Your feet may be among the most uncomfortable places on your body to develop psoriasis symptoms. Itchiness, rash, and dry, thick skin aren't just bothersome — symptoms like painful sores and cracked skin can make it difficult to walk, stand, or even put on socks.

Notably, it’s possible to develop other conditions that affect your feet, such as fungal infections, that may resemble psoriasis. If you think you have psoriasis on your feet or have developed some other skin disease, it’s important to get the right diagnosis and work with your dermatologist to find the best treatment.

What Does Psoriasis on the Feet Look and Feel Like?

In many cases, psoriasis on the feet presents like psoriasis does elsewhere on the body. The most common type is plaque psoriasis (called palmoplantar psoriasis when it’s on the feet and hands).

Psoriasis symptoms on the feet may include:

• Clearly defined discolored patches or lesions on the skin, often covered with thick, silvery scales
• Patches of thick, dry skin that may crack or bleed easily and that may cover the entire sole
• Soreness, burning, or itching, either on a discolored patch of skin or over much of the foot
• Small patches of skin that are scaly but not necessarily discolored
• Signs of inflammation, such as heat and discoloration
• Small pustules (bumps filled with pus) on the bottom of the feet
• Psoriasis of the toenails (tiny dents or pits, ridges or grooves, white or yellow discoloration, nail thickening and nail lifting or separation)

Pain and discomfort from psoriasis on the feet may be worse than pain that develops elsewhere on the body because of the pressure caused by walking. Feet are highly sensitive, which can make basic movements uncomfortable if they are affected by psoriasis. When your feet hurt, even getting out of bed or wearing socks can be painful.

Many MyPsoriasisTeam members with psoriasis on their feet report that their feet feel like they are on fire. One member even said, “My feet feel like I’m walking on knives.” Another member shared, “My feet are inflamed, red, and painful.”

Occasionally, different types of psoriasis will appear on the feet.

Pustular Psoriasis

Palmoplantar pustular psoriasis (PPP) is a form of pustular psoriasis that affects the palms of the hands and soles of the feet. PPP can cause pustules of varying sizes on the bottoms of the feet. These pustules tend to resolve themselves eventually, although they may leave you with discolored patches or stains on your feet. For some people, palmoplantar pustular psoriasis comes and goes in cycles, with symptoms appearing during flare-ups and improving during remission.

Psoriasis on the Toenails

The toenails are actually part of the skin. They grow out of the nail plate, which is directly under the cuticle. Because of abnormal growth in the nail plate, psoriasis may affect your toenails.

Toenails affected by psoriasis may look thick and ridged. They may lift or separate from the nail bed, develop white or yellow discoloration, or become pitted over time. Once the nail has grown, it cannot be altered unless it is cut or filed.

Treating psoriasis on the toenails usually means treating the skin around the nail, including the nail bed, the cuticle, and the nail folds around the edges of the nail. Nails are difficult to treat, but some of the newer biologics have greater success.

Foot Psoriasis vs. Fungal Infections

As noted, psoriasis and some fungal infections can cause similar-looking symptoms on the feet.

One such fungal infection is athlete’s foot, a type of ringworm called tinea pedis. Symptoms that psoriasis and athlete’s foot share include rash, scaling, blisters, inflammation, discoloration, and dry, cracked skin. Athlete’s foot tends to start between the toes, whereas palmoplantar psoriasis typically affects the soles of the feet. Additionally, athlete’s foot may cause your feet to smell.

It’s also possible for your toenails to develop a fungal infection called tinea unguium (or onychomycosis), also a type of ringworm. This infection can cause some symptoms similar to those of nail psoriasis, including thinning of the nail plate, nail crumbling, onycholysis (nail plate separation from the nail bed), and discoloration.

Nail psoriasis and tinea unguium have distinctive symptoms, too. Among them, fungal infections often just affect a single toe, whereas nail psoriasis often affects multiple nails. Additionally, an odor may accompany a fungal infection but doesn’t occur with foot psoriasis.

Unlike psoriasis, fungal infections can be contagious. They also require different treatments than psoriasis. Therefore, it’s important to check with your dermatologist if you develop symptoms on your feet and aren’t sure what’s causing them.

What Causes Psoriasis on the Feet?

The causes of psoriasis on the feet are the same as those of psoriasis diagnosed elsewhere on the body. Researchers are not exactly sure what causes the skin condition, but many believe it results from a combination of environmental and genetic factors. Psoriasis is an autoimmune disease — it occurs when part of the immune system is overactive and mistakenly attacks the body’s healthy tissues.

Specific factors, such as an infection or dry weather, may trigger psoriasis symptoms. When a person with psoriasis experiences a trigger, their skin cells multiply faster than normal in certain areas, like the feet, causing the characteristic scales and itchy, discolored plaques. There are also several risk factors for psoriasis, including smoking, excessive stress, and having a family history of the condition.

Treatment for Psoriasis on the Feet

If you think that you might have psoriasis on your feet, make an appointment with a podiatrist or a dermatologist. These experts can help determine whether psoriasis or another condition (like eczema or a fungal infection) may be causing your dry, flaky, itchy feet. Clinical examination of your skin and possibly a skin biopsy will help confirm the diagnosis.

If a doctor determines that psoriasis is causing your symptoms, there are several treatments you can discuss with them to help ease your discomfort. Keep in mind that finding the right treatment may take some time.

Take Care of Your Feet

Start by taking good care of your feet. Wash them regularly with a gentle soap that does not dry the skin or trigger flares. Your doctor can offer medical advice to help you find a soap that will work for you. If you are prone to outbreaks of psoriasis on your feet, an oatmeal foot bath may also soothe your skin.

When your feet are clean and dry, use a gentle moisturizer to keep your feet well hydrated. Some lotions with urea or salicylic acid are specifically designed for people diagnosed with psoriasis.

Topical Corticosteroids

Strong corticosteroid creams or gels are often the first line of treatment for people who’ve been diagnosed with psoriasis, especially if it’s pustular psoriasis. Follow your podiatrist’s (or dermatologist’s) instructions when applying steroid creams.

Phototherapy

Phototherapy, also known as light therapy, is a treatment used for psoriasis and other skin conditions. Phototherapy involves exposing the skin to certain types of light. Your dermatologist may recommend a broad spectrum of light or focus on one type, such as ultraviolet B (UVB) rays or UVA rays.

Read more about light therapy for psoriasis.

Systemic Therapy

If your psoriasis is persistent or severe, your doctor may recommend systemic oral or injected medications, like methotrexate, cyclosporine, or one of several biologics. These medications target the immune system, disrupting the skin cycle, and help to bring about remission.

Find Your Team

On MyPsoriasisTeam, the social network for people diagnosed with psoriasis and their loved ones, more than 123,000 members come together to ask questions, share advice, and connect with others who understand life with psoriatic disease.

Have you experienced psoriasis on your feet? How have you managed your symptoms? Share your experience and tips with others in the comments below or by posting on your Activities page.