Interdigital maceration: Throw the kitchen sink at it

interdigital maceration

Interdigital maceration is a condition that occurs when the skin between the toes is exposed to moisture and dampness for too long leading to the characteristic softening, white appearance and breakdown of the skin. This can create a perfect environment where bacteria and fungi can grow, which may lead to infection.

Causes of interdigital maceration

The cause of interdigital maceration is the accumulation of moisture from the sweat in the skin between the toes.

Factors that increase the risk for interdigital maceration include:
1. Excess sweating (hyperhidrosis)
2. Poor foot hygiene practices resulting a failure to dry between toes
3. Swelling of the feet which will increase the compression between toes and the sweat is less likely to evaporate)
4. Wearing footwear too much so that moisture between the toes can not evaporate
5. Using creams between the toes may also increase the risk by letting moisture build up

Differential diagnosis: ‘Toe jam‘; soft corn; interdigital fissure; interdigital erythrasma, tinea pedis, erosio interdigitalis blastomycetica.

Treatment of interdigital maceration

You fix interdigital maceration by making sure it stays as dry as possible between the toes. This is done by using good foot hygiene practices. You need to clean your feet with soap and water and then make sure you dry between the toes, preferably with a thin towel. If you can’t do this your self, then you need to get a carer to help.

You should go barefoot as much as you can to allow air to circulate between the toes. Toe spreaders can be used to help keep the toes apart and let the air circulate. During the day, make sure you change your socks regularly if you sweat a lot to prevent moisture accumulating.

Topical applications of astringent evaporative solutions have a drying effect on the skin as they evaporate. For example, Witch hazel, surgical spirit, Tincture of benzoin (Friar balsam) and povidine iodine in alcohol (eg Betadine).

If an infection such as tinea pedis (athletes foot) is also present between the ties antibiotics or anti-fungal medications may be needed.

Forum discussions on interdigital maceration

Treating idiopathic interdigital maceration

Personal Opinion on interdigital maceration

Easy: dry between the toes; stay barefoot as much as possible; use surgical spirits. If that does not help, it usually means that you are forgetting to do it.

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