Psoriasis typically causes a dry, scaly rash that can affect the feet. Topical treatments, moisturizers, medication, phototherapy, and other approaches can help manage it.
Psoriasis is a long-term condition that affects over 8 million people in the United States. Doctors do not fully understand what causes this skin condition, but they believe it may arise from an immune system issue.
In this article, we look at the symptoms, causes, and treatment of psoriasis on the feet. We also cover how people can tell the difference between psoriasis on the feet and athlete’s foot and offer lifestyle tips for reducing psoriasis flare-ups.
What are the signs of psoriasis in the feet?
There are several types of psoriasis. The most common type is plaque psoriasis, which occurs in around 90% of people with the condition.
Plaque psoriasis can occur on almost any part of the body, including the feet. This type causes dry patches of skin known as plaques.
Psoriasis may present differently on light and dark skin. For example, psoriasis often appears red or pink on light skin but may cause violet, gray, or dark brown patches on darker skin.
These plaques are usually covered in silvery scales and can be itchy and sore. In more severe psoriasis, plaques may also crack open and bleed.
Another type of psoriasis that can occur on the feet is called palmoplantar pustular psoriasis, which specifically affects the palms of the hands and the soles of the feet.
People with palmoplantar pustular psoriasis typically notice many tiny, pus-filled blisters on their feet, hands, or both. Despite their appearance, these blisters cannot be spread to other people.
When a person has psoriasis, a rare condition can develop that can affect the entire body, as well as the feet. Doctors call it erythrodermic psoriasis.
Erythrodermic psoriasis is an acute condition and causes inflammation on over 90% of the body’s surface, making it appear inflamed and erythematous. This means the affected skin becomes red, which may appear a deeper red or dusky color on dark skin.
Besides psoriasis, triggers for this condition include other inflammatory skin conditions, certain cancers, and some medications.
Erythrodermic psoriasis is serious and requires immediate medical attention.
What triggers psoriasis on feet?
Psoriasis develops when the body replaces skin cells too fast. Doctors do not fully understand what causes this skin condition, but they believe it is an autoimmune disease. This means the body’s immune system attacks healthy tissue, such as skin cells, by mistake.
A person’s genes may play a role in the development of psoriasis, and it may run in families. People with other autoimmune diseases are also more likely to develop the condition.
Many people with psoriasis find that certain things trigger or worsen their symptoms. Potential triggers can vary from person to person but may include:
- a recent injury to the skin, such as a cut, insect bite, or sunburn
- emotional stress
- weather changes, especially when they cause skin dryness
- an illness or infection
- certain medications
Some people first notice psoriasis after they have experienced a trigger. If the condition affects the feet, a person may mistake their foot symptoms for an allergic reaction or an infection, such as athlete’s foot.
Is it foot fungus or psoriasis?
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Athlete’s foot is a common fungal infection that occurs on the feet. Unlike psoriasis, it is contagious, meaning it can spread from person to person.
A person can get athlete’s foot from surfaces, towels, and clothes carrying the fungus.
In most cases, the condition should be treated. A person can usually treat it at home with over-the-counter antifungal medications.
Psoriasis on the feet and athlete’s foot can look similar. A person may need to consult a doctor if they are unsure which condition they have, particularly if they have not had psoriasis before.
Some differences between athlete’s foot and psoriasis might include:
- Location: Though both conditions can affect any part of the foot, athlete’s foot can appear between the toes or under the nails. Psoriasis can also affect the nails and the soles of the feet.
- Color: Psoriasis and athlete’s foot can both look scaly and red in people with light skin. On dark skin, they may also appear gray, purple, or dark brown. Psoriasis also tends to change color and appearance over time or develop overlying silvery scales.
- Pain: Psoriasis on the foot can feel sore and painful. Athlete’s foot is mainly itchy, but frequent scratching can cause the infection to hurt.
- Nail changes: Athlete’s foot can trigger an infection in the area under the nails. It can cause the nails to lift and look yellow and brittle. Psoriasis can cause similar changes, and it can also cause the nails to look like they have small pits or dents in them.
- Joint stiffness: Some people with psoriasis have achy, stiff joints and other symptoms.
Treatment for psoriasis on the feet
As yet, there is no cure for psoriasis. However, a range of treatments can help relieve symptoms and reduce flare-ups. The choice of treatment will often depend on the type, location, and severity of a person’s psoriasis.
The three primary treatments include topical medications, light therapy, and systemic medications.
Topical medications come in different formulations, such as creams and ointments, that people apply directly to their skin. Examples include:
- emollients
- steroids
- vitamin D analogs
- calcineurin inhibitors
- coal tar
A person can buy some topical treatments, such as emollients, mild steroid creams, and coal tar foams, over the counter. A doctor can prescribe stronger topical formulations.
Light therapy, also known as phototherapy, usually takes place in hospitals or clinics and involves doctors exposing a person to UV light. For light therapy to be effective, people may require 2 or 3 sessions per week.
Systemic treatments work throughout the body and include oral and injected drugs. Doctors typically prescribe these medications only for severe psoriasis due to the risk of serious side effects and the need for close monitoring.
Examples of systemic treatments include:
- immunosuppressants, such as methotrexate or cyclosporine
- steroids
- retinoids
- phosphodiesterase 4 inhibitors
- biologics
Treating psoriasis on the feet can be challenging due to its location. Working with a doctor, people may need to try several different treatments before they find one that is effective. In some cases, an individual may require a combination of treatments.
A doctor may recommend topical corticosteroids, coal tar, light therapy, or systemic medications for people with psoriasis on the feet that they find difficult to treat in other ways.
Current guidelines suggest prescribing a biologic drug, such as infliximab (Remicade) or adalimumab (Humira), among others, for palmoplantar psoriasis. These drugs affect how the immune system works and aim to treat the underlying cause of psoriasis.
Other drugs a doctor may prescribe include acitretin (Soriatane), methotrexate (Rasuvo, Otrexup), and cyclosporin (Gengraf, Neural, Sandimmune, and others).
Lifestyle tips
Some lifestyle changes may help reduce or prevent flare-ups of psoriasis. These may include:
- staying healthy, such as by maintaining a moderate weight, exercising regularly, avoiding smoking if applicable, reducing alcohol intake if you drink, and eating a balanced diet
- keeping the skin moisturized, such as by regularly using emollients and avoiding soaps and cosmetics that can dry out the skin
- using a symptoms diary to identify and avoid specific psoriasis triggers, such as certain foods and weather
- minimizing stress if possible, such as through meditation, yoga, therapy, or other strategies
Frequently asked questions
Here are a few common questions about psoriasis on the feet.
How do you get rid of psoriasis on your feet?
Treatment for psoriasis on the feet may involve a combination of topical medications, light therapy, and systemic medications, such as immunosuppressants. Several lifestyle changes can also help reduce flare-ups of psoriasis over the long term.
A person can work with a doctor to determine the best course of treatment for them, which may depend on the specific type, location, and severity of psoriasis.
What does psoriasis on the feet feel like?
Plaque psoriasis can cause dry patches of skin on the feet, which often feel itchy or sore. Other types of psoriasis may cause painful, pus-filled blisters on the soles of the feet or scaly, dry patches of skin throughout the body.
Why am I getting psoriasis on my feet?
While experts are unclear on exactly what causes psoriasis on the feet, certain triggers may worsen psoriasis for some people.
Potential triggers may include stress, changes in the weather, illness or infection, certain medications, or a recent injury to the skin.
Takeaway
Psoriasis on the feet can be painful and more challenging to treat than the condition developing on other parts of the body. There are many treatment options available, but a person may need to work with their doctor to find one that is effective for them.
Keeping the skin moisturized, avoiding potential triggers, and maintaining a healthy lifestyle may also help prevent psoriasis flare-ups.
