I am a 22 year old girl. I am a part time student and also work at a supermarket. For comfort while running errands, I wear rubber shoes or canvas every day. I do not wear socks to give my feet some time to ‘breathe’ but I have never had a reaction until lately.

I have been feeling itchy and at times see small whitish patches on my feet. Friends recommended that I use baby powder but that has not helped at all. What can I use to stop the itchiness and spots or should I change my shoes? I do not have a bad odour as I change my shoes daily.  

Agnes, Nyarutarama

Dear Agnes

From what you have described, it seems that you are suffering from a fungal infection of the feet. This usually occurs due to an infection by Trichophytan fungus. When one wears shoes for long hours, the dampness causes precipitates and aggravates the infection.  

Walking around bare footed on damp floors or with damp feet could initiate the infection. Fungal infections tend to be intermittent, where the itching would be intermittently present. Depending on the severity of the infection it can be mild to severe.

Persistent itching and subsequent scratching becomes a potential source of bacterial infection causing boils or small abscesses. Individuals with lowered immunity like those suffering from diabetes or HIV are more prone to develop this kind of infection. They can contract it with just slight exposure and develop more severe symptoms.

The condition can be diagnosed easily by the physical features. It can be confirmed by seeing the fungal material microscopically in a scraping taken from one of the white patches to which a drop of potassium hydroxide or normal saline is added.

Test for diabetes would also be useful because if there are high blood glucose levels, the infection would be resistant to treatment. This happens because high blood glucose levels provide a rich media for all kinds of infectious microbes to grow and multiply.

Instead of baby powder, an antifungal dusting powder would be more useful for you. It should be used for at least four weeks to ensure complete cure.

Otherwise the infection present in superficial layers of the skin would cure but the one present in deeper layers would flare up repeatedly as the dormant fungal spores multiply.

If itching is severe, taking anti -allergy drugs for about a week would provide relief. Try to keep your feet dry always. If possible, once or twice in between work, remove your shoes for a few minutes, so that the feet can breathe.

If ever socks are used, use cotton socks as nylon socks would also aggravate the problem. There is nothing to worry about because this is a completely curable condition.

Allergy to the fabric of the shoe or the material in the inner lining can also cause this kind of itching, but usually instead of white patches there would be rashes and or small eruptions associated. Eczematous dermatitis is yet another cause for itching of the feet, but here along with itching and patches, there would be associated small eruptions.

Dr. Rachna Pande is a specialist in Internal Medicine at Ruhengeri Hospital