Footwear‑Related Skin Breakdown: First Aid & Prevention for Medical Staff

Footwear Problems That Lead to Skin Breakdown

Shoes That Chafe

Chafing occurs when shoes rub repeatedly against the skin, usually at the heel, ankle, or top of the foot. Common causes: stiff materials, synthetic linings, poor fit, or new shoes not yet broken in. Chafing can quickly progress to blisters, cuts, and pressure injuries.

Shoes That Are Too Tight

Tight shoes compress the toes, forefoot, and sides of the foot. This leads to:

Redness
Pressure points
Skin shearing
Nail trauma
Blisters between toes For diabetics, this can escalate to ulcers due to reduced sensation.

Bunions That Rub

Bunions create a prominent pressure point that easily rubs against shoe walls. Synthetic shoes increase friction and heat, worsening inflammation. Wider shoes and natural materials reduce pressure and prevent skin breakdown.

New Shoes & Hiking Footwear

New shoes – especially hiking boots – often cause:

Heel blisters
Toe rubbing
Arch pressure
Synthetic‑surface irritation Wool padding prevents friction and absorbs moisture during break‑in.

Toe Deformities & Overlapping Toes

Hammer toes, claw toes, and overlapping toes rub against shoe tops or each other. Wool strands separate toes, reduce moisture, and prevent skin maceration.

Diabetic Neuropathy

Diabetics may not feel rubbing, heat, or pressure. This makes them vulnerable to:

Hidden blisters
Deep pressure points
Cuts under the foot
Ulcers from synthetic insoles Protective wool padding and wool insoles are essential.