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reference presentation true The Foot and Ankle Knowledgebase, L.L.C., L.L.C., L.L.C. 2000 en-US Toe Box Dermatitis | Causes and treatment options toe box dermatitis Toe box dermatitis - learn about the symptoms and treatment recommendations - part of the Foot and Ankle Knowledge Base.

Toe Box Dermatitis

-Thursday, 14 January 2021
  • Summary
  • Symptoms
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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 by the rubber, non-breathable toe box construction of certain shoes. Toe box dermatitis is found equally in girls and boys.


  • 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.


Rubber toe boxThe toe box of the shoe is the semi-circle that covers and protects the toes. A rubber toe box contributes to an increase in temperature inside the shoe and inhibits the release of perspiration in the shoe. The increased heat and excessive perspiration creates an inhospitable environment for the skin. 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 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. 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 of this harsh environment, we see peeling and redness in the skin; 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


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 breathe and accept moisture. Consider rotating shoes, wearing them only once every other day. And don't forget open toe sandals that eliminate the issue of toe box dermatitis altogether. Drying agents can help to inhibit moisture. 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, in conjunction with toe box dermatitis, we will see an opportunistic fungal infection of the skin or nail 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 are pending.

Author(s) and date

Dr. Jeffrey OsterThis article was written by medical advisor Jeffrey A. Oster, DPM.

Competing Interests - None

Cite this article as: Oster, Jeffrey. Toe Box Dermatitis.

Most recent Article Update: January 15, 2021.

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

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