Dryness Between Toes: Causes and Treatment Options

Dryness of the toe web space of the big toe?

Hello Dr.
Wu, at the beginning of June, I noticed a small white spot in the webbing of my big toe, which was diagnosed as tinea pedis (athlete's foot).
I have been diligently applying medication every day.
Initially, there was extensive peeling in the webbing of my big toe, but it has now progressed to mild dryness.
I have been continuously applying the medication from June to September, and the doctor said I could stop the treatment.
Although it appears normal externally, upon closer inspection, there are still visible dry areas.
Today, I visited a different clinic, and after a skin scraping examination, no tinea pedis fungi were detected.
However, the doctor mentioned that it might be undetectable due to the medication I have been using and advised me to continue applying it.
Previously, I was using an ointment, but now I have asked my family to send me an antifungal spray.
I would like to ask the doctor if the dry areas could possibly be caused by irritation from the ointment? Since I am currently in Japan, I am unable to return to Taiwan for a doctor's visit.
Thank you for providing me with the opportunity to ask this question.

Ma Li, 20~29 year old female. Ask Date: 2021/10/01

Dr. Wu Yuxin reply Dermatology

I apologize, but without actually seeing the lesion, it is not possible to make a definitive assessment.

Reply Date: 2021/10/01

More Info

Understanding dryness between the toes can be a multifaceted issue, often stemming from various causes, including fungal infections, skin conditions, or even reactions to topical medications. In your case, it seems you initially experienced a fungal infection, commonly known as athlete's foot (tinea pedis), which was treated with topical antifungal medication. While the initial treatment may have resolved the visible signs of the infection, the persistent dryness you are experiencing could be attributed to several factors.

Firstly, the use of topical antifungal creams can sometimes lead to skin irritation or dryness, especially if used over an extended period. These medications often contain active ingredients that can be potent and may disrupt the natural moisture balance of the skin. This disruption can result in dryness, peeling, or even a feeling of tightness in the affected area, even after the infection has been cleared.
Secondly, environmental factors play a significant role in skin health. If you are currently in a dry climate or experiencing cold weather, this can exacerbate skin dryness. The skin between the toes is particularly sensitive and may react more noticeably to changes in humidity and temperature.
Moreover, the transition from using a cream to a spray formulation, like the one you mentioned (療黴舒噴藥), could also influence how your skin responds. Sprays may contain different excipients or alcohol, which can further contribute to dryness or irritation, especially if the skin is already compromised.

To address the dryness, consider the following options:
1. Moisturization: After applying any antifungal treatment, consider using a gentle, fragrance-free moisturizer specifically designed for sensitive skin. This can help restore moisture and prevent further dryness.

2. Limit Irritation: If you suspect that the topical medication is causing irritation, you might want to give your skin a break. Discuss with a healthcare professional about the possibility of pausing the antifungal treatment for a few days to see if the dryness improves.

3. Hydration: Ensure you are drinking enough water and maintaining hydration from within. This can help improve skin health overall.

4. Consultation: Since you are currently in Japan and unable to return to Taiwan, consider seeking a local dermatologist's opinion. They can provide tailored advice and possibly suggest alternative treatments that may be less irritating.

5. Observation: Keep an eye on the affected area. If the dryness persists or worsens, or if you notice any signs of infection (such as increased redness, swelling, or discharge), it is crucial to seek medical attention promptly.

In conclusion, while the dryness between your toes may be a result of the antifungal treatment, it could also be influenced by environmental factors and the formulation of the medication. A balanced approach that includes moisturizing and monitoring your skin's response will be essential in managing this condition effectively. Always consult with a healthcare professional before making any changes to your treatment regimen.

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