Do Your Feet in Sky-High Stilettos Get You Down? Feet Deserve More than a Pedicure!
Having fun over the holidays takes more than just a great dress or a fabulous mani-pedi. While you put on lotions, potions and serums on your face and the rest of your body, what do you do for your feet? Shoes are key to any event on your social calendar, the shoes you wear can cause you more than just aching arches, they can cause some foot damage. However all is not lost according to Beverly Hills dermatologist, Dr. Jason Emer. Courtesy of an array of peels, lasers, microdermabrasion, sclerotherapy, fillers, and fat-grafting treatments, Dr. Emer says that old soles (!) can regain a younger appearance and mistreated, aching (and aging) tortured feet can live to wear sandals another day!
Here to answer a few questions about this trend of ” toe-tal makeovers”, dermatologist Dr. Jason Emer took time from his Beverly Hills practice to answer a few questions!
Dr. Jason Emer:
It’s mostly women who come in complaining of foot pain or calluses, and it typically roots from: standing all day (i.e. waitresses, hostesses, hair stylists, actresses, etc.), being out all night (i.e. club kids), or wearing very high heel, designer shoes (which are meant to look good, but not feel good). I usually can address the pain if it’s on the bottom of the foot with filler injections to give extra support or “padding” to the bottom of the foot.
Once this is addressed, I do a full examination and often find prominent blood vessels, sunspots or freckling, wrinkles/crinkly skin, or rough texture, which then leads to a discussion of foot care and foot beauty. The foot is trending to be the next hand; every woman wants her feet to look beautiful, especially in open-toed shoes, high heels or sandals.
Men don’t bring up the look of their feet as often as women; however, men still worry about the texture and the tone, as well as nail care. Chemical peels and topical exfoliating creams leave the skin feeling soft and smooth, and this is where I typically start treatment for men. Improvements are noted so quickly that they start asking for the next available options, and then we progress to nail care and filler treatments if they have heel or foot pain, or Botox treatments for sweating.
Botox is amazing for foot smell and sweat, and is fantastic for runners or those who are on their feet all day in occlusive thick socks or shoes to prevent the sweating, which causes the feet to have odor and be predisposed to fungal and other infections.
SW: 2) What does Heel-to-Toe Rejuvenation.. really consist of in terms of treatments?
1. Fillers for the bottom of the foot for pain (it improves corns as it gives cushion), as well as fillers for the top of the foot to camouflage enlarged tendons that we often see with aging.
2. Peels or laser treatments to exfoliate the skin, improve wrinkling, sun damage, and pigmentation/sunspots.
3. Sclerotherapy or laser treatments for enlarged veins or abnormally shaped spider-type blood vessels — I have two special devices, VeinViewer and AccuVein, that I use to highlight vessels at the top of the skin, and as deep as 10mm. This allows me to see if there are any underlying issues causing foot swelling or pain, and guides treatment with my lasers and injectable medications to dissolve the veins.
4. Botox treatments for sweating, foot odor, and/or to prevent fungal disease (especially good for diabetics or those with blood vessel issues in the lower legs).
5. Foot creams to apply twice daily for exfoliation, which over time leaves the skin of the foot, particularly the heel, feeling soft and smooth.
6. Nail care, which can include anything from proper pedicure recommendations to laser treatment advice. It also might involve utilizing oral pills for fungal nails and foot soaks to remove any odor and avoid potential foot infections (this is particularly good for people on their feet all day, especially with occlusive footwear and socks).
SW: 3) What is the age range of someone who asks for this? Do men get this treatment as well as women?
Dr JE:(See response to question 1) I’ve had patients as young as high school students get Botox treatment and foot soaks for sweating and odor, as well as peels and at-home cream exfoliation to improve the texture and cracked heels. My older patients often have foot and heel pain due to loss of the fat pad under the foot as we age, and as we stand/step on our feet frequently over time.
Fillers injected into this area (even permanent fillers like silicone, or semi-permanent fillers like Radiese) work almost instantly to provide cushion that was otherwise lost with age and repetitive use. For the majority of my patients, pain miraculously disappears, and what was unable to be worn before, can be worn again.
SW: 4) Is it possible to go a la carte for some of the treatments?
Dr JE: Of course — We have a menu of options, and for patients where one particular issue may be more troublesome than others, we focus our treatment(s) in that direction.
SW: 5) What are the most conservative options? What are the most extreme treatments?
The most extreme is to remove the nails if they are discolored to let them regrow naturally, and this can take up to a year. A century ago, they used to just cut off the toe when someone had fungal or bacterial nails!
The most conservative treatments are vein injections and in-office peels. Injection are often used for removal of dilated blood vessels, and it’s very safe, effective and delivers results in as little as one or two treatments. In-office peels are used to exfoliate and soften the skin, and remove debris and dead skin cells. At-home topical exfoliating and moisturizing creams are also recommended to everyone as a simple, yet effective treatment – just be sure whatever cream used has urea, lactic acid, salicylic acid, or glycolic acid in it.
SW: 6) How long do these treatments take on a per treatment basis? What is the length of time commitment for a foot rejuvenation?
Time is specific to the individual treatment. In general, with all cosmetic procedures, you do a series of 1-3 treatments to optimize the skin, veins, and nails, followed by maintenance treatments every 3-6 months thereafter. It all depends on the specific condition. If it is just rejuvenation without any specific problem, typically you can do treatments every 2-3 months to keep the foot’s skin healthy and glowing.
SW: 7) What can women (and men) do to help pamper and treat their feet well?
Dr. JE: Massages, trigger point injections, acupuncture, and fish pedicures are great for the skin of the feet and for overall foot health.
SW: 8) What the one or two things that women should stop doing that they are doing now?
Pedicures can predispose the nails to fungal or bacterial infections if the nail is lifted or if the cuticles are cut. If you remove these processes from the pedicure, there’s no problem.
High heels and not having the appropriate shoe size/width is devastating to the skin and bones of the foot. Overtime, you can damage your nails with repetitive trauma if the shoe is too small — even to the point where the nails can turn colors and fall off (often called “tennis toes”).
Shoes that don’t relieve pressure on the bottom or sides of the feet cause calluses and corns, and can then require shaving for removal, or filler injections to improve the foot padding. Very occlusive and hot footwear is bad for your skin, as it makes you sweat more, increasing your chances of friction injury, dilated veins and infection.
SW: 8a) How likely is it that a patient would stop doing it because it would help their feet?
Dr. JE: I like to think my patients are very well receptive to all of my advice, and because they see how passionate I am about their care, the majority will make these lifestyle modifications.
SW: 9) What’s the general price tag for this treatment series?
Dr. JE: All the treatments are tailored to the person so there is no set price tag, as there are a multitude of options and combinations. However, some foot creams for everyday use range from $15-$75 each, a chemical peel can be about $150-$300 per treatment, and leg vein injections for a small area is roughly $300-$500 per treatment.
SW: 10) What can patients expect from this treatment series? What will it do for their feet aesthetically and physiologically? How long will it last? Can someone choose to rewind/repeat these treatments again? At what point would a patient evolve into not being a good candidate for this treatment series?
Dr. JE: Like I mentioned above, taking care of your feet is similar to taking care of the rest of your body — you have to treat, and then maintain. Once you start with improving the care of your feet (which may require a series of close-together treatments to optimize the focused problems), you will need to maintain it in order to keep the results. This could mean treatments every 3-6 months forever — just like going to the dentist or hair stylist!
Want to know more about Dr. Jason Emer?
Dr. Jason Emer bio:
Dr. Jason Emer is a board certified and fellowship-trained general, cosmetic and procedural dermatologist.
After completing a preliminary medicine internship in Chicago, Illinois at the Saint Joseph Hospital, Dr. Emer completed a two year Dermatopharmacology fellowship with leading medical dermatologist Dr. Mark Lebwohl at The Mount Sinai Hospital in Manhattan, New York. Significant time was spent focused on conducting clinical trials on investigational treatments in general and cosmetic and laser dermatology. Dr. Emer’s work enabled many medications and devices to become FDA-approved for cosmetic indications such as passive wrinkles and folds of the face, dynamic movement lines of the face, facial lipoatrophy, facial pigmentation/melasma, photodamage/actinic keratoses, hemangiomas/vascular birthmarks, and tattoos. Throughout his residency training he focused the majority of his cosmetic interests in the area of body contouring, liposuction, and fat harvesting and transfer, learning from world renowned experts in the fields of dermatology and plastic surgery. He began an HIV treatment clinic where fat transfer, facial fillers, and other cosmetic and plastic surgical procedures were used to enhance facial features and address body disproportions. All of his patients saw dramatic improvements in their appearances that forever changed their lives. After completion of dermatology residency, for which he was chief resident in his final year.
Dr. Jason Emer’s involvement in education, teaching, and research/clinical trials has facilitated a host of publications including case reports, review articles, and placebo-controlled clinical trials. He continues to run numerous clinical trials on investigational new treatments in the area of cosmetic and laser dermatology and plastic surgery, and lectures and consults for many of the pharmaceutical and medical device companies on a significant number of the products and devices physicians use daily in their practices for facial and body aesthetics. Dr. Emer has written book chapters on the treatment of psoriasis, complications of aesthetic procedures, techniques and guidelines for facial contouring with soft-tissue fillers, and sports related dermatological conditions. He is featured in Allure Magazine as the only male dermatologist beauty product expert and has appeared in the media as a Beauty Guru for his expertise in skin care and body contouring.
Find out more about Dr. Jason Emer at http://www.spaldingplasticsurgery.com
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Our gratitude and appreciation to Dr. Jason Emer for his time and detailed answers to our long list of questions! We really are curious about this topic!
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