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18. The Condition of the Skin

Covered In This Chapter

In this chapter, I look at reading the condition of the skin on the feet and what it tells us about the health of the body itself. Firstly I look at how toxicity, dehydration, stress and gut health are reflected in the appearance of the skin and what its overall texture tells us about the client’s general health. 

Then what do some of the more common skin conditions tell us more specifically about the health of the areas or individual reflexes on which they appear? There is also a section at the end of the chapter for how and when to work on feet when we see skin conditions.

 N.B. There is some overlap between the content of this chapter and the two following, which cover reading the underlying tissue and marks & freckles. Some things that might be considered skin conditions will be covered in them and not in this one.

Skin Conditions

Skin conditions fall into multiple categories depending on their primary cause. And while it is helpful to be able to recognise the most common ones on the feet (especially if contagious), there is a bewildering variety. They can be due to vascular problems, pathogens, poor nutrition, immune reactions, allergens and irritants, diseases, etc. And they are also exacerbated by many other factors, as covered in more detail below, notably dehydration, stress, gut health, and hormonal fluctuations. 

However, the usual prescriptions of ointments, antibiotics, or steroids will tend to only improve the appearance of the skin’s superficial layers and not address the underlying health issues that caused the condition. Lasting improvements will only be brought about by changes within the body that improve skin health from the deeper layers outwards. 

So when working holistically and as reflexologists, rather than focusing on the medical diagnosis of the cause of a condition, it is much more helpful to consider the kind of defence produced by the body. And it is interesting that many skin conditions, whilst belonging to very different medical categories, actually trigger a similar type of defence, and this is reflected in the appearance of the symptoms on the feet. Furthermore, we can see which reflexes are being attacked by the condition and how badly, so which areas of the body need the greatest support, regardless of the medical category the condition belongs to. 

General Skin Quality

Even if there aren’t any specific medical conditions present that require a diagnosis, it is still essential to look out for poor overall skin quality, as this also indicates a problem in the body. Whether the feet are lined, shiny, sweaty, etc., tells us much about the client’s general health and wellbeing. We can also see if poor skin quality is worse at any specific reflexes to tell us what part(s) of the body have been affected the most

The Skin And Detoxification

Sweat glands and the lymphatic system

As sweat is a detoxifying fluid, the glands in the skin make it the largest organ of excretion in the body, and the soles of the feet have more sweat glands than any other area. As both are fluids of detoxification comprised mainly of water, in reflexology terms, the functioning of the sweat glands in the feet reflects the health of the lymphatic system in the body.  

So the appearance of the skin on the feet, especially the plantar aspect, can be an excellent indicator of how many toxins the body is trying to excrete and how successfully. It can generally show overall lymphatic system issues or reflect a deficiency in the lymph flow at specific areas or at reflexes to certain nodes. I will look at this in greater depth in a section below. (N.B. the opposite, i.e. an excess of lymph building up causes the puffy texture on the dorsal foot, which is covered in the next chapter, ‘Reading Underlying Texture’.)

Stress And Gut Health

It is also important to be aware that the need for detoxification through the skin is always greatly exacerbated by excessive stress and poor gut health. These are why some skin problems come and go and vary in intensity over a person’s lifetime. So, if a client is prone to skin problems, whether they have symptoms at that moment or not, they will always benefit from a course of reflexology focusing on the health of the digestive and nervous systems.

Gut health

Because of the close links between gut health and the skin, it may also be helpful to give basic dietary advice and guide your clients to responsible websites. But as reflexologists, we do not have nutritional qualifications, so be careful not to overstep your professional boundaries. Depending on the extent to which the problem is resolved after your treatments, any changes in eating habits, and/or prescribed medication, you could consider referral to a CNCH registered nutritional therapist.

The client should continue reflexology, however, because it will help to actively heal their gut much quicker than dietary changes alone will. And as they cut back on any aggravating substances, such as alcohol, sugar, and processed foods, it will support their nervous system. This is important because their consumption would undoubtedly have been at least partially in response to stress. (If they cannot afford both therapies, encourage them to return to you as soon as they can financially.)

 Stress – acute and chronic

As an aside, it is important to point out here that stress in itself is not harmful, only excessive amounts. Acute stress can actually be beneficial, as it is the correct response of the mind and body to immediate challenges. For example, triggering the necessary mental and physical reactions to cope with an emergency or deadline. 

However, constantly experiencing acutely stressful situations is harmful if the body has insufficient time to rest and recover. But at least clients are generally aware if they are in a state of repeated acute stress and acknowledge its impact on their health.

What is less acknowledged and more insidious in its effect on the mind and body is long-term background stress. This develops regarding a stressful situation that does not need an immediate response. It causes worries, but ones that can be put to the back of the mind and forgotten about momentarily. 

However, because this stress is ever present in the subconscious, it is still detrimental to the mind and body. But because it is not causing an immediate reaction, many clients can suppress the reality of how much chronic stress affects them. Unfortunately, they will not tell you about it nor attempt to address it in other ways.

Emotional Significance Of Skin

As ever, whilst foot reading, look first for physical reasons for the skin’s condition, especially if you suspect a medical condition may present. 

But after this, consider that aside from poor skin health potentially being a physical manifestation of excessive stress, it has a deeper connection to our emotional and psychological well-being. This is so well acknowledged that there is now a field of medicine known as psychodermatology, which deals exclusively with the connection between the emotional state of the patient and the condition of their skin.

The skin is the barrier between ourselves and the world, so it is a form of protection. But conversely, it is also the organ that provides physical contact with others, so how we feel about it is very relevant to intimacy, whether sexual or not. And in a world that puts ever greater emphasis on the importance of having a youthful and ‘beautiful’ appearance, the appearance of our skin is very much connected with how we feel about others and how we perceive they view us and can often reflect an acceptance of or revulsion with ourselves.

All this is not to say that everyone with good skin is happy. But holistically, when looking at emotional energy, skin conditions are a definite sign of attempts by an individual to expel negative feelings. The sections below look at the emotional significance of many skin conditions and textures. But I could not begin to cover the subject in the way it is done in this fascinating article on spiritual and religious aspects of the skin and skin conditions.

Overall Skin Texture

Dry And Lined Skin


Like all the skin cells in the body, those of the feet shrink if their water content is depleted. So, (aside from the effects of ageing, which I covered in the previous post on Reading Lines) the deeper and more pronounced the lines on the skin, the clearer the evidence of general dehydration in the client (photo 1a. following). The production of sweat to prevent the feet from drying out is even more important than in the rest of the body, as the soles of the feet do not have subcutaneous oil glands to provide a layer of moisture. 

So dry and lined feet are most commonly caused by a deficiency of sweat, which is a result of dehydration. And as I wrote above, this reflects poor hydration in the body generally, showing that the ability to detoxify depends on a healthy fluid intake for the lymphatic system

If the feet are dehydrated, do not simply focus on getting the client to increase their water intake. Instead, make them aware that they can increase hydration by eating more fruit, vegetables and naturally cooked foods. And make sure they know of the dehydrating effect of chemically processed and heavily salted foods and the impact of caffeine, alcohol, and sugary drinks. 

And that smoking, medications, and illegal drugs can also dehydrate the body and, therefore, the skin. Also, not many people are aware of this, but as we talk, we lose moisture from the mouth, which can contribute to dehydration. To check whether a client talks a lot for work, for example, as then it is important to constantly sip water.

Send a text reminding a client whose feet appear very lined to drink more water the day before sessions. This can help avoid side effects, such as headaches and cramping when your treatment stimulates detoxification.

Unfortunately, many clients, especially older ones, may hesitate to drink too much water due to bladder weakness and the fear of not finding a public toilet when leaving their house. Unfortunately, the number of public toilets is decreasing. While this may not seem to be a major problem, it actually contributes to serious health issues in the long term. 

Emotional Significance

Dehydration shows a lack of self-care and self-esteem; the person does not consider themselves worthy of giving themselves what they need to flourish and grow. This is especially true if you point out the need for them to drink more water, but they choose to ignore your advice.

Other reasons for dry skin

However, many other reasons explain why some clients’ feet still look and feel dry, even though they are well hydrated. And why cosmetic lotions will only help temporarily, as although they reduce the loss of surface moisture produced by the sweat glands, they do not address the fundamental causes of the dryness. In these cases, the feet will not be so lined necessarily, but their overall texture is dry.

It can be caused by a problem with the sweat glands due to a medical condition such as hypothyroidism or diabetes. So if there is extreme dryness, a referral to a GP should be considered. But in reflex terms, it shows that the medical condition is affecting the functioning of the lymph glands in the body, especially in the areas that appear the driest, for example, in the heels/groin lymph node reflexes.

Also, poor diet or malabsorption of nutrients can commonly cause a dry skin texture to develop (see next section). Or, it can be dried out by external factors, such as air conditioning, central heating, and exposure to chemicals.

Chalky/Ashy Skin

Quite often, the skin has a dry and slightly chalky appearance. The lines will still be evident if the feet are also dehydrated (photo 1a. following). If they aren’t dehydrated, the skin will appear relatively smooth but still have a chalky texture (photo 1b. following). This texture can be due to a deficiency or malabsorption of various vitamins, or most commonly EFAs (essential fatty acids), affecting skin cells’ healthy growth.

When skin with a higher degree of pigmentation becomes dry, the term ‘ashy skin’ is commonly used rather than chalky, but essentially both refer to the same problem (photo 1c. following). The dead skin cells are simply more visible on darker skin (although some dermatologists believe it may also have a slightly different composition, so be more prone to drying out).

A lack of EFAs can be easily rectified by dietary changes. However, if the client already has a sufficient intake and a healthy diet and lifestyle, then consider poor absorption. In this case, the gut needs support from your treatments, and possibly enzyme supplements may also help, but they are for a nutritional therapist to prescribe.

Emotional Significance

Any problem with poor nutrition shows a lack of self-love and care. Like inadequate hydration, it shows the person fundamentally has low self-esteem and does not consider themselves worthy of the benefits that good food will provide them to grow and flourish. If it is a problem with malabsorption, this shows the person is trying to care for themselves but ultimately rejecting what they need.

photo 1a.

This foot is very lined and clearly dehydrated. It also has a slightly chalky-looking texture to the epidermis, but this may not be as noticeable as the following.

photo 1b.

This foot is not very lined but has a chalky texture, especially noticeable around the lungs, ascending colon, head, and heels/pelvic area. This is typical of a lack or malabsorption of various vitamins or EFAs.

photo 1c.

This foot has a lot more pigmentation in the skin, so the dead cells are much more evident, giving it a very ashy appearance. But essentially, we are looking at the same type of dry skin as in the previous photo, although maybe more developed.

Sweaty Feet

As covered previously, the feet sweat as a natural way to detoxify the body. So if your client sweats a lot for no particular reason, then consider the feet are desperately trying to get rid of toxins that the other organs of excretion cannot cope with. If the feet also smell bad, this is caused by the sweat mixing with bacteria on the skin. Though there are many skin conditions that this can be connected to, ultimately, the reason why the body is susceptible to this involves problems with the balance of gut bacteria, as described in the following section on peeling skin.

If the feet are sweating excessively, it can be due to a medical condition known as primary hyperhidrosis, so if the client has not had a diagnosis for the sweating, then refer them for one. This has a variety of causes, including endocrine imbalances, affecting the nervous system and the adrenal glands. It happens especially during times of significant emotional change and hormonal fluctuations, such as puberty or pregnancy, and holistically it is a sign that the nervous system is overwrought. 

Reflexology can sometimes help the sweat decrease or even dry up during the treatment, especially if it is an anxiety-related medical condition that is causing it. But whatever the cause of the hyperhidrosis, if it eases during the treatment or lessens by the next one, this is undoubtedly a sign that you are helping to balance the body.

It can be challenging to work on the feet when hyperhidrosis is present, but reflexology is greatly beneficial if you can manage it. You could work on the hands, but they are also often affected. It is possible to apply corn starch to absorb the sweat as you work or give the treatment with the client wearing a thin pair of socks. In terms of techniques, working to balance the endocrine and nervous systems is very important. 

Starting to sweat during a treatment

Sometimes the feet begin to sweat during a treatment. This may be a sign of a healing reaction due to reflexology triggering instant detoxification through the skin or an emotional response to something being said. In the upcoming chapter on ‘Other Visible Reactions’ to your treatment, I cover this in more detail.

Emotional Significance

Excessive sweating is connected to great anxiety because of its connection to adrenal gland malfunction. But if a client sweats a lot, it also suggests a desperate attempt to rapidly expel a negative emotion and eliminate something from their lives as quickly as possible.

Shiny Skin

This has a different sheen to that of sweaty feet, as the skin’s surface will appear quite dry. It can be a symptom of various medical conditions such as diabetes and scleroderma. But the generic reason is that there is a restricted blood supply to the feet, reducing the oxygen to the skin cells. This causes them to grow tighter and narrower, giving them a shiny appearance. The circulation-boosting effect of reflexology will help with this.

Thin Papery Skin

The leading cause for this is age, as the cells change and there is less collagen in the dermis. But some medications, typically long-term steroid usage, can also make the skin thinner. In this case, taking bioflavonoids, especially rutin, can help, but they should be prescribed by a medical professional. Thin skin is usually pale with a blue or green tinge as the veins underneath become more evident. 

There is also the condition of loose and saggy skin, but I will cover this in the next chapter, ‘Reading Underlying Texture’.

Skin Conditions At Reflexes

Hard Skin Patches

When localised patches of hard, dry skin are visible, they are not caused by dehydration. While this may also be present, they will show more specific foot conditions. Usually, hard skin is either corn or callous, which has gradually built up to protect against friction in areas subjected to disproportionate weight bearing because of the client’s poor gait. Or where the foot is rubbing against an ill-fitting shoe, but remember, poor footwear itself will cause incorrect gait. 

And/or they can be part of a foot condition known as fat pad atrophy, when the reason for the hard skin developing is the shrinking of the protective subcutaneous fat pads in the soles at either the ball or heel of the foot. This is common with age, especially in women, but can also be connected to poor footwear, athletic activities or medical conditions. Certainly, if the patches of hard skin are painful to walk on, you should refer your client for a medical diagnosis.

So hard skin always indicates where the musculoskeletal system in the foot has been under chronic pressure, and there will be equivalent tension and tightness in the corresponding areas of the body. Thickened, hard skin is also very dry and creates a blockage in the energy flow to and from any spots on which it is found in the feet. 

Depending on the reflexes on which the hard patch is found, it will impact health differently. When it appears on joints such as vertebrae (photo 2a. following), it means there is a reduction in interstitial fluid and, therefore, less cushioning between these joints in the body. This impacts their flexibility, causes friction and possibly contributes to the build-up of osteoarthritis.

Where hard skin is seen on reflexes lined with mucous membranes, such as the lung (photo 2b. following), it indicates dryness and lack of moisture over the area of the membrane on which it has formed. And if the skin is also yellow, then the mucous there has become thick and congested with toxins as a result (as we saw in the chapter on colour).

Tension and tightness in the local joints inhibit the healthy flow of lymphatic fluid. So hard skin at a reflex to lymph nodes, such as at the armpit (photo 3b. following)shows a deficiency in the amount of lymph able to reach them. Likewise, a yellow tone to the skin indicates a build-up of toxins there. (Image 1. following, shows the placement of the lymph system in the body, but it is also good to buy a foot chart showing their anatomical reflexes on the feet.)

image 1.

Treating hard skin patches

Encouraging the client to use a pumice stone on hard skin will help temporarily to improve the flow of energy and also make a fraction more room in the shoes for the feet to align correctly. And, of course, suggesting an improvement in footwear is important, as well as any exercise especially stretching types, to loosen the joints in the body. 

We can also work a lot in our treatments to loosen the feet, which will help improve the misalignment that has made the protective layer of hard skin build upThen there will be more room between the joints for the interstitial fluid, allowing a freer flow of lymph and mucous in the area. After loosening the joints, we should also spend more time stimulating these systems.


Callouses are usually found on the soles or sides of the foot, are generally wider and shallower than corns, and vary in shape. There are a few areas where they are frequently seen, and the most common is over the lung reflexes (photo 2a. following) due to friction over the metatarsals. As explained above, this shows poor moisturisation of the mucous membrane there. If the skin is also yellow, the mucous is thicker and, therefore, harder to expel.

Hard skin also frequently builds up on the medial edge of the hallux, where the toe rubs against the shoe (photos 2b. & 2c. following). In terms of the musculoskeletal system, this means the base of the skull, and depending on how far down it reaches, the top of the cervical spine is affected. In this case, it is a barrier to the energy flow between the mind and the body. Therefore, it is interesting to note that the hard skin affects the area of the brain reflex that corresponds to the cerebellum, which is the lobe responsible for movement and coordination, i.e. putting thought into action. 

photo 2a.

Again there is an extensive area of calloused skin over the metatarsal lung reflexes. It is very yellow, showing that dehydration contributes to the thickening of the mucous.

But there are also pads of hard skin on toes 3 & 4. And a ridge of hard skin running down the centre of the pad of the little toe. See the section below about hard skin on the small toes.

photo 2b.

It is very common to find a callous on the medial edge of the big toe. This is over the cerebellum area of the brain reflex. And also where the bundles of nerves cross over from the left brain to the right body and vice versa. 

In this toe, it also spreads through onto the dorsal toe and affects the mucous membranes of the nasal passages and the mouth.

photo 2c.

The hard skin at the edge of the hallux over the spine reflex shows reduced interstitial fluid in the vertebrae.

It carries on into the chest area, indicating dehydration over this area too. It affects all the reflexes here and the anatomical reflex to the oesophagus. There is also hard skin at the base of the skull in a similar place to that in photo 2b.

As well as having hard skin here, it is very common to see one or both big toes leaning laterally. As we saw in the chapter on reading the toes, this means the client is prone to leaning their head to one side or to one side, then the other. This indicates a thoughtful pose, but the build-up of hard skin (especially if seen on both toes) means it has become a chronic posture associated with those prone to ‘overthinking’. This is a form of anxiety, as it indicates a fear of acting on one’s thoughts and beliefs, which corresponds to the function of the cerebellum. 

The two big toes lying at angles going away from each other also show a divergence in connectivity between the two sides of the brain and, therefore, conflict in thought processing. I will look at this more in the upcoming chapter on left-right balance. But this area of the big toe is also around the reflex area at the base of the brain (just above vertebrae C1.), where the nerve bundles cross from one side of the brain to supply the other side of the body. Because of this, hard, dry skin reflects problems with the balance and harmony between the two sides of the person on all energetic levels: physical, mental, and emotional. 

If the build-up of hard, dry skin also goes into the dorsal aspect of this area over zone 1 of the hallux, it will also affect the face reflexes (photo 2b.); it shows poor lubrication at the membranes of the nose, mouth, and throat. (Again, the hard skin here is frequently seen with a yellow tinge, showing thickening mucous.)

 Video 1. following shows a simple but effective technique to stretch the neck and release the vertebrae to ease the pressure and the blockage. (As ever, be very careful if there are joint conditions.)

Further down the medial edge of the hallux is also very prone to friction with footwear, and hard skin is often seen along some or all of the upper spine reflexes, T1-7 (photo 2c.). In terms of hydration, this indicates reduced interstitial fluid and flexibility between the affected vertebrae. 

This will also impact the individual nerves that exit from the lower vertebrae and, therefore, the organs they supply. Also, consider the hydration of the organs directly in zone 1: the mucous membrane of the oesophagus, especially if there is yellowness present, and the thymus and the thoracic lymph ducts. 

If there are flat patches of hard skin over the pads of the small toes (photo 2a.), it shows potential problems with sinus flow. Or on toes 2 & 3, there can be dry eyes and problems with tear ducts, which is more common these days due to excessive time on digital devices. If the dry pad is over the 4th toe, there may be issues with the inner ear fluid, which amongst other things, can affect balance.

A thin ridge of hardened skin running down the pad of the little toe (photo 2a.) shows the toe is being pushed medially and flattened at an angle under the 4th toe. Over time, the skin ridge builds up along the angle at which the toe lies. When you see this, consider the temporal mandibular joint and the lymph nodes there, as well as the ear’s health, including potential ear wax build-up.

Hard skin over the plantar heel is common, sometimes covering the entire area. In this case, the flow of lymph throughout the whole pelvis is being affected (image 1.)If it is only seen at the medial edge, then it is affecting the groin lymph nodes specifically and possibly lubricating the genitals and/or anal passage.


These are round with a hard centre and are often painfulThey can be seen on the plantar and side edges of the foot, but they also frequently develop where the skin rubs against the shoe at a chronically dorsiflexed toe joint (photo 3b. following). In a previous chapter on toes, we have seen that this shows chronic tension and hunching forward of the shoulder girdle. 

So it is necessary to work by plantarflexing the toe joints to ease the pressure on the joint and, therefore, the effect of the corn on local reflexes. Reflex wise (depending on the toe,) the dryness of the skin means problems with lubrication of the mucous membranes in the mouth affecting the cheeks or the gums, which will impact the teeth, or middle or inner ear/eustachian tube, or poor flow in the tear ducts of the eye.

Corns are also typically seen beneath the shoulder reflex at an area corresponding to the armpit and the axillary lymph nodes reflex (photo 4a. following)Interestingly, they occur here more in women than men, which may be because poor footwear is more of an issue with women. However, they may reflect a problem caused by wearing underwired bras, which restrict the lymph flow throughout the breast. Whenever you see them, pay close attention to the chest lymph node reflexes in both sexes, especially women, because of the density of the breast tissue.

Sometimes corns are seen in zone 2-3-4 on the sciatic loop reflex on the plantar heel (photo 3a. following). This means the sciatic nerve is affected, and maybe even the bend in the sigmoid colon if one is seen on the left heel. The helper reflex to the ovary or testis is also found between these zones on the loop. So a corn here can show problems with hydrating any of these reflexes. 

photo 3a.

There is a very evident corn over the sciatic loop reflex. This place also anatomically corresponds to the lower bend in the sigmoid colon as well as the testis/ovary helper reflex. 

photo 3b.

Toe 2 is dorsiflexing, being pushed upwards by the laterally leaning hallux. This has caused the mid-toe joint to rub against the underside of the shoes. The friction has resulted in a buildup of hard skin which has developed into a corn. The toes need to be plantarflexed, to release tension in the joint and allow proper hydration of the sinus/teeth/eye reflexes. 

Seed corns 

Seed corns are different from regular corns. They are tiny circular dots of hard skin,  sometimes seen at the centre of a regular corn (photo 4a. following), but often seen in multiple numbers spread across the lung or pelvis (plantar heel) reflex (photo 4b. following)They are thought to be caused by blocked sweat ducts in the soles. But as the sweat glands are organs of detoxification, seed corns indicate problems with hydration and detoxification in that reflex area of the body, specifically with lymph fluid. Therefore depending on where they are seen, consider lymph flow, either in the lung and breast or the pelvis.

photo 4a.

The hard skin just beneath the shoulder joint shows poor lymph flow into the axillary nodes of the armpit. Because of its central hard core with a ‘dot,’ it does look quite similar to a verruca. But it looks as if there may be a seed corn at its centre.

photo 4b.

An example of multiple seed corns spread over the plantar heel, and there are even a couple over the descending colon. it is thought that they are found where there is a blockage in the sweat glands in the feet.

Reflex wise this means there is a problem with lymph flow and detoxification over the pelvic area. It is quite usual in the case of seed corns for the surrounding skin to be very dry, as it is here. So the area is generally dehydrated.

Emotional Significance

Hard skin emotionally signifies attempts at building up a shield of self-protection, exactly as it does for the physical body. Its appearance on a reflex indicates that the area of the body is affected by the emotions that the person has tried to protect themselves from. For example, when seen over the lung reflexes, this is very much associated with unprocessed grief and not letting go of the past. 

Whilst shielding oneself may be a natural and correct response to an immediate emotional attack, long term, it leads to contraction and restriction. A hard defensive shell builds up, making it difficult for others with good intentions to break through. Physically the hard skin means toxins cannot be satisfactorily expelled, so emotionally, this means previous bad experiences are not being released. 

Their memories are being held onto out of fear of making themselves vulnerable again. They must be put in the context of the past; otherwise, their toxicity will block healthy emotional energy, and new and existing relationships of whatever type will struggle to flourish.

Encourage the client to remove as much dead skin as possible with a pumice stone. But take note of how they respond to your advice. Whether they take heed of your advice will indicate how much effort they put into self-care and how much they value themselves. But if they are over-enthusiastic, rubbing until the skin is red raw can also give an insight into possible feelings of anger and wanting to attack themselves.

Occasionally, the foot can rub against something other than the shoes. Thickening skin over the area seen here (photo 5a.) is due to the skin rubbing against a carpet and is often seen in parents or carers of young children. It is due to frequently sitting with the feet tucked underneath the buttocks and the dorsal ankle touching the carpet.

In reflex terms, it is over the groin lymph nodes and the fallopian tubes/vas deferens. So this indicates an energy blockage that will affect the energy flow in this body area. And anatomically, sitting in this position for long periods and bending forwards towards the child would compress the lower abdominal area and organs in that part of the body.

photo 5a.


Verrucas are a prevalent cause of the development of hard skin, and they often have a similar appearance to a corn. However, they are not caused by friction but by a virus, and they are contagious, so check with the client before starting your treatment whether a patch of round hard skin is a verruca or not. The significance of verrucas for foot reading has already been covered in depth in a previous theory chapter, but I will briefly go over it here. 

Because they are a virus, I would consider the dryness of a verruca as relating to poor lymph flow to the reflex on which they occur. As they are a long-term condition and notoriously difficult to eliminate, consider a chronic health problem at the reflex. This may be deeply buried and related to a weakness the client has forgotten about or may not even realise they have until other factors cause it to flare up.

Emotional Significance

Verrucas relate to a deep, long-standing issue that the client has tried to bury rather than deal with openly, so has pushed to the back of their mind as much as possible. But regardless, they will still subconsciously impact mental health and physically affect the part of the body connected to the reflex where the verruca is seen.

photo 6a.

These are a cluster of verrucas. In this case, the problem was chronic stress in the mouth area related to a long-standing emotional issue.

photo 6b.

This is a single verruca, but this one is not too dissimilar to the corn in photo 3b. but has a very distinct core. It will impact the lung/chest area and also the heart.

Cracked Skin

This usually occurs when the skin on a callous becomes extremely dry and starts to split. Then pressure bearing down on the feet as these small fissures are walked upon causes them to deepen and form cracks. Sometimes the cracks will open up like wounds, which can become infected

If they appear in the skin for no known reason or are very deep, they can be due to medical conditions such as diabetes and hypothyroidism. In these cases, refer the client for a diagnosis. Or, the extreme dryness can be for nutritional reasons due to a lack (or malabsorption) of Essential Fatty Acids, zinc, and/or various vitamins, including A & D. Whatever the causation, the cracks signify a serious impairment to the functioning of the sweat glands in that part of the feet and, therefore in reflexology terms, the functioning of the lymphatic system.

The most common area where they occur is the edges of the heels, from where they often spread into the soles (photo 7a. following). It is commonly seen in clients whose gait puts too much pressure on the heels, especially if they are overweight, which may be another indication of diabetes or hypothyroidism. The reflexes to the pelvis’s lymph nodes are found on the plantar heels, so they show problems with them.

Another very common position for the skin to crack is beneath the bottom of the ball of the hallux (photo 7b. following)In the previous post on lines, we saw that a stress line often emanates from the spine reflex around T6/7/8 because of downward pressure in the spineWhen this line gets deep and dry enough, the weight bearing and flexing of the joint causes it to split. Depending on the reflexes into which it passes, it can indicate problems with the lubrication of the stomach membrane or the bronchial tube, for example.

Emotional Significance

This is an extreme form of dry skin, so it involves all the emotions associated with that condition but taken further. It is an attempt to build up protection, but the pressure has been too much and caused a breakdown. Consequently, the cracks in the emotional shield leave the person underneath exposed and open, even more, vulnerable than before.

photo 7a.

Cracked skin here shows extreme dryness in the sweat glands, which systemically equate to the reflexes to the lymphatic system in the body. In reflex terms, it relates to very poor flow in the pelvic lymph nodes and is so extreme it may involve a medical condition.

photo 7b.

This crack is caused by a stress line developing due to downward pressure from the head and diaphragm into the vertebrae around T6-7. The stress line goes from the spine across into the bronchial tube area. The extreme dryness will impact breathing and could be due to lung conditions.

Peeling, Flaking Or Scaly Skin

This can be caused by many different foot disorders and needs a medical diagnosis to determine the cause. It is a sign of problems with the reproductive function of the skin cells that the new skin cells do not have the chance to form properly before the older ones start to die. It is often accompanied by inflammation and blistering, which can become infected. (I cover blisters in a section below.) It may also be contagious, so it should not be touched.  


Peeling is most commonly caused by Athlete’s foot, as sweaty, damp footwear provides a good breeding ground for the fungal yeast infection which causes it. It usually starts on the toes but can be seen anywhere on the foot (photos 8a. & 8b. following). It is treated with anti-fungal creams; however, holistically, we need to consider the underlying reasons for the client’s excessive sweating (which I covered in the section above) and the reason for the fungal growth. 

The fungus is associated with candidiasis, an overgrowth of the bacteria candidaIn any problem with bacteria, we need to consider gut health, and candida flourishes when the diet is poor, particularly including a lot of sugar and processed foods. Candidiasis can cause significant problems with digestion and really needs a dietary overhaul.


The other most common skin disorders that cause peeling and flaking skin are psoriasis and eczema, which are generally thought to be related to auto-immune responses. Whatever the reason for the peeling skin, as the condition deteriorates, other symptoms can develop, typically itchiness, then inflammation, and pustules. I look at these in a section further down.

Skin shedding

This is when whole sheaths of the top layer of the skin peel off as one, and the skin underneath appears healthy and fresh (photo 8c. following). There is a difference with a fungal infection when the skin beneath is not fully developed. It is easy to confuse this with a fungal infection, though, so do not diagnose it.

Emotional Significance

Peeling deals with the issue of skin renewal, so it is emotionally connected to how the person is adapting to challenges from the outside world. Because the skin layer is developing and shedding too quickly, the new skin underneath is not fully developed and is not ready to be exposed. It shows that the person has to change too fast; they can’t cope with life changes, and they feel exposed and vulnerable. If it is associated with an auto-immune disorder, consider why the client is attacking themselves.

However, when the skin underneath is healthy, it can be a good sign, associated with rebirth or new life, a shedding of one’s old skin in preparation to move forward into a new phase. 

photo 8a.

This shows the fungal skin of Athlete’s foot in an early stage. It is starting to develop over the ball of the hallux in zone 1. But in zone 2, it has deteriorated further and started to peel.

photo 8b.

This foot shows fungal skin on and between the toes in a later stage. The underlying skin is red and not fully developed. It is exposed by the peeling of the top layer of the skin.

photo 8c.

The skin here is peeling in sheets. The new skin underneath has quite a healthy appearance, so it may be shedding naturally and not be due to a fungal infection.

Blisters And Lesions

The leading cause of blisters is the skin’s acute response to friction from new/ill-fitting footwear. The skin becomes inflamed, and the area beneath the epidermis fills with lymph to form a protective cushion and prevent infectionOf course, there is a connection with the lymphatic system in the body; ill-fitting footwear and the discomfort of the blister will cause short-term difficulties with walking. This corresponds to the fact that blisters at a reflex show that the corresponding area of the musculoskeletal system in the body has just been under acute pressure. But the condition is due to a healthy response, and blisters usually heal quickly without any long-term impact. 

But sometimes, an area may be prone to repeated blisters, giving the skin underneath the appearance that it has been rubbed red raw. Like hard skin, this is often caused by constant friction from uneven weight bearing on the area due to poor gait. But in this case, the shoe is also a little loose, causing constant movement of the foot against it rather than being squeezed because the shoes are too tight. 

Red raw skin is often seen over zone 1 on the ball of the hallux (photo 9a. following), where it affects all the reflexes found in this part of the chest. And on the Achilles tendon, which in reflex terms means there is tightness in the muscles of the lower back, putting pressure on the sciatic nerve (photo 9 b. following)And on the lateral edge of the little toe (photo 9c. following), which tells us that there is pressure on the outer ear/jaw (TM Joint). This pressure will cause tension in the lateral neck, continuing down the trapezius muscle into the shoulder joint and, inevitably, into the arm

Blood blisters 

These are due to a break in a blood vessel near the skin surface due to pinching or squeezing, and like blisters, they tend to heal quickly. They also show there has recently been acute pressure on the corresponding part of the body to the reflex on which they are found, but one that has impacted the cardiovascular system. 

Emotional Significance

Blisters always appear on inflamed skin, which, as we have seen previously, shows the presence of irritation and anger. They show the person is getting angry about something, causing friction in their lives, and the situation has become too much to internalise. They are trying to put up a protective layer to cushion the emotion, but underneath, the anger is still there, and the feeling is very raw. 

When the problem happens repeatedly, the skin eventually sometimes builds up a thicker layer of skin, but this will still be very inflamed. It shows the anger has not subsided despite the protective layer. And if blisters continue to appear on top of this (photo 9b. following), the person is still reacting with hurt and anger despite their attempts to cover up their emotions. 

So these emotions particularly affect the health of the reflexes on which they appear. When it is over the ball of the hallux, it shows that the person is constantly trying to get something they are angry about off their chest. On the Achilles tendon, it relates to the lower back, so to anger about lack of support, especially from family. And at the little toe, it shows tension in the jaw hinge and gritting one’s teeth, so angry defensiveness about what the person hears and speaking their mind. And as tension here also affects the shoulder joint, it will go down into the arm. Here is associated with frustration about not using the arm and hand to act on one’s thoughts, whether the desire is to reach out to touch and hug or lash out to hit. Or the frustration can be due to the repression of creative energy, which would require using one’s hands.

photo 9a.

Here, on the ball of the right hallux, repeated friction has caused a callous to form with a yellowish tinge to the skin. So there are toxic emotions involved, but a protective layer has developed. But on the left hallux, the skin still looks raw, open and inflamed. 

photo 9b.

There are blisters on both Achilles’ tendons, and from the redness of the skin around them, we can see this is a recurring problem. They relate to long-term problems with the lower spine and pelvic alignment. Emotionally it relates to issues with support from those close to the person.

photo 9c.

Blisters and raw red skin on the little toe show there are repeated issues with tension in the jaw and shoulder. This tension will inevitably be carried on down the arm.


Pustules are blisters where the lymph becomes pus, a mixture of infected cells and dead white blood cells. They can be a reaction to an external threat, such as contact with harmful chemicals or bacteria that have entered small fissures in a blister. In these situations, as long as the pustules clear up the threat effectively and heal properly, they are a healthy response. 

But sometimes, multiple pustules develop and do not heal quickly. This can be symptomatic of various skin conditions resulting from internal or external attacks on the body. The specific type of attack on the body that caused it to respond this way will vary depending on other factors, such as the individual’s weaknesses, genetic makeup, lifestyle, etc. 

But because the body’s method of defence – the production of pustules with underlying inflammation – is the same, all these conditions tend to have a similar appearance, even when caused by very different things (photos 10a. 10b. & 10c. following)The common denominator in all cases is that the immune system is under attack and struggling to cope, which will happen when the person suffers from elevated stress or becomes rundown. And this is why some conditions frequently lay dormant for long periods until triggered when the person is under high levels of pressure.

The skin conditions that multiple pustules are symptomatic of can be caused by an allergic reaction, often to multiple substances at once or something that should be harmless. This is thought to be the case with the auto-immune disorders psoriasis and eczema, which cause the body to attack the skin by mistake. Or they can develop in response to an internal viral attack on the body, which on the feet in adults would most commonly be shinglesThey can also be produced in response to ectopic pathogens, notably advanced cases of Athlete’s foot.

Depending on the nature of the condition, you may need to work on the hand or avoid areas of the foot. But however you treat, it is important to work the nervous system for stress, the lymphatic system, and the organs of detoxification. Of course, it is also very important to work the adrenal glands for stress levels, but this is especially true if the skin is itchy and/or known allergens are involved in the condition. Working on the adrenal reflexes will help to balance elevated histamine levels that cause this. Leaky gut syndrome is one of the main reasons for elevated histamine levels, so also work on reflexes for that. 

Aside from this, the health of any reflexes on which the pustules are found is particularly impacted, so bear this in mind if you need to work on the hands. And note where the pustules were sited for when the skin has healed, and you can work freely on the feet to help prevent repeat attacks


While not typically producing pustules, hives (urticaria) are a typical auto-allergic response with thickened skin, inflammation, and itchiness due to elevated histamine and high-stress levels. So consider working them in the same way as pustules.


Ulcers are symptomatic of various health conditions, notably diabetes, and occur when the tissue beneath the skin has started to break down. If you have clients who are diabetic, you should be aware of the recommended guidelines of your professional association regarding treatments. It is important to keep an eye out on the feet of a diabetic client for any cuts or lesions in the skin that could become infected and ulcerous. But the benefits to the circulation from regular reflexology can help prevent ulcers from forming. 

Emotional Significance

Infected blisters show that the person’s attempts to protect themselves from what they perceive as emotional attacks have not succeeded, and the situation has become completely toxic. The redness in the skin around them shows irritation and anger. 

When the condition is itchy, the person is frustrated, blaming themselves for not coping with the situation and starting to turn on themselves. They also attack themselves when the condition is part of an auto-immune response, so consider self-loathing on some level. If a lesion deteriorates to where it becomes an ulcer, the situation has started to eat away at the person very deeply.

photo 10a.

This is the early stage of pustular psoriasis. Psoriasis is thought to be an auto-immune reaction with multiple potential triggers.

photo 10b.

This is pompholyx eczema. It is hard to tell the difference between this and psoriasis. But eczema tends to cause greater itchiness. There are several types of eczema and their causes are uncertain, although they are also likely to be a type of autoimmune disease. 

photo 10c.

This is shingles and is highly contagious. You would not work on the client at all. The skin’s reaction is still very similar to that in the previous photos, despite being the result of a virus.

Webbed Toes

It is not uncommon to have toes joined together by webs of skin, and they are occasionally part of a medical condition. But usually, they are a harmless genetic abnormality, and because they are something the client has been born with, the body will likely be perfectly well adjusted to them. It is a good idea to pay extra attention to the area’s reflexes, just in case the webbing is causing a problem with them. Sometimes the skin is operated on to separate the toes if they are causing a restriction to balance and movement or for aesthetic reasons. 


After trauma to the foot, skin that regrows over scar tissue will have a different texture and often has different pigmentation. It is important to look out for scarring because, as we know, it is remarkable what clients will forget to tell you aboutSometimes it will be obvious such as after bunion operations, but other times the scar may be very small and easy to miss (photo 11a. following)If the operation or injury is recent, the colour of the scar will be darker as the tissue is still inflamed. Over time it should return to the same shade as the surrounding skin, except for keloid scars.

Wherever there is scarring, it reflects trauma to the musculoskeletal and nerve reflexes on which it appears and therefore has had the equivalent impact on those areas of the body. Bunion operations, for example, will affect the flexibility of the thoracic spine, thyroid function, etc. (photo 11b. following), and local circulation.

The density of the scar tissue left after the trauma permanently impedes the local circulation of blood and lymph. So if the trauma is recent, it is really important to work around the area while the skin is healing as soon as possible. This will speed recovery and help keep scar tissue to a minimum.  

But even if the trauma was not recent, it is worthwhile to work around the scar tissue to help local lymph and blood flow through the reflexes. The other thing to focus on is keeping the muscles and tendons as flexible as possible to prevent further deterioration, such as arthritis setting into the affected joints

(Use caution and common sense regarding when to start working on the foot while scarring is forming. Ensure your hands are sanitised and work gently around a small minor wound; otherwise, until the skin has closed over, you will need to work on the corresponding hand to that foot.) 

Besides those scars caused by trauma to the foot itself, it is fascinating to note that sometimes there will be a scar-like appearance on the skin at a reflex where there was an operation in the body. We have seen scar lines in a previous post, but this is a small area of differently textured skin where the client has not had any trauma to the foot itself but is on the direct reflex site of scarring in the body.

Emotional Significance

Accidents are a sign of mind-body disconnection, which I covered in the last chapter under bruising. So if the scar results from an accident, it is helpful to know what was happening to the person emotionally at the time, especially in recent times. But whatever the cause, scars are a sign of trauma at some point in the person’s life, and they will be a constant reminder, especially if they are visible. 

But what is most important is how well the scar has healed or is healing, as this indicates how well the person has recovered from the trauma. The thickness of the scar will depend on the wound’s deepness, but the amount of scar tissue beneath the surface reflects how much they have tried to bury the memory of the trauma. 

photo 11a.

These scars on the hallux are from a bunion operation and have healed well. However, scars always indicate there has been trauma at the reflex. And a joint that has been operated on will not be very flexible, so it will benefit from gentle massaging and stretching to help keep it from becoming arthritic and keep the reflex areas in the body from stiffening.

photo 11b.

This is on a finger but is typical of the kind of tiny scar it is easy to miss on a foot. It may have formed as a result of something that happened to the foot, but also, sometimes, this type of change in skin texture is seen at reflexes where there was an operation in the body.

Visible Skin Conditions

Ultimately, it is always the therapist’s decision whether they are happy to give a treatment. Still, it is very useful to familiarise yourself with common infectious conditions to make an informed decision and to avoid touching contagious skin. This website provides a good guide for reference. But as a general guide, don’t work anywhere the epidermis is broken, there is pain, flaking, itching, oozing or a rash. Refer the client for a medical diagnosis if they have not yet had one. 

If you choose to work with clients with infectious skin conditions, small areas such as verrucas can be covered with hypoallergenic plasters and worked around (never on). You can wear non-latex surgical gloves and always use an antibacterial/viral hand wash. Otherwise, work on the area on the opposite aspect of the foot or the hands for part or even all of the treatment if the condition is widespread.

Feet Reading Assessment

photo 14a.


The ankles are a good hip-width apart, but the feet are being held too medially upright. If relaxed, they would roll outwards more to approximately 11 and 1 o’clock angles. This indicates tension in the hips is keeping the legs upright at 12 o’clock. 

We can decide whether this tension is temporary or chronic by seeing how easily the client can relax their knees and let their legs roll outwards. And also by reading other things on the feet, e.g. lines and skin, which I do further down. 


The shape of the two feet is quite different. The longitudinal arch of the left foot is longer and more curved, and the right foot may appear smallerBut in actual fact, the reason for this (although it’s not clear from the photo) is that the right arch is higher, so this foot is foreshortened, appearing shorter. The different shapes of the longitudinal arches and the highness of the right arch would be more evident in real life. But even from the photo, we can see the contrast in the curvature between the two sides of the spine. This can cause back problems as well as balance issues.

The width of the metatarsal area/chest & lung reflex area is slightly narrower on the left foot. The cuboid bones, especially the left, are quite pronounced, so there may be knee problems, and the tension in the hips may be connected to them, so it is likely chronic rather than temporary.

The left foot is further away from us on the couch than the right, indicating a horizontal pelvic tilt. This could be because the left leg is shorter. Or it may be caused by poor posture, constantly leaning to one side when sitting, for example. Either way, it may result in lower back problems.


The neck of the right hallux is straight up until the distal joint, but then the toe leans too laterally. So the neck is straight, but the head is prone to leaning down on this side. However, all of the left hallux is leaning laterally, so both the neck and the head are prone to leaning down on this side into the shoulder. These postural misalignments may be causing neck problems. 

The two ear reflex toes on the right foot are completely squashed down into zones 4-5 of the shoulder/clavicle. There may well be ear or shoulder problems, including the inner ear. Tension around the shoulder joint will inevitably go down the arm as well.


There are a lot of short but pronounced stress lines over the left lung/chest area. They are particularly noticeable over zones 4-5 and go up towards the left eye reflexes and even into the little toe. They may be due to some form of pressure here because the left metatarsal area is narrower than the right foot.

Stress lines exit from the mid-spine and cut across the right kidney reflex, forming a ripple-like effect. There are also deep lines across the left kidney, but the vertical line running up the left ureter into kidney zone 2 is unusual and maybe a ‘connector’ line. This kidney is under a lot of pressure as both horizontal and vertical stress lines are present.

Stress lines are coming from both hip reflexes, which would be another indication of chronic pelvic tension. On the right, they continue to the ileocecal valve/start of the ascending colon, on the left around the sigmoid flexure, and then across the small intestines. 

Because these stress lines start in the hips, tension contributes to digestive issues. At both of the small intestine reflexes, there is a ‘pitting’ type texture caused by many deep parallel lines crossing, so there may be a history of pathogenic overgrowth there


The core kidney area on both feet is very pale, with a bluish tinge on the left foot and a bluish-green tinge on the right. This shows poor oxygenation of the blood supplying these organs, as well as some toxicity on the left, and gives further concern for kidney health. 

There is a lot of redness on the feet, so there is a lot of inflammation in the tissues. The lateral zones of the right lung and zone 5 of the digestive area are particularly affected as they are crimson. But it is even more intense over the soles of both heels, which look almost brown, meaning it is chronic and stagnated. The pads of the toes are also inflamed in contrast to their necks, which, where visible, are pale. So there is also a lot of inflammation in the head. 


There is dry chalky skin over the left lung region particularly, so there is dryness in the mucosal membrane of this lung, along with multiple stress lines showing compression. 

There is a strip of dry skin over the medial edge of both of the heels (more evident on the left). So there is a problem with hydration and lymph flow at the reflexes of the groin. The friction that caused the hard skin to build up here is due to poor gait. Therefore, as the movement of the groin and the hips are directly connected, this further indicates that the tension in the hip muscles is chronic rather than temporary.

Repeat of photo 12a. for ease of study


The difference in the shape of the two feet shows an emotional conflict between past and present and an alteration in her way of thinking associated with the time when the change in the shape of the feet occurred. The other thing that strikes me is that because of the overly medial presentation, the feet are not relaxed and open, but holding on, not letting go. This shows an attempt at control, including defensiveness and standing her ground. 

Tension in the hips affects all the pelvis area and also goes down into the legs, so it is related to hesitancy or fear of moving forward. The pelvis and lower spine support the rest of the body and are connected to home and family. The hard skin in the groin area also shows an attempt at defence and protection related to gynaecological history, sexual matters, or sexuality. 

The heels are very inflamed, so there is a lot of anger around the situation with home/family, and it is dark, so quite stagnant, which means it is a long-term issue. And the stress from her hips is going straight into her intestines, impacting her ability to nourish and care for herself. 

There is a lot of red, inflamed skin generally over the outer areas of the foot, with a pale core with a greenish tinge on one foot. This shows an excess of energy in the form of anger directed externally, leading to a deficiency of energy going to the inner self. So there is an issue with denial of self, related to sadness connected to envy. 

The whiteness over the necks of the toes shows a lack of energy in the throat and mouth, so she is not expressing herself properly or speaking her mind. And the compression of the left ear down into the shoulder shows there is something that she really does not want to hear. The tension from this will extend into the shoulder joint means she is trying not to physically act on it, whether that means withholding affection or lashing out. 

But the redness from these toes continues into zone 4-5 over the lung/chest area. This means anger affects her ability to breathe freely and move on. The dry skin over the left lung shows grief which she has not yet acknowledged, but the stress lines over the area show it still affects her.

This is the Q&A section, so please go ahead and comment on this chapter if you wish. If you want to ask me something privately so only I can view it, make a note and I will not make it visible to others. 

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