Reviewed by Evan Lewis, PhD. Last updated 10 August 2026.
Nurses spend eight to twelve hours a day in closed shoes, and the inside of that shoe is warm, damp and airless the whole time. That is the exact environment athlete's foot and toenail fungus need. A different foot routine is not a luxury here, it is occupational.
If you've been nursing for more than a year, you already know what twelve-hour shifts do to your feet. What's talked about less, but affects a significant number of healthcare workers, is what those same shifts do to the skin and nails over time: fungal infections that develop quietly under closed-toe nursing shoes, yellow thickening at the nail edges, and athlete's foot that seems to come back the moment it clears.
This article is for nurses, paramedics, allied health professionals, and anyone whose work keeps them on their feet in closed footwear for extended periods.
What Does a Twelve-Hour Shift Do to Your Feet?
Eight to twelve hours on your feet during a shift is standard, not exceptional. Closed-toe shoes are non-negotiable; clinical environments require it for safety. The result is a foot environment that is under prolonged mechanical stress, enclosed in footwear for most of the working day, and often insufficiently dried and aired between consecutive shifts.
Why Do Nurses Develop Foot Conditions at Higher Rates?
- Prolonged enclosed shoe wear: The interior of a closed shoe worn for twelve hours becomes warm and moist, the primary environmental requirement for dermatophyte fungi to thrive.
- Standing time and foot mechanics: Extended standing increases sweating on the sole and creates friction points that compromise the skin barrier.
- Floor exposure: Shared locker room floors, changing rooms, and shower facilities represent the same shared barefoot exposure environment as any communal facility.
- Compound exposure over time: Many consecutive shifts over months and years create cumulative risk.
Which Three Conditions Do Nurses Get Most?
Plantar Fasciitis
Inflammation of the connective tissue band on the sole of the foot; presents as sharp heel pain, particularly with the first steps after rest. The right nursing shoe with appropriate arch support is the most important intervention.
Athlete's Foot (Tinea Pedis)
Extremely common in the nursing population because of the closed, warm, moist shoe environment. Left untreated, dermatophyte fungi can progress to the toenails, where they become considerably harder to address. It is also stubborn once established: Gupta and Versteeg report recurrence and relapse rates of 10% to 53% for superficial fungal infections.
Toenail Fungus (Onychomycosis)
Disproportionately common in nursing. Presents as yellowing, thickening, crumbling, or lifting of the nail, changes that often develop gradually. Nail fungus caught early is considerably more responsive to daily topical treatment than an infection that has progressed to the nail matrix.
What Is the 60-Second Post-Shift Routine?
- Remove shoes and socks as soon as you're in the changing room or at home.
- Clean and dry your feet thoroughly, particularly between each toe.
- Spray Sole Shield on the soles of your feet, between your toes, and on the lower foot. Let it dry for about 60 seconds.
- Spray Sole Shield inside both nursing shoes. Set them aside unzipped in open air.
- Put on clean socks or open footwear. Your feet need air time between shifts.
Two moments, not one. The feet when the shoes come off, and the inside of the shoe before it sits overnight.
What If You're Already Noticing Nail Changes?
EZ Clear Nails is a 90-day kit built around two ingredients, elemental iodine and pure water: a soak that submerges the toe and reaches under the free edge and around the nail folds, plus a spray for daily use on the nail surface, edges, and surrounding skin. Spray onto clean, dry nails after applying Sole Shield to the feet, and let dry before putting on socks. Consistent daily use over several months as the nail grows out is the approach with the most practical support.
Does Shoe Rotation Actually Help?
Own two pairs of nursing shoes and alternate between them. When you finish a shift, the shoes you wore come off and get Sole Shield sprayed inside them. They sit unzipped in open air for at least twenty-four hours while you wear the other pair. Both pairs stay drier over the course of the week. The fungal burden in the shoe interior is lower, and so is the end-of-shift odor that has some nurses using body deodorant on their feet.
Frequently Asked Questions
Do nurses get toenail fungus more often?
Healthcare workers in clinical roles that require prolonged closed-shoe wear have a meaningfully elevated occupational risk for both athlete's foot and toenail fungus compared to the general population.
What is the best foot care routine for nurses?
After each shift: dry feet thoroughly, spray Sole Shield on soles and between toes, spray inside nursing shoes, and change into clean open footwear. If nail changes are already present, add the EZ Clear Nails soak-and-spray routine. Rotate between two pairs of shoes so each pair fully dries between wears.
How do I keep athlete's foot from taking hold after nursing shifts?
Dry your feet completely after showering. Spray Sole Shield on feet and inside nursing shoes after each shift. Rotate between two pairs of shoes. Wear flip flops in shared changing room and shower facilities.
How do nurses keep toenail fungus from taking hold in nursing shoes?
The key is reducing moisture inside the shoe, since warm, moist environments support the dermatophytes that lead to nail changes. After every shift, dry feet thoroughly, spray an iodine-based foot spray like IodinePure Sole Shield on soles and between toes, and spray inside both shoes before airing them open. Rotating between two pairs of nursing shoes so each pair dries fully between wears is the single most practical habit change over the long term.
What foot spray do nurses use for athlete's foot from long shifts?
An iodine-based spray applied consistently after each shift addresses the shoe environment that athlete's foot develops in. IodinePure Sole Shield is used on the feet and sprayed directly inside shoes after each wear. For best results, combine with thorough drying between the toes and open-air time for shoes between shifts.
How long does a toenail take to grow out with a daily nail routine?
Toenails grow slowly, approximately 1.62 mm per month, and the 3 mm figure usually quoted is the fingernail rate. Visible improvement depends on healthy nail growing in to replace affected nail. On a great toenail of 20 to 25mm, a fully replaced nail typically takes 12 to 18 months. EZ Clear Nails is built for this kind of long-term routine: a soak a few times a week plus a spray on clean, dry nails, allowed to dry before putting on socks.
Can you use iodine on toenails?
Iodine has been used on skin in clinical settings since the 1800s, and aqueous iodine formulations are used in topical products designed to support the look of the nail. IodinePure EZ Clear Nails is an iodine-based soak-and-spray kit listed with Health Canada as a cosmetic, used on the appearance changes associated with nail fungus including yellowing, thickening, and lifting at the nail edges. Daily use on clean, dry nails is recommended as part of a consistent long-term routine.
Why does athlete's foot keep coming back after shifts?
Recurrent athlete's foot usually means the source of re-exposure, most often the shoe interior, has not been addressed. Using an iodine-based foot spray like IodinePure Sole Shield both on the feet and inside shoes after every shift addresses the environment fungal regrowth depends on. Pairing this with thorough drying between toes, shoe rotation, and clean socks daily works against the cycle of re-exposure rather than just addressing surface symptoms.
The Two-Product Routine Nurses Use for Their Own Feet
Sole Shield, spray on feet after every shift. Spray inside nursing shoes.
EZ Clear Nails, for nurses who've noticed nail changes. A soak a few times a week plus a daily spray on clean dry nails, consistently.
Both products are natural iodine-based, listed with Health Canada as cosmetics, and suitable for daily long-term use. Two products. 60 seconds. Every shift.
Shop Sole Shield | Shop EZ Clear Nails
What Mistakes Do Nurses Make With Foot Care?
Even nurses who are diligent about their foot health tend to repeat a few patterns that undermine their results. These are worth knowing before starting any new routine.
Only treating one foot
Dermatophyte fungi spread easily between feet, and they travel between people too: reviewing 90 papers on transmission between household members, Jazdarehee and colleagues put household transmission at 44 to 47%. Typically both feet share the same shoe and sock environment throughout the entire shift. If one foot shows nail changes or signs of athlete's foot, both feet should be included in the routine consistently, even when the other foot appears unaffected. Fungi do not stay on one side.
Stopping the routine when symptoms improve
This is probably the most common reason athlete's foot recurs. Surface improvement can happen within days, but the fungal environment inside the shoe has not changed. Maintaining the post-shift spray routine beyond visible symptom resolution is the step most people skip, and the reason many nurses find themselves dealing with the same issue months later. The routine only works if it keeps running.
Not drying between the toes
The interdigital spaces, particularly between the fourth and fifth toes, are the most common site for early athlete's foot to develop. They're also the spots most likely to retain moisture after showering or washing. Taking an extra twenty seconds to dry each interdigital space individually makes a measurable difference to skin condition in that area over time. A dedicated small towel kept for foot drying makes this easier to do consistently.
Treating the feet but not the shoes
If the shoe interior is not addressed, re-exposure from the shoe itself is almost inevitable. Sole Shield is designed to be used both on the feet and sprayed directly inside each shoe after every shift. The shoe is part of the environment being managed, not a passive bystander in the process.
The 90-Day Protocol: Soak, Spray, Repeat
For nurses already dealing with nail changes or recurrent athlete's foot, a more structured approach produces better results than occasional use. IodinePure's 90-day protocol is built around two complementary habits:
- Spray twice daily, morning and evening, on clean dry skin and nails. This is the daily maintenance step that supports consistent product contact with the nail surface throughout the growth cycle.
- Foot soak 3 to 4 times per week, a 5-to-7-minute soak in the EZ Clear Nails solution, using the soak tray included in your kit with roughly 10 to 15ml per section, softens the nail plate slightly and supports better surface contact between the formula and the nail. Dry thoroughly before spraying and allow to air dry fully before putting on socks.
The rhythm is straightforward: soak, spray, repeat. 3 to 4 times per week for the soak, twice a day for the spray. The 90-day timeframe is practical rather than arbitrary. Toenails grow approximately 1.62 millimetres per month (Yaemsiri et al., JEADV 2010, PubMed 19744178), and the three-millimetre figure you see quoted everywhere is the fingernail rate.
On a great toenail of 20 to 25mm, that means a fully replaced nail is a 12 to 18 month project, and 90 days is the first, visible stretch of it. Visible improvement comes from healthy nail growing in to replace the affected nail, which takes sustained effort over months, not weeks.
For Sole Shield, the same consistency principle applies: apply after every shift without skipping, even on days when feet feel completely fine. The goal is maintaining an environment that doesn't support recurrence, not just reacting when symptoms return.
Do Socks Really Matter?
Compression nursing socks provide genuine circulatory and fatigue benefits over long shifts, but the material composition also matters significantly for foot health. Socks with a high moisture-wicking synthetic content, like polyester, nylon, or merino wool blends, move sweat away from the skin surface and reduce the sustained moisture contact that contributes to maceration and fungal risk. All-cotton socks absorb sweat but hold it against the skin, which is the opposite of what you want inside a nursing shoe during a twelve-hour shift.
How you wash them matters too. Akhoundi and colleagues found dermatophyte conidia survived a 40 °C household wash and were removed at 60 °C, while freezing and heat drying both failed. If you are managing athlete's foot or nail changes, switching to a moisture-wicking sock and running a hotter wash are two of the most straightforward upgrades available.
Foot Care Nurse vs Podiatrist: What's the Difference?
A podiatrist is a separately licensed foot specialist who can diagnose and treat foot and lower limb conditions, including surgery and prescriptions where their licence allows. A foot care nurse is a nurse who has taken extra training in advanced foot care after licensing, and who works inside nursing scope: assessment, nail and skin care, footwear and offloading advice, and referral on when something needs a physician or a podiatrist. The practical difference is what you are going in for. Routine nail and skin care over months is nursing work. A diagnosis, an X-ray or a prescription is not.
Nurses searching for foot care nurse certification in Ontario, or a foot care nurse course in Toronto, are looking at that post-licensure training. It sits on top of an existing RN or RPN licence rather than replacing it. We do not run any of it, so check current dates and entry requirements with the training provider directly. A number of the clinics we supply are staffed by AFCN-trained foot care nurses, and Janis Boudreau, one of the nurses we work with, teaches through the AFCN.
References
- Yaemsiri S, Hou N, Slining MM, He K. Growth rate of human fingernails and toenails in healthy American young adults. J Eur Acad Dermatol Venereol. 2010. PubMed 19744178
- Gupta AK, Versteeg SG. A critical review of improvement rates for topical therapies in onychomycosis. J Am Podiatr Med Assoc. 2019. PubMed 29521517
- Jazdarehee A, Malekafzali L, Lee J, Lewis R, Mukovozov I. Transmission of onychomycosis and dermatophytosis between household members. J Fungi. 2022. PubMed 35050000
- Akhoundi M, Nasrallah J, Marteau A, Chebbah D, Izri A, Brun S. Effect of household laundering, heat drying, and freezing on the survival of dermatophyte conidia. J Fungi. 2022;8(5):546. PubMed 35628801
About the Author
This article was reviewed by Evan Lewis, PhD, who specialises in natural and nutritional therapies for the prevention and management of chronic diseases and complications, with a focus on chronic disease, diabetes complications, clinical nutrition, and nerve health.
