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Psoriasis on Feet: Symptoms, Causes, and Treatments

Posted on March 31, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Sarah Winfrey

Psoriasis is an autoimmune disease in which skin cells grow and build up faster than normal. Some people with psoriasis develop symptoms on their feet. Itching, rashes, and dry, thick skin can be particularly bothersome on the feet and make walking or standing uncomfortable.

If you think you have psoriasis on your feet, it’s important to get the right diagnosis and work with your dermatologist to find the best treatment for your skin.

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 on the feet may appear with:

  • Clearly defined red, purple, or brown 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 red patch of skin or over much of the foot
  • Small patches of skin that are scaly but not necessarily red
  • Signs of inflammation, such as heat and redness
  • Small pustules on the bottom of the feet

Pain and discomfort from psoriasis on the feet may be worse than pain from psoriasis 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 blister-like pustules (sores) of varying sizes on the bottoms of the feet. These pustules tend to resolve themselves eventually, although they may leave you with brown 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 that are affected by psoriasis may look thick and ridged. They may lift from the nail bed, develop 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.

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 psoriasis, but it is believed to result from a combination of environmental and genetic factors. Psoriasis is an autoimmune condition — it occurs when part of the immune system is overactive and mistakenly attacks the body’s healthy tissues.

Psoriasis symptoms may be triggered by specific factors, such as an infection or dry weather. 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, red 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 psoriasis is determined to be the cause of your symptoms, there are several ways you and your doctor can help alleviate your discomfort. Keep in mind that it may take a while to find the right treatment.

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 particularly 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 after you have 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.

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 disease cycle and helping to bring about remission.

Get Support Today

Managing the symptoms of psoriatic disease can be a challenge. The good news is you don’t have to go it alone. MyPsoriasisTeam is a social network for people diagnosed with psoriasis and those who love and care for them. More than 90,000 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 MyPsoriasisTeam.

All updates must be accompanied by text or a picture.
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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