Itching of the feet is not an uncommon sensation. We all experience it every now and then and for most of us it is not due to any serious skin diseases. Often it is just a matter of poor ventilation, tight shoes, itchy socks and accumulated sweat on the skin during the course of the day that lead to mild itching and even soreness. However, once the footwear is off and the feet are relaxed, these sensations should subside.
Itching of the feet and toes that may extend to the ankles, can occur with a host of skin conditions. These conditions may not always be unique to the skin on the feet. For example, psoriasis which is an itchy chronic skin condition can also affect the feet and ankles. However, there are some conditions that are unique to the feet, toes and ankles. Chronic itching may occur with or without a rash in these conditions
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, sides or upper part of the foot is usually itchy, sore, reddened, damp, and may peel off and crack (Picture 1). Athlete’s foot is common in athletes but anyone can get it. People who constantly have wet feet due to occupation, humid environment, or wearing poorly ventilated shoes are commonly affected. One can contract Tinea pedis from a public shower or gym floor or by sharing contaminated shoes.
Picture 1. Athlete’s foot: a cracked and scaled skin due to a fungal infection.
Tips for Foot Itch
Read our latest article on how to deal with itchy feet. The importance of proper washing, airing your feet and resting it. How good circulation to the feet and good foot care can help.
More on tips for preventing foot itch.
Treatment options (1):
- Anti-fungal over the counter (OTC) 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 you 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 a bath; you can use hair dryer 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, usually develops on the foot, or other parts of the leg, or on the 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 drugs, such as thiabendazole as ointment, or, in widespread lesions, by mouth can be used. With treatment, itch 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 soil and sand.
In tungiasis, an itchy or painful 4-10 mm sized white rash with the black center appears on the foot. It is caused by burrowing flea Tunga penetrans (sandflea, 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.
In pitted keratolysis, small shallow cavities appear in the upper layer of the soles or palms. They are common in people with excessive perspiration and may sometimes itch. Treatment, if necessary, is with OTC antibiotic ointments. Prevention is by keeping feet dry.
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 is 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.
In acroangiodermatitis (Gk. akros = tip of the limb; angeion = vessel; dermatitis = skin inflammation) purplish patches and ulcers appear on the foot in young adults with various vessel disorders (3). Lesions represent irregular vessel overgrowth resulting from impaired blood supply to the foot, for example, in venous thrombosis or venous fistula. Lesions are usually painful and itchy. Treatment involves correction of the underlying disorder.
Palmoplantar keratoderma refers to thickening of the skin on the palms and soles that may appear in different inherited or acquired skin disorders (Picture 3). It may appear at any age.
Picture 3. Palmoplantar keratoderma: a thickened skin on the feet of a young child.
(source: Samuel Freire da Silva, M.D., atlasdermatologico)
Without a Rash
- Dry skin
- Swollen ankles due to heart or kidney disease, or hypothyroidism
- An old ankle injury or surgery
- Intestinal parasites. Gastrointestinal symptoms would be likely present.
- Varicose veins
- Diabetes, causing peripheral neuropathy (itch usually occurs at night)
- Sulfates in cleansing products
- Psoriasis. An itch may appear years before any rash.
With a Rash
- Heat rash
- A reaction to plants when walking with sandals or barefoot
- Athlete’s foot (fungal infection by Tinea pedis or foot ringworm). Discoloration or scaling is typical.
- Cholinergic urticaria
- An allergic reaction (hives or eczema) to socks
- Stasis eczema
- Crohn’s disease
- Scabies mites, dust mites, chiggers
- Bed bugs
- Nummular eczema
Remedies to treat athlete’s foot (health.med.umich.edu)
Treatment of Larva migrans (emedicine.medscape.com)
Acroangiodermatitis – pictures, treatment (dermatology.cdlib.org)