Why do your feet itch?
What are itchy feet?
Feet are exposed to many potential irritants like allergens, bugs, and fungus that can cause itchiness. Your feet also spend long hours in the potentially moist, hot environment of your shoes and socks, which can be a breeding ground for bacteria and fungi.
The most common causes of itchy feet are contact dermatitis, fungal infections like athlete’s foot, or bug bites from scabies, mosquitos, or bed bugs. These conditions may also cause a rash, blisters, or scaly skin.
In some cases, conditions such as diabetes and kidney or liver disease can cause Inflammation or affect the nerves, making your feet feel itchy.
Many causes of itchy feet can be treated with topical (applied to the skin) or oral anti-itch or antifungal medications, or topical steroids.
A common misconception is that itchy feet are always caused by a foot fungus. Many times I see patients who come in for “foot fungus,” but when I look at the feet it's eczema, dermatitis, or psoriasis. It may even be an internal cause of itching like liver or kidney diseases. —Dr. Lauren Levy
What causes itchy feet?
1. Athlete’s foot
- Red, itchy rash on your feet or between your toes
- Flaky or peeling skin on your feet
Athlete’s foot (tinea pedis) is a common fungal infection that affects your feet and toes. You can get it from walking barefoot on public floors, such as the floor in a locker room, the surface surrounding indoor pools, and gym mats (which is why it’s called athlete’s foot).
Athlete’s foot typically affects the bottom of your feet, but sometimes it can occur on the top of your feet, in between your toes or in the nail.
Athlete’s foot can be treated with over-the-counter (OTC) antifungal creams. The fungus can live on shoes and socks, so wash your socks in hot water. If you know of a sports store that sanitizes equipment, you can ask if they will sanitize your shoes. Wearing shower shoes in pool and public shower areas can also help prevent athlete’s foot.
See your doctor if the rash does not improve after using OTC antifungal medication for 2 to 4 weeks. You may need prescription oral antifungal medication.
- Red, itchy, and scaly rash on the bottom or top of your feet
- Small, fluid-filled blisters on your toes or the side of your foot
Eczema, or atopic dermatitis, is a common childhood skin condition, though adults can get it too. In adults, eczema usually develops on the feet and hands. This is called dyshidrotic eczema. It is usually on the soles of your feet but can be on the top of your feet as well.
Eczema is caused by a lack of certain molecules that keep your skin hydrated and moist. Water escapes from the skin, leading to symptoms such as itching and making your skin more vulnerable to irritants and allergens.
Your doctor may suggest hydrating your feet daily with an oil-based moisturizer, such as Vaseline or Aquaphor. Topical steroids, either OTC or prescription, can lessen the inflammation and itching. OTC or prescription antihistamines can also help with itching. But if you have moderate to severe eczema, you may need ultraviolet light therapy or immune-suppressing oral or injectable medications.
3. Contact dermatitis
- Red, itchy rash
- Scaly skin
- Bumps and blisters
- Swelling, burning, or tenderness
Contact dermatitis is a skin reaction to an irritant or allergen. It may be triggered by a material in your shoe, like rubber or leather.
If there’s no clear cause of your contact dermatitis, your dermatologist can help you identify what you are allergic to with patch testing. Patches containing different allergens are placed on your back for two days. After removing the patches, the dermatologist will check for any rashes caused by the allergens.
Treating contact dermatitis involves avoiding the allergen and using an OTC hydrocortisone cream or antihistamine to quiet the itching. Your doctor may also prescribe a topical steroid for the rash.
- Red, itchy plaques on your feet
- Thick, silvery scaling
- Pustules (pus-filled bumps) on the soles of your feet
- Thick, yellow, or brittle nails
- Joint pain (arthritis) or back pain
Psoriasis is an autoimmune disease that can affect any part of the skin, including the soles of the feet. It occurs when the immune system mistakenly attacks your skin, triggering your skin cells to regenerate faster than normal. It’s not clear what causes the attack, but genetics and environmental factors likely play a role.
When psoriasis affects the feet, it usually develops on the palms of your hands too. This is called palmoplantar psoriasis.
Symptoms vary, depending on the type of psoriasis you have. Forms of the disease include plaque psoriasis, pustular psoriasis, and nail psoriasis. Some people have psoriatic arthritis, which also causes swollen and painful joints.
There is no cure for psoriasis, but there are several treatment options. These include topical steroids, an oral medication called acitretin, ultraviolet light therapy, or oral or injectable immunosuppressants.
People with psoriasis have sharply demarcated red plaques on the feet and often have pustules. Those with contact dermatitis have an itchy, red rash in the shape of the contact allergen. Those with eczema, or dyshidrotic dermatitis, have small blisters on their feet. Lastly, people with foot fungus have scaling diffusely on their feet or in between the toes, and may also have toenail fungus. —Dr. Levy
- Pink or red skin rash that may be slightly raised
- Welts (red bumps or splotches)
- Burning and stinging
Hives, or urticaria, are swellings of the skin that are often itchy. They can be caused by a particular food, medication, viral infection, or autoimmune disease. But for many people, there’s no obvious reason.
Hives can occur on any part of the skin, including the soles of the feet. Symptoms usually last for less than 24 hours, then show up in a different area.
While minor hives aren’t an emergency, hives can sometimes be part of a serious allergic reaction. If you’re also experiencing swelling of your lips or tongue, trouble breathing, or diarrhea, go to the ER.
Minor hives can be treated with OTC antihistamines. If your symptoms don’t improve after a week or they interfere with your daily life, see your doctor. You may need to take prescription medication to get relief.
- Severe itching
- Red bumps
Scabies is an infestation of tiny mites called Sarcopte scabiei. Symptoms develop when the mites burrow into your skin. It’s a contagious condition that can spread rapidly through close contact with groups of people, such as families, nursing home residents, and hospital patients.
The bumps often appear in folds of skin, including the ones on the soles of your feet. Other commonly affected areas include between the fingers, around the waist, and in the armpits.
Scabies is treated with a topical anti-parasite medication (permethrin) or an oral anti-parasite medication (ivermectin). Your doctor may also prescribe topical steroids to help with itching. The itch can last for several weeks after the mite has been treated. This is called post-scabetic dermatitis.
Because scabies is so contagious, you’ll need to wash all of your clothing and linens in hot water. Anyone you live with should also be treated for scabies because people can be carriers without having symptoms.
7. Liver disease
- Itchy skin
- Yellow skin and eyes
- Abdominal pain and swelling
- Swelling in your legs and ankles
- Dark urine color
- Pale stool color
- Chronic fatigue
When your liver isn’t functioning properly, a yellowish substance called bilirubin builds up in your blood. Bilirubin is formed when red blood cells break down. It’s normally removed from your body by your liver. When your bilirubin levels are high, your skin becomes itchy and turns yellow.
If you have symptoms of liver disease, your doctor will order tests to figure out why your liver isn’t working. These include blood tests and an ultrasound or CT scan of your abdomen.
The itching caused by liver disease can be treated with a gentle hypoallergenic moisturizer, OTC or prescription antihistamines, or, in severe cases, ultraviolet light therapy. Your doctor may also recommend lifestyle changes, such taking lukewarm showers to prevent your skin from becoming dry. If your liver function improves, your itching may stop.
8. Kidney disease
- Dry skin
- Loss of appetite
- Fatigue and weakness
- Urine changes
- Muscle twitches and cramps
- Swollen feet and ankles
Itching caused by kidney disease is called uremic pruritus. When the kidneys aren’t working properly, it can lead to a buildup of certain substances that they would normally filter from your blood, such as urea. These substances can cause severe itching, especially on your palms or the soles of your feet. The itching may be worse at night.
If you have symptoms of kidney disease, your doctor will do blood and urine tests to figure out why your kidneys aren’t functioning. Treating the itching with OTC or prescription oral antihistamines may be helpful. Other medications that help with nerve conduction, like gabapentin, may be recommended.
If you require dialysis (a procedure that removes excess water and toxins from the blood), the itching may go away after your treatment.
- Itching, numbness, or tingling on the soles of your feet
- Sharp, jabbing, throbbing, or burning pain
- Sensitivity to touch
- Lack of coordination and falling
Neuropathy is a dysfunction of the nerves. It can occur anywhere in your body, but it usually affects your feet and hands. When you have neuropathy, your immune system releases substances (cytokines) that can irritate the nerves and cause itching.
There are several causes of neuropathy, including injuries, infections, and conditions such as diabetes, multiple sclerosis, or other neurological disorders.
Treatments for neuropathy include topical, OTC pain medications (such as capsaicin cream or lidocaine) that numb the nerves and reduce itchiness, pain, and burning in the feet. Your doctor may prescribe an oral medication that helps with nerve pain, such as gabapentin.
Does pregnancy cause itchy feet?
The increase in hormones that occurs during pregnancy may dry out your skin and make your feet swell. Both can cause itchy feet.
In some cases, itchy feet during pregnancy may be a sign of a condition called intrahepatic cholestasis of pregnancy, which affects the release of bile (digestive fluid) from your liver cells. The bile gets trapped in the liver, then spills into the bloodstream, which causes itching.
If your feet itch during pregnancy, see your doctor, who may do a blood test to check your liver enzymes. If they’re elevated, you may have to deliver your baby early to prevent complications.
Do your feet itch only at night?
You may notice that your feet are itchier at night. The itch may seem more intense simply because your mind isn’t as busy at night, so you’ll probably notice the itch more. Plus, itchiness may feel better during the day when you’re walking around, since pressure on the feet can help reduce itching.
Feet always itch more at night. The pressure from walking usually helps block the nerves that send the itch signals. When you are laying in bed, the itch can become more noticeable and certainly more frustrating if it interferes with sleep. —Dr. Levy
How to stop itchy feet
- Soak your feet in cold water or an ice bath.
- Moisturize your feet with a gentle cream.
- Topical steroids for rashes
- Antifungal creams (Lamisil) for athlete’s foot
- Antihistamines (Benadryl, Claritin, Zyrtec, etc.) for allergies
- A menthol-based cream, like SARNA lotion, applied several times a day for itchiness (Keep it in the refrigerator.)
When to see a doctor
- Foot itching lasts more than 2 weeks despite OTC treatment
- Foot itching that occurs during pregnancy
- Itching is severe and keeps you up at night
- A rash on your feet isn’t getting better with over-the-counter treatment
- Signs of kidney or liver problems, such as swelling of the legs, arms, and stomach; yellowing of the skin or eyes; or a decrease in frequency of urination.
Dr. Levy is a board certified dermatologist specializing in medical derm with expertise in acne, rosacea, skin cancer, psoriasis, and skin manifestations of rheumatologic disease. Her undergraduate education was completed at the University of Pennsylvania where she graduated summa cum laude and was inducted into the Phi Beta Kappa honors society. She graduated with a distinction in research from the Icahn School of Medicine at Mount Sinai and was inducted into the Alpha Omega Alpha Honor Medical Society. During medical school, she received a one year Doris Duke Clinical Research Fellowship Award. During that time, she investigated imaging techniques for early diagnosis of head and neck cancer. Her training continued with a medical internship at Memorial Sloane Kettering Cancer Center followed by dermatology residency in the Department of Dermatology at Yale University, one of the most prestigious dermatology departments in the country. Following her residency, she worked as a clinical Instructor at Yale School of Medicine. She currently sees patients in New York City and Westport Connecticut and is a Clinical Instructor in the Department of Dermatology at Mount Sinai School of Medicine. She is a Fellow of the American Academy of Dermatology.
Dr. Levy is well published in the field of dermatology having written articles on atopic dermatitis, psoriasis, acne, and skin manifestations of systemic disease. She is an avid lecturer and has been invited to lecture at state wide dermatology meetings. She is the editor of a board review Dermatology textbook.