Shoe contact dermatitis

Shoe contact dermatitis can be defined as an allergic reaction to shoes or other footwear. This often occurs because the skin on the feet reacts to particular substances (allergens) found in footwear, such as leather or rubber, glues or decorative substances.

The condition 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
These 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.

Diagnosis of the condition is usually through the use of special allergy tests, i.e. patch tests, that involve testing against a number of different chemicals. 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.

Treatment
Shoe contact dermatitis should clear rapidly once the offending allergen is identified and removed. Until this happens, 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.