So you got warts. Or fungal nails, or athlete’s foot, or bunions, flat feet, or calluses.  And to make it all worse, your parents are blaming your shoe choice.  Well at the risk of taking sides against your parents, it’s highly likely that you can place that blame squarely back on your parents.  And all you parents out there, read on, as you can just keep on passing the genetic buck back to the previous generation.

Like any complex machine, we have a blueprint.  And that blueprint, as Watson and Crick (and Rosalind Franklin – let’s give her due credit) discovered is none other than DNA, which codes for each of our physical traits, from eye color to height, or strength to chronic disease state.  Of course we can work on our strengths and weaknesses, but at its core, our DNA determine much of our physical and often mental state, from our heads to our feet.  And just as familial hypercholesterolemia is one of the most common genetically inherited diseases and can lead to high cholesterol levels even in a vegan, so too, many common foot issues are genetically based.

For instance, upwards of 90% of those with bunions can identify a family member with the same condition.  And while hygiene is a factor in the development of fungal infections of the skin and nails, most of the patients I treat are clean but presumably carry the gene that confers a lack of resistance to fungal infections.  Walking on a locker room floor is a great way to pick up a stray human papilloma virus looking for a home, but only in those predisposed to viral infections of the skin. And yes, someone discovered that there is a gene for susceptibility to fungal and viral infections of the skin.  We can hypothesize that there is a selective advantage to decreased resistance to fungal and viral infections – perhaps an increased resistance to bacterial infections?  I leave that to the evolutionary biologists out there.  The point is that while nurture, in the form of lifestyle, activity and shoegear are major factors in the development of foot issues, our genetic composition may predispose us to these conditions.  And that’s something that can’t be changed, and it’s all your parents’ and grandparents’ fault.

So if the genetic roulette wheel has been less than kind to your feet, don’t fret.  In the spectrum of disease processes, those that limp into my NYC podiatry office are typically clustered together in the quality of life issue, and are readily treated.  As I am wont to tell my patients: this should be the worst thing that ever happens.

See you in the office.

Ernest Isaacson