Psoriasis on the feet requires a specialized treatment plan due to the frequent pressure and friction.

All types of psoriasis can affect the feet, but the most common is plaque psoriasis that causes thick, scaly patches that are pink or red in lighter skin and purple or dark brown in darker skin. Treatment options include topical treatments, coal tar, UV light therapy, and systemic medications that change how your immune system works.

Symptoms

Like other types of psoriasis, psoriasis on the foot may show up as red, scaly, itchy patches that are thick and dry. In addition, skin on the feet can crack and bleed.

When psoriasis develops on the feet, it’s important to get a diagnosis from a healthcare provider right away so that you can start treatment. Your doctor will perform a physical exam and ask about your symptoms, family history, and any environmental or medical triggers. You may also need a blood test or other tests.

Most cases of psoriasis on the feet are plaque psoriasis. These types of psoriasis look similar to other plaque psoriasis areas on the body, but they tend to be smaller and less itchy than other forms of the condition.

In some cases, your doctor may prescribe a topical cream or ointment that helps relieve inflammation and reduce scales on the feet. They may also recommend light therapy, which exposes the skin to controlled ultraviolet rays that help control inflammation and itching.

In some cases, your dermatology provider may prescribe oral medications to treat foot psoriasis if it’s not responsive to topical treatments or it’s causing significant pain and discomfort. These medications work by slowing down your immune system’s response to prevent the buildup of scaly, inflamed skin. Developing a treatment strategy that combines home care, medication and light therapy can help manage your foot psoriasis so that it doesn’t interfere with your daily life.

Diagnosis

Identifying the symptoms of foot psoriasis and seeking prompt medical attention are essential for effective management. Your doctor may prescribe a combination of medications to reduce inflammation and relieve itching, or he or she might recommend other treatments to help control your symptoms.

Psoriasis plaques are the hallmark of this condition, and they usually appear as thick, scaly, red or silvery patches. They develop because your immune system speeds up skin cell growth, causing the cells to build up faster than normal. When these cells shed, they form the scaly surface of a plaque.

The most common treatment for mild to moderate foot psoriasis is topical medications, such as corticosteroids. These are available as ointments, creams, gels, foams and shampoos. Your doctor might recommend a mild one to use on the affected areas daily during flares and at other times as needed, or a prescription-strength medication such as calcipotriene or tazarotene.

Other treatments may include phototherapy, which uses narrowband UVB light to target thick plaques on the soles of the feet or around the toes without exposing unaffected areas. This can be done in a dermatology office or with a home phototherapy unit. Some patients with foot psoriasis might also benefit from steroid injections, which deliver a higher dose of medication directly to the site of the inflammation.

Treatment

Psoriasis treatments vary depending on the type of psoriasis you have. Symptoms of plaque psoriasis on the feet tend to improve with regular use of steroid creams or ointments (topical corticosteroids). These medications reduce inflammation and slow skin cell growth, which helps control symptoms. Stronger topical steroids may cause skin thinning, so you should only use them as directed by your health care provider.

Pustular psoriasis on the hands and feet (palmoplantar pustular psoriasis) causes small, fluid-filled bumps that may be itchy or painful. This type of psoriasis is less common than other types of psoriasis and is more often associated with smoking or other health problems, such as heart disease.

Guttate psoriasis usually appears on the soles of the feet, but it can also appear on the palms. This form of psoriasis is triggered by infection and may be linked to other serious conditions, such as heart failure or diabetes.

Systemic treatments work throughout the body to control psoriasis and are given as pills (like methotrexate) or shots (like Humira or Stelara). UV light therapy is a treatment where you take a tablet called psoralen, which makes your skin more sensitive to ultraviolet A (UVA) light. You then sit in a special light booth twice or three times per week for a few months to help control your psoriasis.

Prevention

There is no cure for psoriasis, but treatments today are more effective than ever and research into new approaches to this chronic condition continues. Managing your symptoms can help reduce flare-ups and improve quality of life.

An overactive immune system causes psoriasis. It speeds up the growth of skin cells, which form thick, scaly patches that flake and itch. The exact cause isn’t known, but genetics and environmental triggers seem to play a role. People with psoriasis can have many types of the disease, and symptoms may flare up or go into remission for years at a time.

Plaque psoriasis, the most common type of psoriasis, usually appears on other parts of the body and is characterized by raised patches of dry and scaly skin. It often bleeds and cracks, and is sometimes itchy or sore. It can also affect the nails. Pustular psoriasis is rarer, and it causes small pus-filled blisters to form on the palms of hands or soles of feet. It can be itchy or painful, and it is more likely to occur in people who smoke cigarettes.

Some tips for preventing psoriasis on the foot include using emollients (moisturizers) to keep skin soft and supple, and wearing shoes with padded soles or wide toe boxes to minimize friction. Avoiding triggers that make psoriasis worse is also important. This can include avoiding hot or cold weather, certain medications, and stress.