Trench Foot

Trench foot, also called immersion foot and Non Freezing Cold Injury (NFCI), is a condition in which prolonged exposure to wet, cold and/or unsanitary conditions leads to the feet being infected, swollen and either red or pale. The term stems from World War I, when the soldiers experienced the condition while wearing tight boots in the trenches. Trench foot exists today, mostly within the homeless population.

Symptoms

Trench foot can affect any part of the foot, including the toes, heel and sole. 

The most common signs of trench foot include numbness, pain, wrinkling of the skin, and discoloration of the feet ranging from pale to red (erythema) to blue (cyanosis). A foul odor may arise as the tissue begins to decay, and swelling may set in. 

As trench foot progresses to a severe state, the feet may begin to develop blisters, open sores and fungal infections. This stage is sometimes called jungle rot or tropical ulcer. If left untreated, it can lead to gangrene and amputation.

Causes

Though the exact cause of trench foot is unknown, the disease typically arises when the feet are kept in damp, cold, unsanitary conditions for prolonged periods of time. Plantar hyperhidrosis (extreme foot sweat) can also cause trench foot. 

Many people confuse trench foot for frostbite, but contrary to popular belief, trench foot can arise without freezing temperatures. In fact, some cases have been reported in weather as warm as 60 degree Fahrenheit (16 degrees Celsius), and it can affect people who are strictly indoors. 

Trench foot can arise in as little as one day in damp, cold or unsanitary conditions. While it first affected soldiers in Napoleon’s Army and soldiers involved in trench warfare during World War I and II, today it mostly affects the homeless populations, hikers, sports enthusiasts, campers and festival goers. 

Treatment 

Trench foot usually takes about three to six months of recovery time. Prompt treatment is necessary, because neglected trench foot can quickly lead to gangrene and eventual amputation of the feet. 

Treatment of trench foot usually includes a thorough washing and drying of the feet to get rid of any bacteria or fungus present as well as soaking the feet in warm water or using heat packs to gently rewarm them. A potassium permanganate footbath may be used, as it can help draw excess fluid out of the affected skin.

As the feet return to normal condition, the patient may experience pain, a tingly feeling, excessive sweating and cold sensitivity. These symptoms may be temporary, or they might last for several months. 

Prevention

Trench foot is simple to prevent with just a few measures, including:

• Keep the feet thoroughly washed and dried 
• Only wear clean, dry socks. Change them several times per day if necessary
• Keep your shoes clean and dry whenever possible
• Use waterproof or polypropylene sock liners if you’ll be in damp conditions for prolonged periods of time
• Wear proper cold-weather shoes and socks if you know you’ll be in extreme weather conditions 
• Always make sure you can freely wiggly your toes in your socks and footwear to make sure they aren’t too tight and you aren’t cutting off circulation 
• Use talcum powder, antiperspirant or Vaseline to keep excess moisture away from the feet
• Avoid synthetic footwear materials like rubber
• Treat foot conditions such as hyperhidrosis as soon as possible