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 walking, standing, or even putting on socks uncomfortable or painful.

It’s important to know that other skin conditions, like athlete’s foot, can look similar to psoriasis. If you notice changes to the skin on your feet — or if your current symptoms aren’t improving — talk with a dermatologist (skin specialist). Getting the right diagnosis is the first step toward finding a treatment plan that works for you.

What Does Psoriasis on the Feet Look and Feel Like?

When psoriasis shows up on your feet or hands it’s called palmoplantar psoriasis. Some people experience symptoms only in these areas, while others may have psoriasis affecting multiple parts of their body.

Psoriasis symptoms on the feet may include:

• Clearly defined discolored patches or lesions on the skin
• Patches of thick, dry skin that may crack or bleed, sometimes covering the entire sole
• Itching, either on a discolored patch of skin or over much of the foot
• 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)

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Pain and discomfort from psoriasis on the feet may be worse than pain that develops elsewhere on the body due to 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 on the bottoms of the feet. These pustules tend to resolve eventually, although they may leave you with discolored patches or stains on your feet. You can talk to your doctor about treatment options that can help treat PPP.

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

Toenails affected by psoriasis may look thick and ridged. They may lift or separate from the nail bed (skin underneath the nail), develop white or yellow discoloration, or become pitted over time. Nail changes from psoriasis can affect various parts of the nail, including the nail bed, nail plate (what we commonly call nails), and the nail matrix (where the nail grows from).

Treatment may be slow, as nails take time to grow out and respond to therapy. The right toenail treatment may depend on which part of the nail is affected.

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 foot odor.

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 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 start with 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 spread through shared surfaces or personal items. 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, dry weather, or excessive stress, may trigger psoriasis symptoms. There are also several risk factors for psoriasis, including smoking tobacco and having a family history of the condition.

How To Treat Psoriasis on the Feet

If you think that you might have psoriasis on your feet, make an appointment with a podiatrist (specialist in conditions of the foot, ankle, and lower leg) or a dermatologist. Podiatrists can help determine whether psoriasis or another condition (like eczema or a fungal infection) may be causing your dry, flaky, itchy feet. An 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 are specifically designed for people diagnosed with psoriasis.

Treatments for Your Feet

The right treatment for you will depend on several factors, including the severity of your condition, how widespread your psoriasis is, and if you have other health conditions. Your healthcare provider may recommend the following options for treating your feet:

• Topical treatments, such as corticosteroid creams or gels, are often the first line of treatment for mild disease. Nonsteroid creams are available too.
• 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.
• Systemic therapies, such as biologics or methotrexate, target the immune system to control psoriasis. Your doctor will likely consider these options if your condition is more severe or widespread.

Find Your Team

On MyPsoriasisTeam, the social network for people diagnosed with psoriasis and their loved ones, 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.