Painful Fashion: When Trendy = Torture

High heels, huge handbags, tight jeans, and decorative contacts may be in style, but they also can take a toll on your body.

Medically Reviewed by Louise Chang, MD on November 30, 2007
8 min read

High heels have made Susan Juarez's feet ache to their soles, and she even sprained her ankle once while dancing in stiletto boots. But soaring, slimming heels remain the 24-year-old Californian's favorite fashion vice. "I like that they make me taller, and they just look a lot sleeker," she says.

Like Juarez, legions of women have suffered in the name of painful fashion. How many of us have endured strappy sandals that cut into our feet, oversize designer bags that hurt our shoulders, too-tight jeans, and corsets that nip 3 inches off our waists but leave us breathless?

Sometimes, the cure is simple. Replace the enormous tote with a small handbag and the shoulder pain vanishes.

But in more dire cases, the beauty trap turns into true torture. A decade of stiletto heels can create painful foot deformities, and as little as one night of improperly worn fashion contact lenses can trigger a serious eye infection.

Of course, it's only natural to want to look smashing, so don't worry: You need not resign yourself to a wardrobe of ballet flats or shapeless outfits. With an ounce of common sense, experts tell WebMD, you can still turn heads -- and not by crashing down a staircase in your 6-inch platforms.

That huge designer handbag sounds like a good idea, right? It's elegant and in vogue, and you never have to leave behind your bottled water, sandwich, snacks, makeup bag, hairbrush, hair gel, Band-Aids, aspirin, and copy of War and Peace.

But after a few hours, you have nightmarish flashbacks to the time you lugged that overstuffed carryon from one end of O'Hare Airport to the other.

Whenever patients complain of shoulder or arm pain, Leon Benson, MD, an orthopaedic surgeon at Evanston Northwestern Healthcare in Illinois, always glances at what they carry into the exam room. If it's a huge purse, he wonders, "What have you got in there -- bricks?"

Actually, the size of the bag isn't the problem, but the weight, says Benson, who is also a spokesman for the American Academy of Orthopaedic Surgeons. A big bag can be packed lightly, but its spaciousness tempts many women to load it up.

How much is too much? "I would propose that anything that causes pain is too heavy," Benson says.

Carrying a heavy purse won't cause permanent skeletal deformity, he says. "It just hurts a lot" because the shoulder muscles bear constant stress.

Some tips for preventing pain:

  • If you carry a heavy purse, alternate it between both shoulders.
  • Switch your handbags so that you're not carrying a big purse every day. Or bring your big tote to the office, then remove essential items, such as a wallet and keys, and carry them within a smaller purse.
  • If you buy a big purse, choose one with wider straps, which helps distribute weight over a broader area of your shoulder, Benson suggests. For fashion-conscious women who prefer skinny straps, the thicker straps "may not be the best look," he concedes, but it could be a shoulder-saver.
  • Buy a backpack-style purse to better distribute the weight, suggests Carol Frey, MD, a Southern California orthopaedic surgeon. "If you have to carry a lot of stuff, I would invest in a very fashionable backpack."

Fashion mavens may spend hours grazing the racks for the right pair of tight jeans. But these, too, can be a painful fashion choice, along with tight-fitting synthetic underwear, pantyhose, girdles, and body shapers. While tight garments can accentuate curves, they also boost the risk of vaginal yeast infections. Symptoms include pain, itching, burning, and abnormal discharge.

"Yeast, being a fungus, grows where it's warm and moist. If you have clothing that's tight-fitting and won't allow air circulation, that's where the problem is," says Josephine Von Herzen, MD, an obstetrician-gynecologist at Salem Hospital in Salem, Ore., and a spokeswoman for the American College of Obstetricians and Gynecologists. Tight garments also cause rubbing and irritation, she adds. "That can be pretty uncomfortable."

What can you do to cut your risk of yeast infections?

  • Avoid tight-fitting undergarments and pants. Find looser pants with a flattering cut.
  • Wear 100% cotton underwear. "Cotton is more absorbent than nylon or polyester," Von Herzen says.
  • Don't sleep in tight-fitting garments, or avoid wearing underwear while sleeping at night.
  • Don't wear pantyhose unless they have a cotton crotch.

High heels make the legs look more toned and elongated, but poorly fitted ones are a major cause of female foot problems, says Frey, who is also a spokeswoman for the American Academy of Orthopaedic Surgeons. The biggest risk: the bunion, a foot deformity marked by an often painful swelling at the base of the big toe. The big toe can also angle in toward the smaller toes.

"The No. 1 cause of bunions is a tight-fitting pair of shoes, particularly the high-heel shoe with the narrow, pointed toe box," Frey says. "Clearly, the pointed shape crowds the toes together, and over time, your foot will start to take on the shape of the shoe." In general, deformities appear after roughly 10 years of wearing women's fashion shoes, she says. "Some people can get away with it and not have deformities, but actually, the majority of people pay some price."

Aside from bunions, the smaller toes can bend permanently to fit into tight shoes, eventually resulting in hammertoes, Frey says. Pinched nerves, corns and calluses, and ingrown toenails round out the list of the top five women's shoe-related complaints.

While high heels are more likely to cause deformities, "Actual injuries -- broken bones, ankle sprains, ligament tears -- are from platforms, backless shoes, and clogs, usually elevated ones," Frey says. "There's no stability in the back, and what happens is that you hit a crack in the cement and your foot just falls off the platform. You're twisting your ankle and falling from a height."

You don't have to give up high heels entirely, Frey says. "We don't tell people not to wear high-fashion shoe wear. That would be an impossible task, nor would we want anybody to not have fun. But be reasonable. We tell people to treat them like dessert -- do it on occasion, not every day."

Other tips from Frey:

  • "If you're going to be wearing a high-fashion shoe, don't wear them if you're going to be standing or on your feet for more than three hours at a time. Try to limit their use. Kick them off under the dinner table and wiggle your toes. You kind of have to plan."
  • If you must don high heels -- for example, for a business presentation or a special occasion -- bring other shoes to slip into during the rest of the day, such as "flat ones or even ones with just a slightly different heel height," Frey says. "Change the position of your Achilles tendon. That's what it likes. It doesn't want to be in one static position."
  • Pick your shoes carefully. "The shoe should be immediately comfortable the moment you put it on. There is no break-in period."
  • "Buy your shoes at the end of the day, when your feet are the biggest."
  • "Stick to a very buttery, soft leather so that during the day, as your foot swells, the shoe will give."

With colored contacts, women can turn their eyes into bewitching shades of sapphire blue, chestnut, violet, or topaz. The lenses spike in popularity around Halloween, when partygoers wear vampire-red lenses or ones that mimic slit-like jaguar eyes.

Decorative, or "plano," contact lenses don't correct vision. Instead, they only change the eye's appearance. Teen girls and young women in their 20s and 30s are the typical customers, says Thomas Steinemann, MD, an associate professor of ophthalmology at Case Western Reserve and a spokesman for the American Academy of Ophthalmology. "They're an extremely hot item."

While decorative contact lenses appear striking and playful, they should never be treated frivolously, he says. "This is not a harmless cosmetic. This is not like buying eye makeup."

Beginning around 2000, Steinemann started seeing patients with injuries from decorative contacts. He recalls one 14-year-old girl who, unbeknownst to her parents, made an impulse buy at a video store -- a $20 pair of green contact lenses -- to match a dress that she planned to wear to a party. Steinemann ended up treating her for a serious bacterial eye infection that required hospitalization and an eventual corneal transplant. "She bought these lenses over the counter -- obviously, no fitting, no screening examination, no instructions, and no follow-up," he says.

Spurred by such injury reports, decorative lenses have been under FDA regulation since 2005; now, they must be dispensed only under the supervision of a licensed eye care professional. But people are still circumventing safeguards and buying the lenses through beauty salons, flea markets, convenience stores, and especially the Internet. And that's not wise, Steinemann says. While it's fine to change eye color with decorative lenses, "you darn well better know the risks, and you'd better know how to take care of them."

Decorative contacts can cause conjunctivitis or pinkeye, corneal ulcers and abrasions, and in very serious cases, impaired vision or blindness. While these problems can crop up with any types of contacts, consumers are more likely to run into eye trouble if they don't understand proper care and if decorative lenses aren't fitted professionally. "Your cornea is no different than any other body part, and one size does not fit all. A lot of these lenses will be too tight or too loose. Either case is a bad situation," Steinemann says.

Tips for wearing decorative contact lenses safely:

  • Make sure that you get your lenses through an ophthalmologist or optometrist, who can properly fit and prescribe them. Never buy them online or in any setting that doesn't include supervision by a licensed eye care professional.
  • Go back to your eye doctor for a follow-up exam.
  • Follow your eye doctor's instructions for properly cleaning and disinfecting your lenses.
  • Wash your hands before handling your lenses.
  • Don't swap lenses with anyone, which can spread dangerous germs from eye to eye.
  • Don't sleep in decorative contact lenses because you can increase risk of bacterial infection fivefold.