Are your child's feet stinky?
If you feel like your child's feet sweat a lot, there are many associated issues you and your child may have experienced. When feet sweat excessively, or are in wet shoes often, this makes an environment that is more hospitable for fungus and bacteria. Associated conditions can include tinea pedis (athlete’s foot), tinea unguim (fungal toenails), paronychia and cellulitis (infected ingrown toenails), and also just stinky feet, shoes and socks.
Working or playing in an environment where your boots/shoes get wet may not be entirely avoidable. However, getting into dry socks and shoes should be of the utmost importance to reduce the amount of time the feet remain wet. Changing socks and boots, especially if there is time to allow the feet dry out in between can really help to limit the discomfort experiences in the feet.
If your child has feet that sweat excessively (I say excessively because EVERYONE’s feet sweat), there are a few things you can do to try and keep them dry and reduce sweating. Once again, changing socks throughout the day may be a routine your child needs to get into. Select fabrics that are more breathable and those which are moisture wicking. This will make it less likely that your feet are pooling in moisture throughout the day. Another option to reduce sweating and/or decrease the chances of developing a fungal infection is the use of antifungal powder. This doesn’t always work, but some people swear by it.
For a more advanced option, topical aluminum chloride such as is in the product Dry Foot Wipes is available. The active ingredient in this will decrease the activity of the sweat glands in the feet, so the feet stay drier. The wipes can be used once weekly to reduce sweating. One word of warning though, your body still needs to get out the heat, so a product like this may result in increased sweating elsewhere (under arms or on the trunk for instance). This does contain aluminum which some people try to avoid so be award of that if you choose to use this with your older children.
Ingrown Nails can be a concern with Wet Feet
To avoid infected ingrown nails, I would break this down into two separate things to avoid. The first is to avoid progression of ingrown nails (as much as you can) by wearing the right shoes. If your child is wearing shoes that are too small in length or width, or those that have a small toebox or restrictive upper, you may be putting undue stress on the toenails. If the toenails are pushed into the adjacent skin, they cause pressure which eventually can cause a small opening in the skin. After this, the bacteria that is on our skin gets where it should not be. This is where infected ingrown toenails come from.
If your child has shoes that give plenty of room and despite this he or she is suffering from ingrown nail pain and/or has experienced an infected ingrown nail, there may be something more to it. Some ingrown nails are made worse by pressure between two toes. A very common example of this is patients who has bunions or hammertoes. These deformities in the feet cause crowding of the toes and the nails also then experience pressure. Spacers can be worn as a simple solution to reduce the amount of pressure between toes.
Another reason that toenails may bother your child in the absence of tight shoes is if their shape already predisposes them to having an ingrown nail. Some people inherit a nail shape that more easily causes pressure and pain. Some people experience an injury to a toe that changes the way that the toenail grows. Just the slow continuous growth of the nail can cause it to cut into the skin and allow bacteria to enter causing infection. If this is the case for your child, trimming the border down temporarily or removing the border in the presence of infection can help temporarily. There is a permanent procedure, however, that removes the curved portion of the nail so that the pressure is alleviated for the long haul. These types of procedures are performed in the office. They require some simple after care (bandage changes) and after fully healed, 98% of the time the ingrown nail will NEVER be a problem again!
Noticing some skin concerns?
If your child's shoes and socks are wet and they wear them on a regular basis, this is an environment that can harbor microorganisms such as fungus and yeasts. These microorganisms are the cause of fungal toenails. The same fungus that can cause athlete’s foot affects the toenails. The fungal infection resolves on the skin much more quickly than on the nail, because the skin turnover is so much more frequent than that of the nails. A new layer of skin is exposed in approximately 2 weeks, where toenails grow (at best) 1mm per month. That means that it take nearly an entire year for a fungal nail to grow out and throughout that time, reinfection is very difficult to avoid.
Treating your child's shoes therefore needs to be on your list as well. Reducing the load of fungus and yeasts in shoes helps to reduce transmission back onto skin and nails and socks that have been washed since the last time wearing the shoes. Antimicrobial sprays are available that help with this. Some people use Lysol, but I find this to be pretty harsh on skin and since your child's feet will be in the shoes, I recommend against it’s use. Instead, a silver based antimicrobial spray should be used. An added bonus here, is that because it decreases the bacterial load in the shoes, it decreased bacterial metabolism and therefore reduces the smell in shoes as well!
If you find your child is dealing with pealing skin, itchy skin, blistering, redness, moisture between the toes – these are all signs of a possible fungal infection of the skin (Athlete’s foot is the layman’s term). It is again important to treat the shoes, change socks frequently and keep feet dry. In addition, antifungal topicals can help treat the condition. I typically recommend its use twice daily for 3-4 weeks. If the condition persists after use of topicals for this period of time, an oral antifungal can help to kickstart improvement.
This is not the time to "wait and see"
If your child has soggy shoes and socks, suffers from athlete’s foot or you think they may have a fungal nail or their nail is painful – call for an appointment. With fungal infection of the skin, the sooner it is treated, the sooner it will improve and the less likely it is to affect the nails. If you think a nail is starting to look a little funky, once again the longer you wait, the more difficult it is to eradicate the problem.