Shoe advice from The Foot Doctor #2


June 27, 2015 by Ville Raivio

VR: You also have a thing for shoes. Is leather your favourite material for footwear? Likely the reader already has a collection of leathery shoes but, from the point of podiatry, why is leather such a great material?


MW: Yes, as you know, I have a bit of an obsession for shoes and leather is my favorite material for footwear. I wear leather shoes/boots as often as possible, so basically anytime I’m not working out in the gym or in scrubs in the hospital. Most days in the hospital, I will just dress up and switch into scrubs as needed, just so I can wear my leather shoes. Leather is a great material for many reasons:

First off, it is a natural material and being such, it is able to breath naturally. This allows the feet to breath more than most other shoes. Too much moisture in a dark, warm, enclosed space is just a breeding ground for both bacteria and fungus. That microbial growth predisposes us to infections that can cause many problems in the future, which include athlete’s foot or fungal nails.

The_Foot_DoctorDon’t worry. It really doesn’t look like this, but I use this when I lecture on it for a bit of a laugh.


Second, real leather is tanned on the inside to give it color and those tanning methods are usually less of a problem on the skin. There are some cases where the chrome tanning agents (for certain leathers) can cause an itchy rash on the skin, but it is more likely that the synthetic materials will do that to people, because most of the tanning agents are not damaging to the skin in the first place. In the end, leather is just skin from an animal, so if the tanning agents preserved that hide, it usually won’t cause much of a problem to live human skin.

The synthetic materials are usually not very breathable and the chemicals used in changing the colors can commonly cause skin irritation as well as lead to increase fungal growth. It is fine if a running shoe has actual mesh to allow the air exchange for cooling, but many sneakers don’t really have these open pores, because many of the more “fashionable” sneakers use synthetic leathers or cheap corrected grain leather that has many coatings applied to make them look nicer. Yes that “leather” will look almost perfect, but it closes off the leather and prevents the shoe from having the durability and breathability of natural leather.


This is an example of an allergic atopic dermatitis that can be caused by irritation to the skin from synthetic leathers. As you can probably tell, this was from a flip-flop strap.


Of course there is a variety of leather qualities and that makes a difference in the durability of the shoes overtime, in addition to their appearance, but that is a bit too in depth for the scope of this right now.

Another part of leather that relates more to the medical side, is that leather can be used in more parts of the shoe than just the upper of the shoe. When it is used as the insole and in other parts to construct the shoe, the shoe will be able to absorb more sweat from the feet to keep the feet drier. That leather insole will eventually dry out (give at least 24 hours between wearing the same pair), so it will be almost like new again. This helps prevent microbial growth. That same leather insole will also start to take the form of the foot overtime, which will further increase the comfort factor and stability of the foot in the shoe.

One also can’t forget that most of the synthetic materials are very thin and pliable. Yes leather can be molded to the foot overtime with wear, but it is still much more durable and rigid than the mesh fibers used in running sneakers. This rigidity will also help to give the foot more support, and there can be even more for the ankle in people who choose to buy ankle boots. I commonly recommend to patients that if they have a history of ankle injuries or general ankle instability, to consider lace up ankle boots, because that thicker leather commonly used in boots is very stable and when tied tight enough, can help prevent an ankle injury in daily life, instead of needing to wear a bulky ankle brace.


Laced Ankle brace that is quite bulky and fits best in sneakers.


The_Foot_Doctor_at_Keikari_dot_com11I’ll take this Gaziano&Girling Glencoe from Skoaktiebolaget any day over that brace, especially at times that I am not wearing sneakers!


Another great quality of leather is that there is so much variety in color options and types. Most people think of dress shoes and boots as just available in a wide variety of browns and black, but as many shoe lovers know, there is grey, blue, green, red, purple, etc. If the colors are not available by common tanning methods, many higher quality shoe companies will dye the leather or even apply a patina (by painting the leather) to give the desired shade. So this gives just as much color variety as the synthetic materials.
There also are many types of exotic leathers that can be used to give different looks and feels for the person wearing the shoes. Most people think of just cow or calf leather, but there is crocodile/alligator, suede, various patterned grain leather, and other exotics, like ostrich, lizard, snake, eel, stingray, turtle, deer, moose, elephant, giraffe, hippopotamus, kudu (a type of antelope), horse hide, shell cordovan (horse but from the membrane above the muscle), etc. They each have different durability, comfort factors, and styles of shoes that work well with each leather. On a non-medical side, but purely for enjoyment, I find this the most important benefit to natural leathers.


VR: Our feet sweat quite a bit each day. Do you have some average numbers to share about the amounts, and how does the liquid affect our skin?

MW: There are about 250,000 sweat glands in an average pair of feet and they sweat about half a pint of liquid (8 ounces – 0.24 liters) per day. The main concern of that amount of liquid released is how it helps microbial growth. It is very difficult to stop the sweating, but using real leather shoes and giving them at least 24 hours of rest between wears is key to help prevent the fungal growth.

There also are many other easy ways to help, such as changing socks during the day and using powder for the feet. There also are alternative types of materials for socks, such as ones with bamboo fibers to help with antimicrobial properties, moisture wicking fibers, or even the newer copper fiber socks to help reduce fungal infections.  In extreme cases, even receiving Botox injections to help decrease the actual sweating can be an option.


VR: Why is the shoe the most important part of our wardrobes?

MW: I feel that the shoe in the most important part of our wardrobe because it is literally the base of our outfit. We are on our feet all day and with all of the factors and possible damage involved, we need to take care of them. When you are comfortable, you appear more confident, and can focus on the task at hand, whether it is work or play. I don’t know how many people here care what the general public think about shoes, but I have read multiple surveys done of women, asking what is the first thing that they look at. Most say they look at the shoes as a sign of attention to detail and pride in what they do by taking care of those shoes.

The_Foot_Doctor_at_Keikari_dot_com12Edward Green Navy Shell Cordovan Double Monk Strap shoes from Leffot


Most people in the professional world are stuck wearing very conservative outfits, and shoes are a way to add some more variety to it all. They can really dress things up, but can make everything more fun as well, by varying color, style of shoe, sole material, etc. Most people in business, medicine, law, etc. are stuck wearing either black, dark blue, or grey pants/suits most of the time and a blue, white, light purple, or light pink shirt for most days of work.

One usually doesn’t have to always wear black shoes everyday (unless they are in banking) and even if they do, they can alternate from a pair of plain cap toe balmorals, to whole cuts, to wingtips (full brogues), to long wing bluchers depending on the formality of the day. I’m personally not a huge fan of black because most doesn’t have much depth to it, like browns and oxblood, but I still keep a few different styles for the variation.
If the person can wear other colors than black, there are so many shades of browns to choose from as well as burgundy/oxblood. I even like to take out a pair of navy blue monks on Fridays here and there, because they can still look professional, without being gaudy. Grey and dark green are two other colors that can still look professional and are commonly not thought of.


Gaziano and Girling Grey St. James from Skoaktiebolaget


Shoe style and color are a way to make a huge difference in the total outfit and let us show our personality and creativity in how we blend or even contrast those colors and styles.


These may be a little much for some of you, but for people who love to wear browns and olive shades in the fall, like me, this Olive shoe with brown burnishing by St. Crispins for The Armoury really helps take it to another level.


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