or other substances. I can wear them barefoot, whereas I used to have to wear stockings or socks (not a good look in the summer). They also make great boots that I can actually hike in in the winter months.”

K16 patient: I have recently bought some new sandals: Ecco Breeze. They are the most comfortable ones I have tried in a while. Not the most attractive ones, but I know you will agree, that is not the top of the priority list, unfortunately!

GEOX

K16 patient: “I use special Geox shoes and custom made insoles, but I don’t buy them because of the membranes. You can take the inlays out and they are big enough for my own custom insoles. It took me 1 year to buy new ones.”

Joya

Joya uses futuristic internationally patented Sole Technology that delivers a sensation while walking that has really never before been encountered. You are given the emotional experience of walking effortlessly on a concrete planet. It’s not about sculpting and toning a chiseled physique. It’s not about being the “cure-all” shoe for orthopedic pain. It’s simply about making walking a joyful and effortless experience.

K16 patient: “I have now had a week to try out my new pair of Joya Lugano Brown Shoes. These shoes are pretty amazing. I have noticed a difference in comfort level while walking and a difference in the amount of sweat my feet produce because of the shoes’ active air technology. While these shoes by no means entirely take the pain away, I believe these shoes are the closest to perfection of technology a shoe can have to take pressure off the feet. These are the most pressure reducing shoe I have ever tried on. This shoe company is based in Europe, so the styles are still limited in the US. They are a little expensive, but in my opinion, worth the increase in number of steps I can endure each day.”

MBT (Masai Barefoot Technology)

K6a patient: “There is a particular brand of shoe that my daughters’ podiatrist recommended called MBT (Masai Barefoot Technology). People my age may remember Earth shoes with the negative heel that was supposed to improve posture and stride and therefore correct a number of health problems; these have many similar claims. We don’t have an opinion on whether they encourage weight loss or prevent cellulite, however, they have had an AMAZING effect on my daughter’s calluses. She has worn them since the first of the year, and the number and severity of calluses has been drastically reduced on both feet! Now, these shoes are more expensive than any I’ve ever bought for myself. We find them ON SALE for $140 — $160, but they sure seem worth it! I have just bought her MBT sandals, and my son is trying a pair of sneakers. My son’s feet aren’t yet as bad as my daughter’s, so we may not see the same dramatic results, but if it keeps his calluses from progressing, I’ll keep buying the shoes. We buy them from www.footwearetc.com although there are other internet sources.”

K16 patient: “I bought a pair of MBT shoes (www.mbt.com) which have taken away almost all of the foot pain I normally experience when walking. The shoes were designed to help improve posture, among other things, but the side benefit for me has been tremendous. After a couple of hours of running errands one day, instead of being exhausted and stressed because of the pain, I still felt amazingly fresh and energetic. I think it’s because the heel ‘sensor’ in the shoe does a great job of soaking-up impact, combined with the rolling motion of the shoe, which requires practically no bending at the ball of the foot. The shoes are pricey (~$250), but they give me more freedom, so I think they’re well worth it.”

Merrell

The Merrell shoes company has made a name for itself providing outdoor footwear that is not only comfortable, but provides the perfect fit right out of the box!

Merrell shoes, has a wide range of shoes including sport shoes and moccasins, as well as products to relieve pain in the feet and lower body. Merrell shoes are both sporty and comfortable due to the groundbreaking technologies used to make these shoes. Many Merrell shoes have Air Cushion Midsole Technology, for example, for added comfort. If you’re looking for Merrell shoes that absorb shock and add stability to your step, you should definitely buy a pair of Merrell shoes with this patented Merrell shoes technology. Every time you take a step, the Air Cushion condenses to absorb the impact up to four times your average body weight to make Merrell shoes a good choice for those concerned about heel pain. This Merrell shoes technology also places your heel in a heel cup to help keep it centered and stabilized, helping to prevent heel pain, pronation and other conditions.

Merrell also has custom fit insoles made of durable Poliyou and dual-density foam, the Merrell Custom Fit Footbeds give you the freedom to customize the fit of your footwear by providing 3 different densities 7mm for the narrow foot, 5mm for a medium foot, and 2mm for the wider foot. In addition, it molds to the shape of your foot for total comfort and support.

K16 patient: “I wear Clarks shoes and Merrell shoes — they are very comfortable.”

Nike

K16 patient: “Nike Sliders and Sandals that have memory foam insoles are very comfortable.”

??? patient: “I am very thankful for my Nike Air ACG trainers with an all-trac trail sole that has full front and back air soles. They are good for helping soften the shock when walking.”

Orthopedic

From the healthy feet store website: “Orthopedic Shoes help relieve pain from those who: Suffer from intense toe pain due to bunions or hammertoes, experience ball-of-foot pain on a regular basis, corns and calluses on feet from shoes that don’t fit right, intense heel pain, plantar fasciitis or painful heel spurs. The bottom line, according to the American Podiatric Medical Association, is that if you have sensitive or problem-prone feet, then you most likely should be wearing an orthopedic shoe. Your feet are the foundation of your body, and wearing good shoes like an orthopedic shoe can give you the comfort you need.”

K6a patient: “I wear orthopedic shoes with custom made orthopedic inserts.”

K6b patient: “I’ve used orthopedics made by podiatrists and phase 4 orthopedics (mail-order) made of moleskin. I try to buy wide shoes and low heeled pumps for dress.”

K6a patient: “I have tried diabetic sneakers which really didn’t work (not soft enough). I have orthopedics in all shoes, ones for more casual and ones for dress shoes.”

Reiker

K16 patient: “I found comfortable shoes! Rieker Cindy! Light, breathable, soft, cushioned, roomy — what more can you ask? I don’t cry very often, but when I had had the pair for a week, our dog ate the other shoe. Let me just tell you that the dog is still alive. And fortunately, although the black ones are out of stock everywhere, I found a pair of brown ones somewhere. I have new shoes, yippeee!”

Sketchers

K17 patient “I have KRT 17… which I have suffered throughout the years, with very painful blisters and cracked, bleeding calluses on both my feet. Well, at the start of summer, not looking forward to the hot days that would be here before I knew it, and, knowing how heat affects my feet (As some of you may already know … “The hotter the day, the worse the feet”)… One of my daughters, who also suffers from this mutation, says to me, “Mom, You might try getting you a lighter weight shoe, and try going without socks”. This was working for her, so I thought, why not. . I always wore heavier tennis shoes, along with shoe inserts, and WITH special “Breathable” socks. I have worn socks all my life… thinking this is what I needed to do, to help keep my feet “Pain and blister-free” ! It didn’t work! Well, I started experimenting with a couple different shoes, AND, going without socks, like she said! The shoe that really seemed to work great for me was the “Skechers Go Walk 3”! I might add, along with PC, I also have high arches which tend to add to the weight-bearing pressure, especially on the middle balls of my feet where it was super painful to apply pressure. Anyways… I investigated, and did some reading on the Skechers shoe. The Go Walk 3 was the best for me for arch support especially. These pics show the shoes I am wearing now. I can’t believe how cushiony they are to walk in! it’s like walking on a cloud! Seems the lining, or insole, is like a built-in sock already, and the upper part of the shoe absorbs the heat and sweat, so there’s no need to wear any socks with these. I went and bought me two pair of skechers, This allows one pair to dry out while I wear the other. But, Please… do your own research, and see what might work best work for you. Sorry I waited ’til the “END” of summer (AFTER the hot days are past), to post this but… I just wanted to do a trial run… to see if they would really do the trick for me, before I reported my findings, and… They did!!! This is the first summer ever in my life, that I did not get any blisters on my feet, and the one’s I already had, are gone! I might add too… I did not get any kick back from Skechers for promoting their brand, but I will write and thank them for making a shoe that FINALLY brings (me) some comfort! Thank you and have (another) great day. Love you all. P.S. I forgot to mention too… I don’t have to wear my shoe inserts with these! They are that comfortable!”

K6a patient “I wear skechers too! With socks though.. never really thought about wearing it without socks!”

K6a patient “I have two pair of Go Walks that I love, too! And I loathe socks in general so these are perfect. I’m sort of an opposite when it comes to my PC and heat; I am fine in the heat, but worse in the cold! One of my pairs of Go Walks is lined with fluffy wool for the colder months so I can still get away without wearing socks until the dead of winter usually.”

K6b patient “I bought a pair of Sketchers GO walk3 in June and they are the most comfortable pair of shoes I have ever worn. I was able to walk through two large airports with little discomfort. The memory foam insoles and the “round discs” on the sole of the shoe give me support and good shock absorbance to reduce the pain at the pressure points. It became my go to shoe for work also when I am standing and walking. I hope Sketchers continue to make the Go walk 3 because they are the only type of sketchers that work for me with my PC.”

K6a patient “I have been wearing Sketchers for the past few years and they’ve been great. My feet haven’t gotten any better but I can tolerate so much more with these comfortable shoes. And you are so right. What works for you and me may not help anybody else. But I would advise people that you owe it to yourself to try as many shoes as possible to see what works. The shoes now are so much better than when I was a little kid so many years ago. I’m 61 now and I still walk as much as I can although I know I have limitations.”

Socks

Sand Socks – SmartWool – Sole Socks – Wicking Socks – WrightSock

Sand Socks

K16 patient: “I was at the beach today and saw a guy selling a product called sand socks. I saw a lot of people on the beach wearing them because the sand was too hot. I bought a pair that I will wear next time to the beach, but this looks like a much better option than the swim shoes I have been wearing. This product is a thin sock that provides breath-ability and has a sole on the bottom to provide support. They are made to protect your feet hot sand, cold sand, dirt & mud, sun blisters & rashes. If you are interested, check out the website — www.sandsocks.net.”

SmartWool

SmartWool has a variety of SmartWool socks and purchase options.

• WOW (wool on wool) technology
• Ultimate Fit, Comfort & Performance
• 4 Degree Fit System – 1 Ankle Band, 2 Arch Band, 3 Instep Band, 4 Instep Band
• Mesh (MVT) Zone for Ventilation
• High Density Impact Zone Ultimate Fit, Comfort & Performance
• Temperature Regulation (four season functionality) Conserving Heat – Maintaining; Releasing Heat – Warming; Absorbing Heat – Cooling
• Moisture Management – Stay drier, Longer with SmartWool
• Odor Control

K16 patient: “I would like to suggest a product that I have used which has increased my walking stamina called SmartWool socks. Found at places like REI, SportSmart, or online by searching SmartWool Socks, this company has a lot of different varieties of socks using their wool technology in production. These socks are great for warm, hot, dry, and humid weather. They keep my feet warm when it’s cold and cool/dry when it’s hot. The thing that matters most is that these socks wick away moisture that is generated from my sweaty PC feet, keeping my feet dry at the end of a 10 hour work day.”

Sole Anti-Blister Socks

SOLE socks This technologically advanced sock features two layers. The inner layer hugs your foot and slides against the outer layer, reducing friction and the chance of blisters. The outer layer features large vent panels for increased breathability and an elastic arch band that keeps the sock in place.

Wicking Socks

An article about socks that hikers wear from GORP.com an outdoor recreation website said, “Wear wicking socks polypropylene or nylon are fine under a pair of wool or wool-and-nylon blend outer socks. The wicking socks are less abrasive, plus they move moisture away from your feet. Never wear cotton socks cotton absorbs moisture and practically guarantees blisters. Wicking usually refers to technical fabrics that move sweat away from the skin to the outer surface of the fabric, where it evaporates.”

K6a patient: “Wicking Socks! I’m addicted to a new kind of socks called wicking socks. Typically, if I wear socks and shoes for any length of time, my sores get soggy and painful. I mean, MORE painful than their usual pain, even if I’m sitting down. Wicking socks are made with synthetic fibers that wick away the moisture from feet and claim to be anti-blistering. I have tried a number of different kinds of these types of socks. Today, I report that I will never go back to cotton or any other kind of socks I used to wear in the past. These new wicking socks have saved my foot life. I particularly like socks that have Cool Max in them but it’s harder to find them in regular stores. I usually have to get them at outdoor recreation stores, and they are a bit expensive. What I’ve done though, because there are so many out there, is buy only one pair at a time. I’ve worn them and washed them a few times. This way I know which ones react best with my feet. I like the socks that have nice padding (but not too thick, usually medium thickness) and still stay soft after being washed. The Thorlo brand is my personal favorite. My feet aren’t soggy and clammy like they used to be when I’ve worn socks and shoes. This has significantly reduced the terrible itching that usually comes when I take off my shoes, and most of all, I can wear socks and shoes longer before the pain of simply wearing them starts setting it. Now, wicking socks aren’t a cure, and I still hurt when I walk, but they have helped me considerably enough that I am hooked for life. It’s amazing I’ve gone so many years not knowing about socks that wick away moisture. It just goes to show there may be other small and simple things out there that could help us PCers, we just might not have thought of them or found them all yet.”

K16 patient: “I just got my Thorlo Socks! I Love them and I am now redoing my sock wardrobe with Thorlo socks. No more very sweaty painful feet with me in these socks!”

??? patient: “I have a ridiculous supply of grey and blue wicking socks. I credit Drysol (aluminum solution), wicking socks, and Spenco low friction insoles (changed 2-3x daily) as my 1-2-3 punch to drastically improving my life/reducing pain and injury on my feet. I also switch sneakers (but identical models) during the day for pure dry cool feet overkill :). As far as the dual layer socks, the theory seems interesting (reduce the shearing forces felt by the foot as it slides), but I wonder if the aggregate layers produce more heat (even if made from a wicking material) at the skin surface. Additionally, I sorta believe that less movement in a shoe, regardless of friction level, just seems to work best for me in avoiding blisters.”

WrightSock

WRIGHTSOCK Double Layer provides year round comfort and performance with no blisters-guaranteed.

WRIGHTSOCK Double Layer delivers the no blister promise through a three-part system:

1. Moisture Management: Dri-WRIGHT inner layer wicks moisture off the skin better than any other fabric. The Result…your feet stay dry.
2. Temperature Regulation: Staying dry means staying cooler in the summer and warmer in the winter. The Result…your feet are more comfortable.
3. Friction Reduction: Interaction between the inner and outer sock layers absorbs friction that is normally transferred to the skin. The Result…skin shear is eliminated.

Insoles

Patients have found that to lesson the pressure and trauma to feet by using a variety of different things, including insoles, can be helpful. Insoles come in a variety of shapes, sizes, and price ranges.

Al Bravo (PC-K6b) who is a podiatrist and PC patient uses Plastazote insoles as well as Poron (trim to fit) insoles. He also recommends a stiff shoe, good fitting shoe to avoid movement/friction with a soft insole.

BYU – Eye Patch – Gel Doctor – Orthopedic – Prothotic – ShockBlockers – Sole Heat

BYU Capstone Project

In 2013 a team of engineering students from Brigham Young University (BYU) chose Pachyonychia Congenita for their capstone project. They gathered data from PCers in the IPCRR.

RESULTS: BYU CAPSTONE. The PC Shoe team gave an excellent presentation which featured numerous mechanical engineering and health projects. Their poster is included below.

The orthotic brace available from Toad Medical (www.toadmedical.com) reduces pressure by 33%. With an extra two-layer foam cushion, the pressure is reduced by 77%. The cost of the brace including the orthotics fittings is about $6400 (USD). We do not know whether insurance will/will not cover these costs. 

The BYU Capstone PC Shoe team found that a really soft thick memory foam on top and then a harder material underneath to make the insole soft and sturdy works the best. A very important finding after all the testing was done, is that the Vasyli Armstrong II Insole (www.vasylimedical.com) at a cost of about $50 USD also reduces pressure by about 30% (not shown in poster). This is a much better pressure reduction than any of the other insoles recommended by PC Patients in the insole survey. If you use the Vasyli Armstrong II or other insoles, we welcome your feedback.

Other PC patients have found the following types of insoles or products to be helpful.

Eye Patch

K6a patient: “I found a ‘bandage’ that is PERFECT for blisters on the heel. It’s called the Nexcare Opticlude Eye Patch. Obviously made for the eye, but absolutely superb for heel blisters. Nice sized padding in the center with thick, flesh-colored tape all the way around the padding. It stays all day, even with friction from the shoe. EXCELLENT product.”

Gel Doctor

A scientist found an article from Scotsman Magazine on April 19th, 2008 “Health & Happy Feet — You don’t have to be a reflexologist to know that our feet take a pummelling through the day and are often deprived of the TLC they deserve. And you don’t have to be a high-heel wearer to know that over-burdened and under-tended feet can be horribly sore, which when you consider how many of us stand on them all day and all too often shove them into shoes that aren’t exactly comfortable, is hardly a surprise. But now help is at hand. Gel Doctor’s new insoles keep your feet well cushioned, but they have an added feature that works wonders for the foot-weary. Filled with liquid gel, they can be warmed up if you suffer from poor circulation, or cooled down (just pop them in the freezer) to soothe and re-invigorate hot, tired feet. There’s also a version that contains a small magnet designed to help stimulate circulation in feet that are prone to becoming tender or swollen. Gel Doctor Liquid Gel insoles with magnet, £12.95, available at www.victoriahealth.com” and recommended these Gel Doctor insoles. If you have tried them, please email your comments to PC Project.

Orthopedic Insoles

From Orthopedic article: “Orthopedic insoles are available in a variety of shapes and designs. The function of the natural arch is to distribute pressure. Insoles with silicone gel absorb shock with each step and distribute pressure throughout the foot to prevent plantar fascitis and other ailments. Mid-size insoles are recommended for most cases of plantar fascitis and they provide comfort, since they are soft and form-fitting. The gel is located in problem area and prevents pressure from reaching vulnerable areas of the foot. Some insoles have blue silicone packs spread throughout the entire insole or just across the middle to protect the metatarsal muscles.

Many insoles are made of a spongy material rather than gel and can be cut to fit the size of the shoe. These insoles provide comfort and shock absorption, but focus on the entire foot rather than on specific areas. They often contain special materials proven to provide relief. Some are made of a light material called polyurethane covered with neoprene which provides support and absorbs shock.

Whichever insole you use, make sure you are also wearing shoes that are a comfortable fit. Insoles can be worn with a variety of shoe styles, and the same insoles can be used for several different shoes.”

K6a patient: “I use orthopedics (insoles) designed with my specific feet molds; made of soft, pressure absorbing material.”

K6a patient: “I use bio-mechanical Orthopedic inserts, but prefer sandals to shoes.”

K6a patient: “InFeet made by BioMed, who makes custom orthodics. At the company, you stand on foamy material that makes imprint of feet and the way your weight is distributed on them. InFeet is made out of spongy-like material. Within a few days, I could feel my feet healing and they looked better. Today, I still have some of the sores on the edges of my feet, but they are smaller, smoother, and I can walk a lot longer before they really start to hurt. Only little issue is sometimes finding shoes to fit the insoles — but it’s well worth the effort.”

Prothotic Pressure Relief

K16 patient: “I would like to suggest prothotic pressure relief insoles, found here. I have these insoles in every shoe I wear. I have had to customize them a little by cutting the cup of the heal off, but after that small customization, these insoles have provided me with an extra 3 blocks of pain free steps a day.”

ShockBlockers

ShockBlockers insoles come in a variety of styles and sizes. From the ShockBlockers website: “Patented ShockBlockers® Insole Inserts dramatically reduce shock to feet and joints. They offer 20% more shock absorption than other insole inserts. ShockBlockers® Insole Inserts combine innovative design and materials. They are for anyone who walks, runs or stands!”

K6a patient: “I use Shockblockers. The inserts reduce shock absorption, leave your feet cool and dry, and retain their shape. Just stick them inside shoes one size larger than regular size. I love them. It makes walking easier.”

K16 patient: “I buy inner soles from OREGON AERO, INC. E-MAIL :customerservice@oregonaero.com“

SOLE Heat-Moldable

K6b patient: “The company is called ‘Sole’ and you can see their products at www.yoursole.com. They have a thinner insole called the ‘Slim Casual’ which I wear with dress shoes, and then they have the ‘Sole Ultra Softec’ which is better for running shoes or bigger shoes. The premise behind these is that you put them in the oven at 200 degrees for 2 minutes, and then put them into your shoe and stand up on them for a couple of minutes. They are pliable enough that they form to your foot and retain that shape. They do a great job of distributing your weight off the pressure points and I find them very comfortable.”

PC patients use a variety of power tools to trim and manage their keratoderma.

Some of these products are listed below.

Dremel

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PediPaws

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Features: quiet motor, traps filings, cordless, won’t crack, splinter, or break nails, rotating filing head gently files nails, fast, easy & gentle.

Callus Remover

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TENS Machine

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Description

From Wikipedia: “Transcutaneous Electrical Nerve Stimulation, more commonly referred to as a “TENS” is defined by the American Physical Therapy Association as application of electrical current through the skin for pain control (APTA, 1990). The unit is usually connected to the skin using two or more electrodes. A typical battery-operated TENS unit is able to modulate pulse width, frequency, and intensity. Generally TENS is applied at high frequency (>50 Hz) with an intensity below motor contraction (sensory intensity) or low frequency (<10 Hz) with an intensity that produces motor contraction (Robinson and Snyder-Mackler, 2008).

TENS is a non-invasive, safe method to reduce pain, both acute and chronic. While controversy exists as to its effectiveness in the treatment of chronic pain, a number of systematic reviews or meta-analysis have confirmed its effectiveness for postoperative pain, osteoarthritis, and chronic musculoskeletal pain ([1]. Recent clinical studies and meta-analysis suggest that using adequate intensity of stimulation is necessary to obtain analgesia with TENS (Bjordal et al., 2003; Rakel and Franz, 2003).”

Patient comments

K6a patient: “Good old mum borrowed a TENS machine for me to use and have had a go this week with it. Unfortunately I didn’t think it was that good, but perhaps I had the wrong mindset as I thought it was going to take away all my pain plus I have a particularly painful foot at the mo as it’s infected badly. My mum borrowed it for me at this years PC conference. It was mentioned that some people with PC use or have used them so that is where we got the idea from.”

K16 patient: “I’ve tried a TENS machine, but wasn’t sure where to place the pads so I asked at the PSM… I think the ankle was the best place. Didn’t get much joy from it before so maybe I was not using it properly.”

K6a patient: “Ankle? Now that is interesting, as I had it around my waist. I don’t think it has a long enough cable for the ankle, but I will try.”

Wikipedia TENS    Healiohealth TENS machines

PC patients use a variety of cutting tools to trim and manage their keratoderma.

Some of these products are listed below in alphabetical order. At the 2015 Patient Support Meeting, Dr. Al Bravo, a podiatrist and PC patient, recommended using the “312 blade scalpel.” Using an internet search, you can find a number of manufacturers of this type of specialty scalpel blade.

PATIENT TIPS & COMMENTS FOR HAND TOOLS

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Callus Shaver

Callus Knife

Nail Clippers

PCers use many different types of nail clippers for trimming nails and calluses.

K6b patient: “Trim with nail clipper. File with sapphire stone.”

K6a patient: “I use big nail clippers or dog clippers. I usually soak first.”

K17 patient: “Nail Clippers — The brand is ProFoot and they can normally be found at Walmart and many drugstores. These clippers are a larger size, better cutting point, and cushioned grips are easier to use (about $11-$15).”

K6a patient uses the following tools for feet and nails: “I use the ped egg (not pictured) weekly for my calluses. Besides the Ped Egg, the other very important tool for me is the small scissors on the photo, which I use to drain and care the open sores practically every day. For my nails (hands and feets), I basically use the salon boards in the photo, at least once a week.”

K16 patient: “My two tools of choice are a single edge razor blade and these large toenail clippers. I’ve never had any success with pumice stones or any other frictional debridement tool. My dad always used single edge blades and that’s what he taught us to use. My father used to soak his feet before he cut them. I cut them without soaking them because it allows me to judge better how thick they really are and I don’t cut myself. When you soak them, the calluses soften making them easier to cut. The downside of soaking the callus is the color of the callus lightens and makes it difficult to judge how thick they are and I feel you are more likely to cut yourself beneath the surface of the callus, which can be dangerous.”

K16 patient: “I have tight hold on the nails. While shortening them, the less movement, the better for the nail bed.”

K6a patient: “I soak in cold water for pain, but cannot walk after the soak. My feet will feel better the next day. I trim my feet about every week. I do not use any type of drill. I use big nail clippers — or dog clippers — to cut my calluses. I use the same tool for my nails. For my palms, I use my teeth.”

K16 patient: “I use Neosporin — “bag balm,” loop balm under my fingernails when they are cracked or really dry. To trim the nails, I soak them and then use wire nippers. At work, I use a bench grinder on the real bad ones.”

??? patient: “I use nail clippers on the side of the nail and then file them smooth to remove the jagged edges. Once complete, I wash my hands thoroughly and apply hand lotion to smooth out the cuticle.”

??? patient: “Soak and use nail clippers and day clippers. Occasionally, I cause trauma to the nail bed if they are too rough when clipping. “

??? patient: “I use a large clipper to cut off calluses.”

Razor blades

K16 patient: “My dad always used single edge blades and that’s what he taught us to use. My father used to soak his feet before he cut them. I cut them without soaking them because it allows me to better judge how thick they really are and I don’t cut myself. When you soak them, the calluses soften, making them easier to cut. The downside of soaking the callus is the color of the callus lightens and makes it difficult to judge how thick they are and I feel you are more likely to cut yourself beneath the surface of the callus.”

??? patient: “I use Schick razors to trim. It is safer than plain razor blades.”

K16 patient: “I use a double-edge razor to peel off my skin, both in my feet and palms.”

??? patient: “I use razor blades to slice off the thick skin on my feet. I usually take a bath first so my skin is softer. I keep it down under a quarter of an inch. After cutting thick skin, I put on socks and wears shoes. The first two days are bad, but then good for a week or more.”

K6a patient: “When I trim my feet and nails, I use a razor blade because it’s flexible.”

K6a patient: “I use double-edge razor blades. When the sores on my feet grow too long, my feet start hurting again.”

??? patient: “I use a single-edge razor blade to keep my callouses thin. I have a hand held sander that I then lightly use to smooth out where I cut. When I have blisters, I pop them right away with a needle and alcohol. I do this as often as needed.”

Cx30 patient: “I soak my feet in warm water to soften the skin, and then use a one-sided razor blade (like used in paint scrapers), which is safer than double-edged. I then gently pare off the thickened skin. I can’t bear to have a podiatrist touch my feet as they are just too sensitive.”

K16 patient: “What I learned in 50 years! Too much care causes more calluses and more pain. Razor blades often take too much off.”

K6a patient: “I soak in salt water, nay temperature when my feet ache (usually hot weather). I use razor blades on calluses when they hurt. My child can tell me which one they need trimmed and how often.”

Scalpels