This was a question I recently got from a colleague. I often get a lot a questions from colleagues, but not usually on this type of topic. Generally, the questions are something like, which foot orthotic do you use for a certain problem, which is the sort of topic that I think I know a bit about and not necessarily about foot creams which is a topic that I do not know a lot about! I not sure any recommendation that I might make on that sort of topic carries any credibility.

I did give this some thought. With regards to the question on which is the best foot orthotics that I could recommend, I typically answer that the best one is the one that has the prescription that match the foot that it is needed for to get the effects that you want. Based on that there is not a one best foot orthotic. I also often say when giving a lecture that a good clinician will not stick to just one type of foot orthotic type; this means that they will have a range of brands with different prescriptions so they can use the one that gives them the design features that they need for a patient. A good clinician needs to be able to mix it up to get a different clinical effect.

The more I thought about this type of foot creams question, then the answer probably could be the same as the orthotic one. Different type of skins need different types of creams. A good clinician would probably not stick to just one brand of skin cream, but have a range of creams brands to use so they can use or recommend the one that gives the desired clinical effect for each individual patient.

This was pretty much the answer that i gave to the colleague along with the recommendation that my advice on this topic should not much credibility as I am not an expert in this one.

What do I typically use anyway when in the clinic? I like the using the 2 different concentrations of the urea creams, as in the absence of good evidence, I get the impression that they do appear to have a different clinical affect on different people. The urea concentration of less than 20% is probably better to moisturize the skin and concentrations of above about 20% are better at dealing with the drier skin and for concentrations of about 40% appears to be more useful at the harder callused thick skin. That is why I mix it up, just like I do with the foot orthotic types. As I am in Australia, so I like to use the Walker’s brand of urea cream. This cream comes as a 15% and 25% concentration, so can choose the one the is needed to meet the clinical needs of different people.

You can get the Walkers urea 25% foot cream and the 15% version online. I still don’t get why that colleague wanted my advice on this topic …