Itchy Feet and Toes - Causes and Treatment | Current Health Articles 2009

Athlete’s Foot (Tinea Pedis, Ringworm of the Foot)

Athlete’s foot refers to infection of the foot by different fungi commonly called Tinea pedis. Skin between toes, on soles, and sometimes on sides or upper part of the foot is usually itchy, sore, reddened, damp, and may peel off and crack (Picture 1). The condition mostly affects people who constantly have wet feet due to occupation, humid environment, or wearing shoes with poor ventilation. Athlete’s foot is common in athletes but anyone can get it. One can contract Tinea pedis from public shower or gym floor, or by sharing contaminated shoes.

Picture 1. Athlete’s foot: cracked and scaled skin due to fungal infection.
(source: Samuel Freire da Silva, M.D., atlasdermatologico)

Treatment options (1):

Anti-fungal over the counter cream or powder, or prescribed ointment or pill
10% tea tree oil cream
Raw garlic, crushed and put over affected area

Not all fungal infections of the foot are caused by Tinea pedis, so when in doubt, doctor should give a diagnosis and prescribe appropriate anti-fungal drug.

Prevention is in keeping feet dry:

Wear cotton socks and change them daily
Dry the skin after the bath; hair dryer can be used carefully to dry the skin between the toes

Mild occasional infection should heal in few days, if feet are kept dry. People who constantly have fungal infection may need several weeks or months to cure it though.

Cutaneus Larva Migrans (Creeping Eruption, Ground Itch, Sandworms)

Cutaneous larva migrans is an immature form of various parasitic intestinal worms often found in feces of cats, dogs, or other animals. Confined mostly to tropical and subtropical areas (central and south US, Central and South America, Australia), it can be contracted by skin contact with moist soil or sand, usually by walking barefoot. Itchy rash in the form of 2-3 mm wide and several centimeters snake-like reddish tunnels, reflecting the travel of the parasite underneath the skin, develops on the foot, or other parts of the leg, or hands (Picture 2).

Picture 2. Rash on the sole reflecting the travel of Larva migrans.
(source: Samuel Freire da Silva, M.D., atlasdermatologico)

Treatment. To prevent itch and to kill parasites, anti-parasitic drug such as thiabendazole as ointment, or (in widespread lesions) by mouth can be used. With treatment, itching should resolve in a day, and skin lesions should heal in a week (2). Without treatment lesions disappear in 4-8 weeks in most cases.

Prevention is in avoiding direct skin contact with the soil and sand.

Tungiasis

In tungiasis, an itchy or painful 4-10 mm sized white rash with a black center appears on the foot. It is caused by burrowing flea Tunga penetrans (sand flea, bug of the foot) that lives in moist soil. It is usually contracted by walking barefoot in rural areas in India or South America. The rash naturally heals within 14 days. Treatment may include physical removal of the flea by the doctor, and anti-parasitic ointments like thiabendazole.

Picture of Tungiasis

Pitted Keratolysis

In pitted keratolysis, small shallow cavities appear in the upper layer of the skin of soles or palms. They are common in people with excessive perspiration and may sometimes itch. Treatment, if necessary, is with over-the-counter antibiotic ointments. Prevention is in keeping feet dry.

Pitted Keratolysis Pictures

Sweaty Sock Syndrome (Juvenile Plantar Dermatosis)

Shiny, dry, reddish skin on the soles that may crack and cause pain or itch mostly affects children with atopic dermatitis. The exact cause is not known and there’s no specific treatment. Friction of feet should be prevented by wearing well fitted shoes. Fissures should be allowed to heal by resting and covering with plasters. Feet should be regularly covered with ointments like Vaseline right after evening shower, and Dimeticone during the day. Condition usually resolves before onset of puberty.

Pictures of Juvenile Plantar Dermatosis

Acroangiodermatitis

In acroangiodermatitis (Greek akros = tip of the limb; angeion = vessel; dermatitis = skin inflammation) purplish patches and ulcers appear on the footof young adults with various vessel disorders (3). Lesions represent irregular vessel overgrowth resulting from impaired blood supply to the foot, e.g. in venous thrombosis, or -venous fistula. Lesions are usually painful and itchy. Treatment involves correction of the underlying disorder.

Pictures and Details About Acroangiodermatitis

Palmoplantar Keratoderma

Palmoplantar keratoderma refers to thickening of the skin on palms and soles that may appear in different inherited or acquired skin disorders (Picture 3). It may appear at any age.