Scrapes, abrasions, blisters and other seemingly minor injuries should be treated promptly. Patients who are unsure if they can treat a minor condition at home should consult their physician. Bacterial infections can be treated with antibiotics, fungal infections with antifungals and other infections with other antimicrobials.

Patients may be referred to a podiatrist or other specialist for treatment of conditions such as bunions or hammertoes.

Foot ulcers can be treated by draining any pus, removing the dead tissue, keeping the area free of pressure and taking antibiotics to kill infections. The U.S. Food and Drug Administration (FDA) has approved the use of the antibiotic ertapenem for diabetic foot infections that do not involve osteomyelitis. This medication, injected once daily, was shown in the SIDESTEP Study of Diabetic Foot Infections to be as effective as an antibiotic that is injected four times a day.

Sometimes patients may need to use crutches or a wheelchair, or stay off the foot while the ulcer heals. Nonremovable casts can improve healing of diabetic foot wounds.

In some cases, wound dressings may be used to protect the ulcerated skin. A product known as a skin substitute also may be used to help close ulcers. These contain human cells known as fibroblasts that are gradually absorbed into the wound. The cells then grow and replace the damaged tissue in the ulcer.

The FDA has also approved a gel product called becaplermin to treat foot ulcers. This drug contains a protein that encourages tissue growth.  In addition, a topical form of vitamin A may improve healing of diabetic foot ulcers, according to recent research.

Other treatment options available include:

• Shoes. Charcot foot can be treated by wearing special shoes that help distribute body weight away from the affected area of the foot. In some cases, surgery may be needed to reconstruct the foot and restore its shape.
  
  
• Debridement. This is the removal (by surgery, hydrotherapy or other means) of dead, devitalized or contaminated tissue.
  
  
• Oxygen therapy. Studies have shown that hyperbaric (high-pressure) oxygen can promote healing of diabetic foot wounds and sometimes prevent amputations.
  
  
• Skin grafts. These can be used to help restore the skin damaged by ulcers. 
  
  
• Surgery or other invasive procedures. Bypass operations from above a vascular blockage down into the foot can restore blood flow to the foot. Angioplasty can also open clogged arteries. This is a procedure in which a balloon is inserted into the blood vessel and inflated. This breaks up the plaque and restores blood flow.

Recent research shows that nerve decompression surgery in the foot and leg can reduce pain, enhance sensation and improve balance in people suffering diabetic neuropathy. Other research shows that prompt surgical removal of dead tissue in people with diabetic osteomyelitis can avert more extensive amputation later.