This was a question I got from a colleague. I get a lot a questions from colleagues, but not usually on that topic. Typically the questions are something like, which prefabricated foot orthotics do you use, which is the sort of topic that I know a lot about and not about foot creams which is a topic that I do not know a lot about! I not sure any recommendation from me on that sort of topic carries any weight.
I thought about it for a bit. With regards to the question on which prefabricated foot orthotics do you recommend, I typically answer that the best one is the one that has the design features that match the foot that it is needed for to get the effects that you want. Based on that there is no one best prefabricated foot orthotic. I also often say in lectures that a good clinician will not stick to just one prefabricated foot orthotic brand; they will have a range of brands with different design features so they can use the one that gives them the design features that they need. You need to be able to mix it up to get a clinical effect.
The more I thought about the foot cream question, then the answer probably should be the same. Different skins need different creams. A good clinician probably would not stick to just one brand, but have a range of brands at there disposal so they can use or recommend the one that gives the desired clinical effect.
That was pretty much the answer that i gave the colleague along with the recommendation that my advice on this topic should not carry a lot of weight.
What do I typically use clinically anyway? I like the 2 different concentrations of the urea creams, as I just get the impression (in the absence of good evidence) that they do seem to have a clinically affect on the most people. The urea concentration of below around 20% is better to moisturize the skin and concentrations of above around 20% are better at the helping get rid of the drier skin and getting up to 40% it appears to be more useful at the harder callused skin. So I mix it up, just like the prefabricated foot orthotic brands. I am in Australia, so I use the Walker’s brand of urea cream from Briggate Medical. It comes as a 15% and 25% concentration, so can choose the one the is needed to meet the clinical needs.
I still don’t get why they sought my advice on this topic ….