What causes skin breakdown and ulceration between the toes, and how should it be managed?
Dec 01, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, skin breakdown and ulceration between the toes may be caused by local moisture, poor ventilation, friction or compression, athlete's foot (tinea pedis), intertriginous erosive eczema, diabetes, or other factors. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general management, medication, or other treatments. In daily life, avoid spicy and irritating foods, and consume more protein-rich foods to promote wound healing.
Generally, skin breakdown and ulceration between the toes may be caused by local moisture and poor ventilation, friction and pressure, tinea pedis (athlete's foot), intertriginous erosive eczema, diabetes, or other reasons. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general management, medication, and other treatments. Specific analyses are as follows:
1. Local moisture and poor ventilation: Sweat tends to accumulate between the toes, and wearing non-breathable shoes causes dampness to linger, promoting bacterial growth that damages the skin and leads to ulceration. Wash feet daily with warm water, thoroughly dry them—especially between the toes—wear cotton, breathable socks, choose spacious mesh shoes, and avoid plastic or synthetic leather footwear.
2. Friction and pressure: Wearing tight or high-heeled shoes can cause repeated rubbing and abrasions between the toes. When wounds become contaminated with sweat, ulceration may develop. Immediately switch to loose, comfortable flat shoes to reduce toe pressure. Clean affected areas with normal saline and gently cover the wound with sterile gauze to protect it.
3. Tinea pedis (Athlete’s foot): A fungal infection of the skin between the toes. Initially presents with blisters, which rupture and form eroded surfaces accompanied by itching and odor. Patients should use antifungal medications such as bifonazole cream, terbinafine hydrochloride cream, or itraconazole capsules as prescribed. Boil socks daily for disinfection and avoid sharing slippers with others.
4. Intertriginous erosive eczema: Inflammation triggered by sweat irritation and friction between the toes, causing redness, erosion, burning, and itching. Patients should use medications such as calamine lotion, desonide cream, or loratadine tablets as directed by a physician. Keep the spaces between toes dry and avoid scratching to prevent worsening infection.
5. Diabetes: Poorly controlled blood sugar levels make the skin on the toes more susceptible to bacterial invasion. Wounds heal slowly and are prone to ulceration. Patients should manage blood glucose with medications such as insulin injection, gliclazide sustained-release tablets, or metformin-glibenclamide tablets as prescribed. Check toe condition daily and treat any injuries promptly.
In daily life, avoid spicy and irritating foods, and consume more protein-rich foods to promote wound healing. Keep foot-washing water temperature below 37°C and avoid soaking feet in hot water. Avoid walking barefoot in rainy weather to prevent exposure of toe skin to contaminated water and subsequent infection. Comprehensive care can accelerate healing of ulcers.
