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Could be dermatitis. Dermatitis is an umbrella term that encompasses any skin inflammation or irritation. Some dermatitis is genetic, like eczema. Some is environmental, like poison ivy. While dermatitis is not generally a serious condition, it can cause significant discomfort and is quite unsightly.

Signs of dermatitis include reddened, itchy, raised, swollen, or scabby skin. When these symptoms appear on the feet and have no obvious cause (such as walking through a field of poison ivy barefoot) we have to look at other factors such as shoe contact dermatitis.

Shoe contact dermatitis occurs when the foot produces an allergic reaction to a compound or material used in shoe making. Rubber accelerators and rubber glues are common culprits. For leather shoes, chemicals such as dimethyl fumarate, chromates, and formaldehyde (all commonly used to treat leather products) can provoke an outbreak. Another common cause are specialty dyes and metal decorations containing nickel or cobalt.

Now, I know what you’re going to say, “but Doc, I’ve worn these shoes for years and this has never happened before”. Unfortunately, just blaming it on a new pair of shoes doesn’t quite work. Chromates, used in leather tanning, can slowly leach out of the material and onto the foot due to our feet sweating inside the shoes. Materials can wear thin over time, exposing glues and bonding agents that may have been previously covered. And unfortunately, it is not uncommon to suddenly become allergic to something that you used to be fine around.

Treating shoe contact dermatitis and preventing it from returning are relatively easy. Identify and remove the offending pair of shoes from your wardrobe and avoid contact with those materials again. Allergy skin tests can be helpful in determining what specifically you are allergic to. For future shoe buying purposes, go for materials treated naturally (ever heard of vegetable tanned leather?) and think about replace rubber insoles with foam. To take care of your shoes, control your foot perspiration with powders, creams, or good socks and make sure to air out your shoes regularly.

The only caveat to shoe contact dermatitis is that it’s important to rule out more serious possibilities. Jumping to the allergic reaction conclusion could leave you ignoring the possibility of bacterial or fungal infections, undiagnosed psoriasis, or other causes. If you have any question about what is causing that annoying, inflamed, itchy rash on your feet, make an appointment with your podiatrist to be sure.

 

A while back we talked about fungus and the lovely things it can do to your toenails. However, we didn’t talk about what happens when fungus infects our skin. The most common fungal infection of the foot is athlete’s foot or tinea pedis, if you want to sound really smart. Athlete’s foot was first described in a medical text dated 1888, but had probably been around for centuries. The first reported case in the United States was traced back to 1920 and may have been introduced to the US by soldiers returning from WWI.

The tinea fungus is responsible for the condition we know as athlete’s foot and there are a few important things you should know First of all, athlete’s foot is really only skin deep and therefore not generally dangerous (just uncomfortable and unsightly). The fungus enters the keratin, or first layer of skin, usually on the bottom of the foot or between the toes and starts to grow there. Usually, the keratin layer of our skin is being flaked off and replaced by the skin underneath, but the fungi responsible for athlete’s foot slow down this process and so the skin remains in a constant state of infection.

This type of fungal infection is contracted through either direct contact with an infected person or contact with a surface on which the tinea fungus is present. Behaviors that put you at risk for athlete’s foot include walking barefoot in public showers, locker rooms, or swimming pools, sharing socks or shoes with infected people, wearing tight and enclosed shoes, and keeping your feet wet for long periods of time. The easiest way to avoid issues with athlete’s foot is to avoid the above behaviors! Always wear shoes in public showers and around pools (or any wet or moist place where fungus might like to grow) and keep your feet dry and air them out every once in a while if you wear enclosed shoes for long periods of time (like athletes do).

Signs and symptoms of athlete’s foot include a painful, itchy, burning, stinging feeling between the toes or on the sole of your foot, blisters that itch, cracking and peeling skin between the toes, and discolored or thick nails that pull away from the nail bed. You may experience just one of these symptoms or all of them. Cases can range in severity, but are generally easily treatable with over the counter creams and medications. If your athlete’s foot persists or seems healed and then returns, your doctor may prescribe a topical or oral prescription anti-fungal.

Severe cases of athlete’s foot can present with other symptoms. Allergic reactions to the fungus, secondary infections, and infection spreading to the lymph system can occur and require more serious treatment. Diabetics or those with decreased sensitivity need to monitor their feet closely to check for signs of complications and should see their podiatrist immediately for a treatment plan.

Whether mild or severe, no one likes athlete’s foot. If you think you may have athlete’s foot, please contact your doctor to be sure you are not experiencing symptoms of a more serious problem. Keep your feet dry and wear your shoes to the pool. It’s that simple to avoid the itchy, burning, unsightly problem of athlete’s foot.