Preventative care is the best care when it comes to preventing foot ulcers. The goal is to stop foot injuries at their most minor level. Be vigilant when it comes to preventing and caring for blisters, calluses and corns. A doctor should be able to inspect a patient’s shoes and inform the patient whether they fit well enough to prevent unnecessary friction or pressure on the foot Orthotics (orthopedic insoles) may be necessary to ensure a proper foot ; other diabetics find that well-fitted athletic shoes are adequate when it comes to keep their foot callus , corn, blister, bunion and hammertoe free. If you have ever had experienced bunions, you know how painful they can be. After all, you can't expect the unusual enlargement of a joint at the bottom of the big toe to feel like a walk in the park. Inflammation is the cause of the condition and typically pressure and pain from footwear that fits poorly is a result of the condition. While people often attribute the footwear itself as the cause of the pain and the need for bunion splints, many experts believe that one's genes are actually the cause of the condition. Heel fissures is the term for cracking of the skin of the heels. This can be a painful condition that can cause bleeding. Walking barefoot or using open-backed sandals / shoes that allow more slippage around the heel while walking are often culprits that cause heel fissures. Skin conditions, such as eczema and psoriasis, can also lead to heel fissures. The skin thickens as a result of the friction. As the skin thickens, fissures will form around the periphery of the heel. These fissures or cracks can become deep and be very painful. Treatment involves removing the callus. Pes Planus, or flat feet, are commonly encountered with Down syndrome. In fact, this foot type will be seen in the vast majority of individuals. This condition may present with neutral gait (no excessive flattening of the arch) in mild cases or may be aggravated by the hypotonia and allow severe pronation (flattening of the feet). In both cases, an orthotic or custom insert for the shoes can support the flattening of the foot against gravity and produce a more ideal walking (gait) pattern. This will reduce fatigue and allow the individual to remain active and more involved. Another effective method is using a strong chemical peel like the TCA peel (trichloroacetic acid) to remove the corn or callus. A TCA peel is very effective as it will only affect the corn or callus, unlike sanding with a pumice stone which will remove skin on areas around or near the affected area. A TCA chemical peel is a controlled chemical burn which will result in the corn or callus peeling away harmlessly in a few days. Depending on the thickness of the corn or callus more than one treatment may be necessary. Top of foot pain is an annoyance and a frustration in many cases, with the pain persistent whenever pressure is placed on the feet. The causes are numerous, but since many foot health problems affecting the top of the foot do not produce any outwardly visible signs, a home diagnosis can be somewhat difficult. Diagnosis the problem is made even harder due to a number of different conditions producing similar symptoms; namely pain in the top of the foot, swelling, and pain or discomfort when walking. Getting to the bottom of the problem usually requires a visit to a doctor and often an x-ray, MRI or CT scan for confirmation.