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Sweaty sock syndrome?

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By Foot Health with Leana

Juvenile plantar dermatosis or sweaty sock syndrome as it is also referred to, is the name given to a skin problem on the feet of children, although in some instances it is seen in adults. It is a condition where the skin becomes scaly and red on the soles of the feet. Occasionally the hands may develop similar signs.
It is usually most severe during the summer months, therefore in tropical countries it can basically flare all the time.

What causes it?
The exact cause of sweaty sock syndrome is unknown, though alternating moist and dry conditions may lead to the condition. It is often seen in ‘atopic’ children, ie those who have atopic dermatitis (eczema), asthma, or hay fever. Their skin seems generally more sensitive than others.
The problem is related to friction. When the foot moves up and down in a shoe, especially when the foot is sweaty, friction is greater. The foot gets wetter in synthetic shoes (eg nylon or vinyl), and moves more in open sandals.
It is sometimes difficult to tell juvenile plantar dermatosis apart from atopic dermatitis, contact dermatitis, psoriasis or a fungal infection.

Who’s at risk?
• Sweaty sock syndrome occurs in children aged 3–15, but it seems to be most common in boys aged 4–8.
• It tends to be a long-lasting (chronic) condition, lasting, on average, about 3 years. It usually goes away when a child reaches puberty.
• Children who have eczema (atopic dermatitis) seem to have a higher risk for developing this syndrome.

Signs and symptoms
The most common locations for sweaty sock syndrome include:
• Big toe
• Ball of the foot
• Heel

The creases between the toes (toe webs) are not usually affected. It occurs as shiny, red patches on the weight bearing surfaces of the feet. The skin appears tight and smooth. Occasionally, painful cracks (fissures) may be present. Even though children may complain of heavy sweating, the skin feels dry and scaly.

Self-care guidelines
If you suspect that your child has sweaty sock syndrome, have him or her try the following:
• Wear sandals or breathable shoes.
• Avoid wearing shoes with rubber or plastic soles.
• Wear thick cotton socks and change them if they get sweaty or wet.
• Use gentle, non-soap cleansers.
• Apply moisturisers at night.
• Seal cracks in the skin (fissures) with liquid bandage.

When to seek medical care
See your child’s doctor if he or she has red, scaly feet that have not improved with self-care measures. If the child has cracks in the skin in addition to a foot rash, try to see the doctor even sooner.

Treatment
To aid diagnosis, tests such as scrapings and patch tests may be recommended. The doctor will probably check your child for a fungal infection (athlete’s foot), by scraping a small amount of surface skin (scale), which will be examined under a microscope. If fungus is not seen, the doctor will probably consider the diagnosis of sweaty sock syndrome.
Athlete’s foot, however, is much more common than sweaty sock syndrome. The physician may, therefore, want to try a course of topical antifungal creams, before concluding that your child has the latter.
Once the diagnosis of sweaty sock syndrome has been confirmed, the doctor may recommend the self-care measures mentioned above, in addition to the following:

• Reduction of friction – Wearing of well-fitted shoes, that are preferably leather, with cotton socks.
• Lubrication of the dry skin – Use of greasy moisturisers which can be very helpful, including white soft paraffin, applied particularly after a bath and before bed.
• Having a rest day – Scheduling of quiet times with little or no walking to allow the fissures to heal.
• Covering the cracks – Fissures heal faster when occluded. Plasters are usually satisfactory. Spray or liquid bandage applied to the fissure will relieve the pain.
• Topical steroids – Topical steroid ointments are often prescribed, but rarely prove more effective than simple emollients. The more potent products are worth a trial for a couple of weeks. If helpful, they should then be reserved for a flare-up, particularly if the affected skin is red or itchy.
• Use of antihistamine pills – These would be for cases of severe itching.

For additional help, you can also see your Dermatologist or Podiatrist.
Your feet mirror your general health . . . cherish them!

Leana Huntley is an
English trained foot health
practitioner attached to ALMAWI Ltd The Holistic Clinic. Contact the Clinic at info@almawiclinic.com or visit the website at www.almawiclinic.com
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