What is the treatment for raw skin between the toes?

Treatment for Raw Skin Between the Toes

For raw skin between the toes, the most effective treatment is application of an antifungal cream such as terbinafine 1% once daily for 1-2 weeks, combined with thorough drying between toes after washing and use of foot powder to prevent recurrence. 1

Diagnosis and Assessment

Raw skin between the toes is most commonly caused by:

1. Fungal infection (tinea pedis or "athlete's foot")
2. Maceration due to moisture
3. Friction or pressure from footwear

Before treatment, assess:

• Location and extent of affected skin
• Presence of scaling, fissuring, or vesicles
• Signs of secondary bacterial infection (increased redness, warmth, swelling)
• Risk factors (diabetes, immunosuppression)

Treatment Algorithm

Step 1: Immediate Care

• Clean the area gently with mild soap and lukewarm water (temperature below 37°C)
• Pat dry thoroughly, especially between toes
• Avoid rubbing which can worsen irritation

Step 2: Antifungal Treatment

Since most cases of raw skin between toes are caused by fungal infection:

• First-line treatment:

  • Terbinafine 1% cream applied once daily for 1-2 weeks 1
  • Mycological cure rates of approximately 94% for interdigital infections 1

• Alternative treatments:

  • Clotrimazole 1% cream applied twice daily for 4 weeks 1
  • Butenafine applied twice daily for 2 weeks 1
  • Ciclopiroxolamine 0.77% cream applied twice daily for 4 weeks 1

Step 3: For Severe or Persistent Cases

If the infection is extensive or doesn't respond to topical treatment:

• Oral antifungal therapy:
  • Terbinafine 250mg once daily for 1 week 1
  • Itraconazole 100mg daily for 2 weeks 1

Prevention Measures

1. Thorough drying:

   • Carefully dry between toes after bathing or swimming 1
   • Use a clean towel and pat dry rather than rubbing 1

2. Foot powder:

   • Apply foot powder after drying to reduce moisture 1
   • Has been shown to reduce rates of tinea pedis from 8.5% to 2.1% 1

3. Footwear considerations:

   • Change socks daily 1
   • Wear clean cotton socks rather than synthetic materials 1
   • Avoid tight shoes or shoes with rough edges 1
   • Allow shoes to dry completely between uses

4. Other preventive measures:

   • Avoid walking barefoot in public areas 1
   • Don't share towels or footwear 1

Special Considerations

For Diabetic Patients

Diabetic patients require extra caution due to increased risk of complications:

• Inspect feet daily 1
• Seek professional care promptly for any skin breakdown 1
• Avoid self-treatment with chemical agents or plasters 1

For Secondary Bacterial Infection

If signs of bacterial infection are present (increased redness, warmth, swelling, purulent discharge):

• Consider topical antiseptic agents
• Consult healthcare provider for possible oral antibiotics

Common Pitfalls to Avoid

1. Inadequate drying: Failing to thoroughly dry between toes is a major cause of persistent infection 1

2. Inappropriate treatments:

   • Avoid greasy creams which can worsen maceration 1
   • Don't use hot water for washing (keep below 37°C) 1
   • Avoid chemical agents or plasters to remove calluses 1

3. Premature discontinuation: Complete the full course of antifungal treatment even if symptoms improve quickly

4. Neglecting footwear: Reinfection can occur from contaminated shoes and socks

By following this treatment approach and preventive measures, most cases of raw skin between the toes can be effectively treated and recurrence prevented.