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Toe Box Dermatitis

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Summary

Toe box dermatitis is a form of dermatitis common in children, caused by extreme temperature and moisture found within the toe box of the shoe.  Toe box dermatitis is primarily caused rubber, non-breathable toe box construction of some shoes. Toe box dermatitis is found equally between girls and boys.

Symptoms

  • Peeling and flaking of the skin of all toes
  • Occasional ingrown nails due to swelling of the toes
  • Redness of the skin is common.  No bruising is found.

Description

Rubber toe boxThe toe box of the shoe is the semi-circle that covers and protects the toes. The rubber toe box prevents the release of perspiration. The rubber toe box also contributes to an increase of the temperature inside the shoe.  This contributes to excessive perspiration and creates an inhospitable environment for the skin. So we grew up and grew out of the rubber sneakers, but guess what? Most shoes have a toe box to stiffen the shoe and promote the durability of the shoes. As a result we see toe box problems in a host of other shoes including work boots (especially safety shoes), clogs, oxfords and others. Simply reach into the shoe and feel for the materials that make up the toe box.

Dermatitis is a generic term used to describe any condition that exhibits inflammation of the skin. The environment in a shoe is pretty harsh, but when you manufacture the shoe with materials that can’t vent moisture, dermatitis is bound to occur. Toe box dermatitis is the term used to describe the skin reaction that takes place as a result of an enclosed or rubber toe box.  But toe box dermatitis can occur at any age. Toe box dermatitis is simply the result of the contrast found when wearing a shoe (sweaty and hot) compared to being barefoot (cool and dry). As a result we see peeling and redness in the skin or what we call dermatitis.

Causes and contributing factors

Contributing factors for toe box dermatitis include synthetic material used in the manufacturing of shoes.

Differential diagnosis

The differential diagnosis for toe box dermatitis includes;

Athlete's foot
Dermatophytosis
Onychomycosis

Treatment

The most important aspect of treating toe box dermatitis is prevention. Avoid shoes with synthetic materials that trap moisture. Wear canvas or leather materials that will breath and accept moisture. Consider rotating shoes, wearing them only once every other day. And don't forget open toe sandals.  Drying agents can help to inhibit moisture. And lastly, frequent changes of socks will always help to wick away moisture, keeping the feet cool and dry.  Most cases of toe box dermatitis clear with these simple methods of care.  Occasionally we will see an opportunistic fungal infection of the foot that can be controlled with antifungal soap or antifungal cream.

When to contact your doctor

Toe box dermatitis that fails to respond to conservative care should be evaluated by your podiatrist.

References

References are pending.

Author(s) and date

Dr. Jeffrey OsterThis article was written by Myfootshop.com medical director Jeffrey A. Oster, DPM.  

Competing Interests - None

Peer Reviewed - This article is peer reviewed by an open source editorial board.  Your comments and suggestions to improve this paper are appreciated.

Cite this article as: Oster, Jeffrey. Toe Box Dermatitis.  http://www.myfootshop.com/article/toe-box-dermatitis

First published online: January 1, 2000.  Most recently updated 12/4/13.
 

Creative Commons License  Toe Box Dermatitis by Myfootshop.com is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License.

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