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Shoe contact dermatitis

Author: Vanessa Ngan, staff writer

What is shoe contact dermatitis?

Shoe contact dermatitis can be defined as skin manifestations on the feet caused by the wearing of shoes, boots and/or sandals. This often occurs because the skin on the feet reacts to particular substances (allergens) found in footwear.

What causes shoe contact dermatitis?

Contact allergic dermatitis

Many different products and chemicals are used in the manufacture of footwear. Allergy may be due to the chemicals found in the material that the footwear is made from, e.g. leather or rubber, from glues used to hold the shoe together, or from decorations applied to the shoe.

Rubber
  • Rubber accelerators are chemicals used to speed up the manufacturing process of rubber. Nearly all rubber compounds contain rubber accelerators.
  • Rubber box toe shoes/boots are the most common cause of shoe dermatitis
  • Other footwear made with rubber include sneakers, tennis shoes, slippers, boots, jandals/flip-flop sandals
  • Rubber cements are used in joining shoe uppers, the outer leather and linings
Leather
  • Dimethyl fumarate (DMF) is a potent allergen found in sachets found in shoe boxes. It prevents mould growth of leather shoes but in doing so permeates the leather
  • Chromates such as potassium dichromate used in leather tanning can be a problem particularly if the feet perspire as sweat leaches out the chromates
  • Formaldehyde is used in the tanning of white leather shoes in ‘white kid’ and ‘new bucks’
Other causes

What are the symptoms of shoe contact dermatitis?

Shoe contact dermatitis usually begins on the top surface of the big toe and spreads to the upper surfaces of the foot. Dermatitis may also be found on the sole of the foot, the side of the feet and heels and the legs.

Symptoms of contact allergic dermatitis may include swelling, redness, blisters or cracks in the skin, burning, itchiness and pain. The allergy can develop over a long period of time as the skin on the feet is repeatedly exposed to a certain allergen found in the shoe. However, it is not unusual to suddenly become allergic to a substance after months or years of exposure.

How is shoe contact dermatitis diagnosed?

Often shoe contact dermatitis is difficult to diagnose as there are a number of other diagnoses that need to be ruled out. These include:

Diagnosis by performing special allergy tests, i.e. patch tests, may involve testing against a number of different chemicals due to the many potential allergens that may be present in the shoe. Patch testing with portions of the patient’s own shoes, alongside a shoe ‘screening tray’ of common additives and chemicals is essential in making a correct diagnosis.

See individual contact allergens for patch testing recommendations.

What is the treatment for shoe contact dermatitis?

Shoe contact dermatitis should clear rapidly once the offending allergen is removed. This will mean not being able to wear the offending shoes ever again unless the allergen can be removed, e.g. allergy to a nickel buckle could be resolved by replacing with a non-nickel buckle.

Over-the-counter creams and ointments containing mild topical steroids, such as hydrocortisone, may be used to help control itching, swelling, and redness. In more severe cases, a prescription topical steroid may be required, as well as antibiotic medication if the skin becomes blistered, painful and infected.

What should I do to avoid shoe contact dermatitis?

If you suffer from shoe contact dermatitis the best way to prevent any problems is by avoiding all footwear that contains the allergen you are sensitive to.

Some steps you can take to reducing shoe contact dermatitis reactions include:

Your dermatologist may have further specific advice, particularly if you are highly sensitive to particular allergens.

Related information

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