What is Sweaty Sock Syndrome (Juvenile Plantar dermatitis)

Sweaty Sock Syndrome is a topic that is near and dear to my heart. When I was about 8 years old, I started suffering from cracks that would form on the soles of my feet. They would happen on the ball of my feet, the heel, but never between the toes. I suffered for 2-3 years from this. It hurt to walk. I do recall that at that time in my childhood, I always wore closed-toe shoes with poor ventilation and thick white athletic socks.

Fast forward a few years, when I was doing my residency for pediatrics in Los Angeles, I learned about a disease entity called Juvenile Plantar Dermatosis and its colloquial name Sweaty Sock Syndrome, and I thought what a clever name for a medical condition. Then seconds later I recalled all the discomfort I went through as a child. Juvenile Plantar Dermatosis is one of the lesser-known types of eczema but can be a real burden to those it affects.

Why did this happen to me?

According to the American Osteopathic College of Dermatology, the feet get wet from wearing socks and shoes that don’t breathe well, and then when the feet rapidly dry out it can lead to cracking and fissuring of the soles of the feet. When this rapid drying happens over and over again this causes micro-damage to the soles of the feet [1].

This problem can happen more in kids with a history of atopic dermatitis (eczema) or excessive sweating (hyperhidrosis). Socks get even sweatier in the hot summer and this can worsen the condition [2].

Sometimes synthetic dyes or rubber found in shoes can be a problem, and it may be good to see if one has developed an allergy to one of these items. This is called Allergic Contact Dermatitis and can be evaluated by conducting patch testing.

Treating Juvenile Plantar Dermatitis

It is reassuring to know that sweaty sock syndrome will end usually by the time of onset of puberty. Until then, wear well-fitting shoes that are breathable. This will reduce friction and prevent the foot from getting as sweaty. Wear cotton socks and if they get moist change them. Finally, take the shoes off when you get home [3]. Since a large part of the problem is the rapid drying of the foot after coming out of the sweaty socks, one should immediately apply an irritant-free moisturizing cream or ointment. It can be helpful to keep a daily moisturizing eczema cream around the house.

Using an ointment may feel uncomfortable and slippery, which is why using a non-greasy yet hydrating cream may be of value. Ingredients found in creams like glycerin and licorice root extract can help infuse moisture and soothe redness.

If the cracks are bad enough, scheduling some downtime with little or no walking may allow fissures to heal. Your physician may also advise using a steroid preparation to the affected area.

References:

“Juvenile Plantar Dermatosis.” American Osteopathic College of Dermatology, https://www.aocd.org/page/JuvenilePlantarDerm# . Accessed 14 August 2020.
Oakley, Amanda. “Juvenile Plantar Dermatosis.” DermNet NZ, March 2018, https://www.dermnetnz.org/topics/juvenile-plantar-dermatosis/. Accessed 14 August 2020.
Cunliffe, Tim. “Juvenile Plantar Dermatosis.” Primary Care Dermatology Society, 6 July 2016,
http://www.pcds.org.uk/clinical-guidance/juvenile-plantar-dermatosis . Accessed 14 August 2020.