Feet of a Smoker: Severe Effects of Smoking on the Feet, Fungal Toenails and Poor Circulation

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A patient in his early 60s returns to my office after 3 1/2 years. Many years of heavy smoking have led to a stroke and poor circulation in both legs that required bypass surgery. He now has an ulcer on his big toe and on the bottom of his foot. Part 1 of this case shows the severe effects of smoking on the feet, in particular the toenails.

Smoking can have devastating effects on the feet, especially for patients with underlying conditions such as heart disease and diabetes. Nicotine in cigarettes is a stimulant that raises blood pressure and is a vasoconstrictor resulting in small veins and arteries. This is why some smokers notice coldness, tingling, or a change of color in their hands and feet. This restriction in blood flow makes it hard for the heart to pump blood through the constricted arteries. The skin and nails of the feet may also change. Often the nails may become thick and brittle, and the skin on the feet can become dry, flaky, and fragile. Some patients may notice sores or injuries in their feet causing the feet to be slow to heal and in worst cases may lead to amputations.

Kevin E. Jefferson, DPM
Metropolitan Podiatry Associates, PLLC
7603 Georgia Avenue NW, Suite 100
Washington, DC 20012
202-882-9682

E-mail: [email protected]

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