Pain and Green Color In Between the Toes: Is Your Hot Tub To Blame?

During this time of year, many people are enjoying the frequent use of a home patio or public hot tub to stay warm in the cold weather.  If you are doing this, and develop pain and discoloration in the spaces between your toes, you might want to read this week's post.
The spaces in between the toes can be a potent breeding ground for various microscopic organisms both benign and infectious.  While these spaces are usually the site of fungus development, there are certain bacteria that can thrive there.  The common varieties of bacteria that live in between the toes are usually benign organisms that simply live on the skin surface in reasonable numbers, and don't cause infections.  Some bacteria, however, can pose a problem, and one in particular thrives in the warm water of a hot tub.

Pseudomonas is a species of bacteria that can infect a wide range of human tissue, from skin to the lungs to the urinary tract.  When it infects skin, especially the spaces in between the toes, it can cause a painful disruption of the normal skin surface, the result being an overly moist eroded surface that is tender to pressure.  A deeper skin wound can also form in more advanced cases, and this infection is particularly dangerous for diabetics or those with poor immune systems.  In addition to the skin damage, a characteristic light green color can be seen in the damaged skin as well as the skin surrounding it.  This bacteria can also infect nail tissue as well, but is at its worse when the skin is infected.  It can be passed along by sharing a hot tub that has not been properly disinfected or drained, and has an easier time infecting others if they already have skin cracks or splitting in between the toes.

Treatment depends on the level of infection.  Sometimes acetic acid (found in vinegar) can be an effective soak to kill the bacteria.  Other cases need specialized antibiotics designed to kill the pseudomonas species, and if the particular species is resistant to oral medications, intravenous antibiotics may be needed.  The suspected hot tub needs to be drained and properly disinfected, and people with the bacteria should avoid the hot tub until the infection is resolved.  Regardless of the severity of the infection, medical treatment is recommended as this bacteria can become difficult to control if not properly addressed.

There is also a common variation of this condition that involves a red itchy rash spread throughout the body, also called hot tub folliculitis.  This involves skin all over the body, but may have an easier time resolving on its own as it does not involve the tight constricted spaces in between the toes.

Until next time,
Scott R. Kilberg DPM

www.inpodiatrygroup.com - foot surgeon, podiatrist in Indianapolis
thediabeticfoot.blogspot.com - diabetic foot problems
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A foot doctor in Indianapolis Noblesville Fishers Carmel Westfield and Fortville Indiana.