Expert Advice: Can footwear cause an allergic reaction?

Footwear can be a surprising culprit when it comes to allergic reactions. While we often associate allergies with foods, pollen, or animal dander, the reality is that our shoes, too, can trigger allergic responses in some individuals. These rashes often target the feet, especially the top surfaces, and can be quite uncomfortable.

The Common suspect: Contact dermatitis

Shoe contact dermatitis can be due to either allergic or irritant reactions. This condition arises when the skin reacts to substances in shoes, like leather, colorants, rubber, or adhesives, and sometimes even elements in socks or stockings. The manufacturing process involves various chemicals, and factors like heat, friction, and sweat can increase the risk. Allergic reactions may stem from the materials themselves or other components like adhesives and decorations like the metals from buckles. 

Contact dermatitis is the leading cause of shoe-related skin irritations, often resulting in an itchy, blistering rash on the upper part of your feet. Although it can occasionally extend to the heels, it's less likely to affect the instep or spaces between your toes. This rash doesn't discriminate; it can impact anyone, regardless of age, gender, or profession.

Treatment options for foot allergies focus on preventing exposure to allergens and relieving symptoms. Its best to avoid or minimize contact with the specific allergen by using hypoallergenic or natural materials for footwear, wearing socks or barrier creams to provide a protective layer, and opting for shoe brands known to be allergen-free.

What Causes Shoe Allergies?

Allergic reactions to footwear can occur due to various allergens present in the materials used, such as dyes, adhesives, rubber accelerators, and leather finishes. Several rubber compounds commonly found in the soles may trigger allergic reactions, particularly contact dermatitis. Compounds like thiuram mix, carba mix, mercaptobenzothiazole, mercapto mix, and black rubber mix are often the culprits behind rashes on the soles of your feet.

These allergens can trigger a range of clinical presentations on the feet, including redness, itching, blisters, eczema, and even anaphylaxis in severe cases.

Presentation of foot allergies may differ based on the specific allergen and individual's sensitivity. Some people might develop immediate allergic reactions upon contact with the allergen, while others may have a delayed hypersensitivity response that appears hours or even days later. The allergic reactions can occur anywhere on the feet, including the soles, sides, and top.

Leather tanning with chromate salts is another common cause of shoe allergies, particularly affecting military personnel and workers in various fields. Rashes from chromate exposure can appear on the top or bottom of your feet, depending on where the leather is in your shoes. To prevent this, consider non-leather shoe alternatives.

Glues and resins: Common shoe allergens include glues and resins like butylphenol formaldehyde resin, which is used to bind shoe parts, mainly leather and rubber. If your shoes have this resin, you might experience rashes on the top and sides of your feet where seams exist. 

What’s the solution? Choose single-piece shoes without glued seams, reducing the risk of contact dermatitis.

Colours and compounds: Sometimes, pigments and metals in the fabric of your shoes can be the ultimate cause. Chromate, cobalt, or even a dye like disperse blue 106 can set off rashes, typically on the top and sides of your feet, where your skin meets the pigmented fabric. Opting for shoes made of non-pigmented fabrics, especially in lighter shades, might just save your feet from this trouble.

The Bottom Line

Footwear allergies are rare but can occur due to the close contact between your feet and shoes. It's vital to distinguish between an allergy and discomfort from poorly fitting footwear. It's crucial for individuals who suspect shoe-related allergies to consider the materials their shoes are made of, opt for hypoallergenic footwear when possible, and maintain good foot hygiene to minimize the risk of allergic reactions. In cases of severe or persistent symptoms, consulting with a dermatologist or allergist is advisable to identify the specific allergen and develop an appropriate treatment plan

So, if your feet need relief, be mindful of your shoe choices to avoid discomfort and skin irritations.

Inputs by Dr. Parmjit Singh Walia, Founder, Dr Walia’s Skin, Laser, and Hair Transplant Clinic, Dr Niti Gaur, MD, Fellowship in Cosmetic Dermatology (Singapore, USA), Board Certified Dermatologist Founder of Citrine Clinic, Gurgaon, Dr. Manasi Shirolikar, Consultant Dermatologist and Founder of Online Consulting Brand drmanasiskin.com, Pratyush Sharma, Chief Marketing Officer at Abros Footwear