Psoriasis on Feet: Types, Causes, Symptoms and Treatment

What is Psoriasis on the Feet?

Psoriasis is a chronic autoimmune condition that affects the skin, causing rapid skin cell turnover which leads to the formation of thick, scaly plaques. This condition, including the type that affects the feet, impacts an estimated 7.5 to 8 million people in the United States and around 125 million globally, according to WebMD. 

When it specifically manifests on the feet, it's known as palmoplantar psoriasis and is characterized by red, scaly patches on the soles and sometimes the palms. This type of psoriasis not only causes physical discomfort but is also linked to a higher risk of several other health conditions, emphasizing the importance of comprehensive management for both skin health and overall well-being.

Types of Psoriasis Affecting the Feet

Psoriasis can manifest in various forms, each with its unique characteristics and impacts on foot health:

• Plaque Psoriasis on Feet: This is the most common type, affecting about 85 to 90% of people with psoriasis. It appears as raised, red patches covered with a silvery scale, known as plaques, and can cause significant discomfort.
• Palmoplantar Psoriasis: Specifically affecting the palms and soles, this form of psoriasis is particularly challenging due to the pressure and friction these areas endure. It can lead to deep cracks, soreness, and difficulty with daily activities.

Other forms of psoriasis that may affect the feet include:

• Guttate Psoriasis: Characterized by small, droplet-shaped spots, this type can also appear on the soles and is often triggered by infections.
• Pustular Psoriasis: A rarer form that leads to pus-filled blisters on the palms and soles, offering a distinct presentation from other types.

Understanding these types is crucial for effective management and treatment. High-quality images can help visually distinguish between these forms, offering a clearer understanding of what each type looks like and how it affects the feet.

Symptoms of Foot Psoriasis

The symptoms of foot psoriasis can vary widely among individuals but commonly include:

• Red and inflamed patches of skin
• Silvery scales or plaques on these red patches
• Dry, cracked skin that may bleed
• Itching, burning, or soreness around the affected areas
• Thick, pitted nails, a sign of nail psoriasis
• Swollen and painful joints, indicative of psoriatic arthritis

If you're experiencing symptoms that could be indicative of foot psoriasis or another condition, consider using an online Symptom Checker. While this tool can offer initial insights based on your symptoms, it's not a substitute for professional medical advice. Always consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.

Causes and Triggers

Understanding psoriasis on the feet begins with recognizing it as an autoimmune condition, a scenario where the body's defense system mistakenly attacks its own tissues. In the case of psoriasis, this misguided assault speeds up the skin cell lifecycle, leading to the rapid buildup of cells on the skin's surface. Research points to genetics playing a pivotal role, with certain genes predisposing individuals to this condition.

Common triggers known to provoke or exacerbate psoriasis include:

• Stress: A well-known catalyst for flare-ups. Managing stress through techniques like mindfulness, yoga, or professional counseling can help mitigate its impact.
• Infection: Particularly strep throat, which can lead to guttate psoriasis. Keeping good hygiene and seeking timely treatment for infections is key.
• Skin Injury: Cuts, scrapes, or severe sunburns can trigger the Koebner phenomenon in people with psoriasis. Protecting your skin from injuries and caring for wounds properly can help prevent this.
• Certain Medications: Some drugs can worsen psoriasis symptoms. If you notice changes after starting a new medication, consult with your healthcare provider for alternatives.
• Weather Changes: Cold and dry conditions often lead to flare-ups. Keeping your skin moisturized and using a humidifier during dry months can offer relief.

Diagnosis Process

Physical Examination

The journey to diagnosing psoriasis on the feet typically starts with a thorough physical examination. Healthcare professionals look for distinctive signs of psoriasis, such as raised, red patches of skin adorned with silvery scales, and may also inspect for nail changes or joint inflammation. 

Family and Medical History

A crucial component of the diagnostic process involves understanding the patient's medical and family history. Given the genetic factors associated with psoriasis, knowing whether close relatives have experienced similar symptoms can be a significant clue in confirming the diagnosis.

Additionally, discussing your personal medical history helps healthcare providers identify any potential triggers or related health conditions that might influence your psoriasis.

Biopsy

In cases where the diagnosis isn't immediately apparent or to exclude other conditions like eczema or fungal infections, a skin biopsy may be performed. This minor procedure entails removing a small sample of skin for laboratory examination. The biopsy can reveal the overactive skin cell production characteristic of psoriasis and rule out other diseases, providing a clear path towards accurate diagnosis and appropriate treatment.

Comprehensive Treatment Options

Managing psoriasis on the feet involves a multifaceted approach tailored to the severity of the condition and individual patient needs. Treatment options range from simple home remedies to advanced medical interventions.

Home Remedies

Home management strategies form the foundation of psoriasis care, emphasizing symptom relief

• Moisturizing Regularly: Keeping the skin moisturized is crucial for managing psoriasis. Thick, oil-based moisturizers or ointments are best as they help lock moisture into the skin, preventing dryness and cracking. Apply these products immediately after bathing while the skin is still damp to maximize absorption. Focus on liberal application over the affected areas multiple times throughout the day, especially before bedtime to allow deep hydration overnight.
• Cool Compresses: Applying cool, wet cloths to inflamed or itchy areas can provide immediate relief from discomfort. This method helps calm inflammation and can be particularly soothing during flare-ups. Simply soak a clean cloth in cold water, wring it out slightly, and place it on the affected areas for several minutes. Repeat this several times a day, especially after activities that may have caused skin irritation or at the end of the day.
• Salt Baths: Soaking your feet in a lukewarm bath with Epsom or Dead Sea salts can help soften plaques and reduce scaling. The minerals in these salts also aid in reducing inflammation. Prepare the bath by adding about one cup of salts to a tub of lukewarm water, ensuring the water is not too hot as this can aggravate the skin. Soak your feet for around 15-20 minutes, then gently pat them dry with a towel, making sure not to rub the sensitive areas.
• Oatmeal Baths: An oatmeal bath can soothe and relieve itchy, inflamed skin. To prepare, grind plain, unflavored oatmeal into a fine powder and add it to lukewarm bathwater. Stir the bath to ensure the oatmeal is evenly dispersed. Soak your feet for about 15-20 minutes. Oatmeal contains compounds that have anti-inflammatory and moisturizing properties, making it ideal for calming psoriasis symptoms. After the bath, rinse your feet with clean water and apply moisturizer while the skin is still damp to seal in moisture.

Topical Treatments

For many, topical medications are the first line of defense against foot psoriasis:

• Corticosteroids: Reduce inflammation and slow down skin cell turnover.
• Vitamin D Analogues: Help normalize skin cell activity.
• Coal Tar: Reduces scaling, itching, and inflammation, though its messy application makes it less favored by some.

Systemic Treatments

Systemic medications are considered for moderate to severe psoriasis or when topical treatments prove ineffective:

• Oral Retinoids: Work by slowing down the skin cell growth cycle.
• Immunosuppressants: Reduce the immune system's activity to prevent the overproduction of skin cells.
• Biologics: Target specific parts of the immune system to block the overactive immune response causing psoriasis.

Phototherapy

Phototherapy or light therapy involves exposing the skin to ultraviolet light under medical supervision, helping to slow skin cell turnover and reduce scaling and inflammation.

Navigating the complexities of psoriasis, especially when it manifests on the feet, often necessitates professional guidance. A podiatrist or dermatologist specializes in diagnosing and managing skin conditions like psoriasis and can offer insights that are tailored to your specific situation.

These professionals can help determine the most effective treatment plan, which may include a combination of therapies to manage symptoms and improve your quality of life.

Living with Psoriasis on the Feet: Lifestyle Tips and Tricks

Adopting a holistic lifestyle can significantly impact the management of foot psoriasis, enhancing treatment efficacy and improving quality of life.

• Dietary Adjustments: Incorporating anti-inflammatory foods such as fatty fish, leafy greens, and nuts can support overall health and potentially reduce psoriasis flare-ups.
• Stress Management: Techniques like meditation, yoga, or therapy can mitigate stress, a known trigger for psoriasis symptoms.
• Foot Care: Gentle daily cleansing, avoiding harsh soaps, and wearing breathable footwear can protect sensitive skin on the feet from irritation.
• Exercise: Regular, low-impact activities help maintain joint flexibility and reduce stress but avoid activities that may injure the feet.
• Avoid Triggers: Recognize and steer clear of personal triggers, whether they're environmental factors, certain foods, or stressors.

Psoriasis on Feet vs. Athlete's Foot

When dealing with foot discomfort, distinguishing between psoriasis on the feet and athlete's foot is crucial for effective treatment. Though they share some superficial similarities, understanding their differences is key to managing each condition properly.

Similarities:

• Itchiness and Discomfort: Both conditions can cause significant itchiness and discomfort, making it challenging to walk or wear shoes comfortably.
• Appearance on Feet: Each can manifest on the soles, sides, or in between the toes, with symptoms that affect the skin's appearance and texture.

Differences:

• Cause: Psoriasis is an autoimmune condition leading to the overproduction of skin cells, resulting in thick, scaly patches. Athlete's foot, however, is a fungal infection that thrives in moist environments, leading to a rash that can crack and peel.
• Symptom Appearance: Psoriasis patches are well-defined, raised, and covered with silvery scales. An Athlete's foot tends to produce a scaly rash that may blister and crack, often starting between the toes.
• Treatment: Treatment for psoriasis focuses on managing symptoms and may include topical treatments, light therapy, and systemic medications. Athlete's foot is treated with antifungal medications aimed at eliminating the infection.