As the largest organ in (or on) our bodies, our skin endures more
physical damage than
any other organ. UV light, blunt trauma, chemicals, dryness and dampness; the
skin is phenomenal in its’ ability to accommodate change. One of the harshest
environments encountered by the skin is the environment we create by wearing
enclosed shoes. And the worst culprit is a portion of the shoe called the toe box.
The toe box of the shoe is the semi-circle that covers and protects the toes.
Remember those cute little red and white sneakers that your mom got you when you
just started to walk? Remember how they had that white rubber toe? That’s the
toe box. But consider what a rubber toe box like that can do to your skin. 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 a
terrible 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 usde 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.
Treatment of toe box dermatitis
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
like Onox 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.
