09/18/2012 09:11 am ET Updated Nov 18, 2012

Are Foot Tattoos Sexy?

In my reconstructive foot surgery practice, I have seen my share of foot tattoos. Some foot tats are small and discreet, others are large and obvious. Women are usually the ones with the foot ink, not men. Popular seems to be names, vegetation (flowers and vines), stars and oriental wording. Sometimes an elaborate ankle tattoo will extend onto the foot. People have even tattooed the bottom of the foot. Celebrities have been known to get foot tattoos as well.

Some women consider the foot tattoo the ultimate shoe accessory as they continue their hunt for the perfect shoe. Many say they are just plain sexy. Others regret them and want them removed. Wacky and bad taste tats also find their way onto the foot.

There are medical reasons to get tattoos on the foot as some use the ink to detract attention from structural foot problems -- such as bunions and hammer toes (...that's one way to put off surgery). People with flat feet can give the appearance of having an arch by inking concave designs on the inside of the foot. A common tattoo for people with webbed toes is to get a line drawn between the toes.

Sexy??? Perhaps the foot is better off without a tattoo? Nonetheless, that's for you to decide. We would like to hear your thoughts and experience with foot tattoos...

Here are 5 things to strongly consider when planning on getting foot tattoos:

1. They can get tremendous wear and tear.

Shoes cause a lot of friction on the skin of the foot, and this can lead to excessive wearing of the tattoo. Over time, this could result in premature fading and disfiguration of the artwork. For this reason alone, some tattoo artists refuse to place tattoos on the feet.

2. Pain. Pain. Pain

The foot has a lot of nerve endings! The bottom of the foot is particular sensate. The borders of the feet can also be quite sensitive as the skin transitions to the skin on the bottom. Foot tattoos can be more painful to place because there is not a lot of subcutaneous fat or muscle, and people could feel things more. Of course, everyone's pain threshold is different as well as the amount of fat tissue on their feet, but still something to consider.

3. Difficult short-term aftercare

It is well known that tattoo aftercare is surrounded by keeping the skin moisturized and clean, to avoid both scarring and infection. As such, this could be a challenge as one needs to wear shoe gear during the few weeks it takes for a foot tattoo to heal. Also, before getting a foot tattoo, make sure that you don't have a fungal infection hiding between the toes as bacteria can fester in these areas.

4. Removal can be difficult.

There are several methods to remove tattoos -- common methods involve laser, excision or dermabrasion. Laser removal is popular but can be a challenge on the foot because there is not a lot of fat, and can make the removal process more involved. As such, try to avoid placing a tattoo directly over bone -- like on the bunion region. Excision is popular for small tats on the top of the foot.

5. Consider future foot surgery.

If you wear high heels and pointy-toed shoes often, then you may develop bunions and hammer toes, so you should consider that you may undergo surgery for this at some point in your life. As such, your tattoo can get intersected by surgical incisions and could become malaligned. Fortunately, bunionplasty and plastic surgery techniques can minimize this occurrence. Areas where incisions are typically placed are located directly on the tops of the toes, on the inside of the big toe, and behind the 3rd and 4th toe.

What do you think about a foot tattoo?

-- Dr. Blitz

To learn more about Dr. Neal Blitz, please visit