The chief causes here are the thermoplastic or rubber-boxed toes, and the cements and dichromates used in tanning. Dyes, anti-mildew agents, formaldehyde and nickel eyelets or nickel in arch supports also can cause dermatitis. A waterproofing silicone spray externally applied has also been the cause. The dermatitis usually begins on the dorsa of the big toe and spreads to the dorsa of the foot. Atopic children will often show a similar dermatitis which, however, will have negative results on patch-tests to shoe ingredients. Sox washed in Bold or bleached with a strong whitener can also cause dermatitis.
Safe sneakers are Converse (Official Boy Scout-Sears), although you must rip out the rubber insole and replace it with the "Vy-Foam" (urethane foam) insole (Dr. Scholl). weejuns (Bass) have no accelerator in them.
While a patient with a shoe dermatitis is being evaluated, he should wear sandals or unlined cloth or plastic shoes, which are inexpensive and generally safe. Unlined moccasins also are fairly safe (L.L. Bean deer hide). If the rubber-box toe is the cause, the Celastic box toe (Celastic Box Toe Company, Kearney, N.D.) may be the answer. Otherwise for men, Johnson & Murphy, French Shriner & Urner and Stacy Adams make excellent shoes. For boys and girls, Gerberich- Payne shoes contain the Celastic box toe, and "Little Yankee" makes a nice shoe for boys.
Weejuns (Bass) are tanned with chromate though often successfully worn. Dermapedic shoes are all vegetable tanned, and their glues are vegetable based. They make men's and boys' boots and shoes. Plastic-molded sandals for women may be obtained from Sandak. Kinney plastic shoes are available in the Northeast. The Musebeck-Foot-So-Port Shoe Co. (Oconomowoc, Wisconsin) makes a kit and has a catalog which they will send to any physician requesting it.
Occasionally wearing down the heel pad or lining will expose adhesive which will cause dermatitis. A felt insole and use of fish glue will assist this. Doctor Fisher says Celastic box toe shoes do not contain any phenolic or rubber adhesive (ref).
Formaldehyde is used in the tanning of white leather shoes in "elk," "white kid" and "new bucks." Tannins obtained from trees are used to tan leather (vegetable tanning) and do not cause dermatitis. However, if the shoe is made of vegetable-tanned leather, the lining should not be chrome- tanned.
Dyes are not often the cause of footwear dermatitis unless the shoe has been re-dyed (ref).
Management of Hyperhidrosis
Sweat leaches out chromates from the leather, so controlling perspiration is essential. Zeasorb Powder (Stiefel) and Dr. Scholl's foot granules in a soap are excellent for reducing some of this. Wearing Surgitube under the sock and then throwing it away is helpful, too, and the old-fashioned foot soaking in a teaspoon of formaldehyde in a pint of water occasionally helps. The astringency of Burow's solution soaks is helpful.
This document is a resource from the
Internet Dermatology Society
Send your comments to:
Rhett Drugge, M.D.
Last update: February 2, 1997