What are the other Names for this Condition? (Also known as/Synonyms)

• Foot Dermatitis
• Footwear Dermatitis
• Shoe Allergic Contact Dermatitis

What is Shoe Contact Dermatitis? (Definition/Background Information)

• Shoe Contact Dermatitis is a skin condition that develops from contact of the skin with any type of footwear, such as shoes, slippers, or sandals, due to an allergic reaction with the material (rubber or leather), chemicals, and dyes used in the footwear
• Contact dermatitis is a condition characterized by skin inflammation that occurs when the skin comes in direct contact with substances that cause irritation or allergy to the skin. Both children and adults may be affected by Shoe Contact Dermatitis
• The treatment of Shoe Contact Dermatitis involves a complete avoidance of the causative agent, and the use of topical creams, as necessary. In many cases, the condition is known to resolve without any complications, and the prognosis is generally excellent

Who gets Shoe Contact Dermatitis? (Age and Sex Distribution)

• Shoe Contact Dermatitis may be observed in both children and adults
• Both males and females are affected
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Shoe Contact Dermatitis? (Predisposing Factors)

The risk factors for Shoe Contact Dermatitis may include:

• Shoe or sandal material such as rubber, leather, resin, etc.
• Adhesives and glues used in the footwear
• Chemical compounds such as rubber accelerators, formaldehyde, and chromium compounds (used in tanning leather)
• Chemicals used in shoes/sandals “packing boxes” to keep them dry and fungus-free
• Natural or synthetic dyes
• Accessories and decoration materials on footwear such as metal buckles

According to medical literature, rubber boots are the most common footwear causing Shoe Contact Dermatitis.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Shoe Contact Dermatitis? (Etiology)

• Shoe Contact Dermatitis is caused from skin contact with the footwear one wears or uses. These may include shoes, sandals, sneakers, flipflops, and boots, among others. It is also known as Footwear Dermatitis
• It is a form of allergic contact dermatitis that occurs when an allergic substance in the shoes/slippers activates an immune reaction in the skin

What are the Signs and Symptoms of Shoe Contact Dermatitis?

The signs and symptoms of Shoe Contact Dermatitis may vary from one individual to another. The manifestation of symptoms may be within a few hours of exposure to the material, or it may be noted after a few days to weeks.

The signs and symptoms may include:

• Skin redness and blister formation
• The blisters may crack and ooze discharge
• Pain, itching, burning sensation, and discomfort
• It may be difficult to walk wearing the shoes or sandals
• The affected areas may include the top, sides, or soles of the feet, including the ankles and heels
• Depending on the footwear type, even the lower leg may be involved
• Sweating, hot-wet weather, wet work environments may aggravate the condition

How is Shoe Contact Dermatitis Diagnosed?

A diagnosis of Shoe Contact Dermatitis may involve the following exams and procedures. However, according to healthcare providers, the condition may be difficult to diagnose.

• Physical examination of the individual and medical history evaluation
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin patch test for allergy
• Skin biopsy, if necessary: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis may be considered to eliminate conditions presenting similar signs and symptoms such as the following:

• Allergic contact dermatitis due to other factors such as socks, perfumes, creams, etc.
• Atopic dermatitis
• Bacterial infection
• Fungal infection such as athlete's foot
• Irritant contact dermatitis affecting the feet due to other factors
• Juvenile plantar dermatosis
• Lichen planus
• Pompholyx
• Psoriasis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Shoe Contact Dermatitis?

The possible complications due to Shoe Contact Dermatitis include:

• Emotional stress due to cosmetic issues
• Superimposed bacterial and fungal skin infections at the involved site
• Difficulty in wearing footwear for a period of time
• Recurrence of the condition following treatment
• Treatment complications

How is Shoe Contact Dermatitis Treated?

The treatment measures available for Shoe Contact Dermatitis include:

• Avoiding exposure or contact with the offending footwear material (once identified), can help resolve the condition quickly
• Sandals without socks leads to direct contact of the skin to the causative chemical. In shoes, keeping the shoes/boots dry, and keeping the feet dry with powder and frequent sock changes, sometimes makes a change of footwear unnecessary
• Use of mild to moderate topical steroids for improving the symptoms
• Oral antibiotics for bacterial infections, particularly if blisters crack and get infected
• Treatment or suppression of fungal and yeast infections with suitable powders, sprays, or creams

How can Shoe Contact Dermatitis be Prevented?

It is important to identify the causative irritant or allergic substance present in the footwear, where possible. Once identified, avoiding the shoes or sandals that contain the offending substance can help prevent Shoe Contact Dermatitis.

In case it is difficult to identify such an allergic substance present in the footwear, then the following measures may be taken to reduce one’s risk for Shoe Contact Dermatitis:

• Use footwear that is made from natural materials including natural chemicals such as vegetable dyes
• For excessive sweating, the use of antiperspirants is recommended
• Avoid keeping shoes packed in boxes, rather prefer to keep them in well-ventilated and dry areas
• Avoid tight-fitting shoes/sandals where possible
• Try to obtain (footwear) product manufacture information from the seller, if possible

What is the Prognosis of Shoe Contact Dermatitis? (Outcomes/Resolutions)

The prognosis of Shoe Contact Dermatitis is generally excellent following removal of the offending material (specific footwear type). The skin rashes are known to recede and clear up with adequate treatment.

Additional and Relevant Useful Information for Shoe Contact Dermatitis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/