FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

EMPLOYEE'S REFUSAL TO WEAR DARK SOCKS MAY HAVE MEDICAL BASIS

Question: I have an employee that doesn't follow the company uniform policy requiring black socks. He claims that all black socks make his feet smell. I've suggested wearing black cotton socks or wearing white socks with thin black ones over them. He refuses, again claiming that all black socks make his feet stink. Does the color of socks really make a difference in foot odor?

Answer: After reading your letter I had a hearty chuckle and reflected upon the diverse challenges facing all managers, particularly those responsible for direct supervision of others. My initial reaction was that your employee was probably somewhat resentful of the company dress policy and was feeling a bit helpless about it. I figured he was using his "stinky feet" claim as a way to try to gain a measure of control and to play "head games" with you. After that initial response, however, I started to wonder if there could actually be some validity to your employee's claim. Our feet perspire just like skin in other body areas. Feet (at least at work) are usually covered in socks and shoes that provide substantial insulation. This insulation keeps the feet hotter and, thereby, makes them sweat even more -- particularly in environments that are already hot. Perspiration in a closed environment of this sort can't easily evaporate, so the feet and shoes themselves become damp.

I'm sure that you remember from middle school or high school life science classes that a warm wet environment is a perfect place to grow fungus and bacteria. Shoe materials, socks and particularly dead skin can provide the necessary nutrients to allow these unwanted visitors to set up housekeeping in your shoes and on your feet. It is the action of these organisms that causes foot odor.

The first rule of good foot health is to wear shoes that fit properly and are in good condition. Second, you shouldn't wear any given pair of shoes more often than every other day to allow time for them to dry out between wearings. It's also important to wear fresh shocks daily. Some individuals have particular problems with increased foot perspiration that can be helped by changing socks at midday and by using an absorbent powder. The daily use of a spray antiperspirant is beneficial, but those with more severe problems may need a more powerful product such as aluminum chloride hexahydrate in a 20 percent solution (Drysol) applied at bedtime.

Now, to address the possible connection between dark colored socks and increased foot odor. Individuals with eczema are at increased risk for having skin inflammation caused by a wide assortment of things, including aniline dyes used to color fabric. Dispersed blue 106 and 124 are the particular dyes most frequently identified as causing this problem. Their use is prevalent in synthetic fibers in the dark blue and black color range.

An individual with sensitivity to these dyes develops a skin rash on the feet that allows undesirable bacterial and fungal infections to start. This then causes "stinky feet." Of course, most people would complain about the skin rash rather than the smell.

So what's a manager to do? It is not your position to be doing a foot exam on your employees. Instead, ask your "white sock" employee for a letter from his doctor explaining that it is necessary for him to avoid colored socks. Give him the benefit of the doubt. Don't hassle him until he has had a reasonable period of time to see his doctor and then for the doctor to send the letter directly to you.

"Family Medicine" is a weekly column.

To submit questions, write to John C. Wolf, D.O., at Post Office Box 110, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.