Psoriasis, an autoimmune condition that most commonly causes thick, scaly patches to form on the skin, is estimated to affect more than eight million people in the United States.
In 12 to 16 percent of people with psoriasis, these patches appear on the palms or soles of feet. This is known as palmoplantar psoriasis.
Most commonly, the type of psoriasis that affects the feet is plaque psoriasis. Pustular psoriasis, which causes small, pus-filled blisters, can also affect the feet. In both cases, the affected skin can crack and bleed, which can make everyday tasks like standing or walking difficult.
“In some cases, people with foot psoriasis can’t even walk,” says Abby S. Van Vorhees, MD, the chair of dermatology at Eastern Virginia Medical School in Norfolk and a member of the NPF’s medical board. “But the good news is that there are treatments available and there’s a lot that can be done to make patients feel better.”
8 Ways To Relieve Your Psoriasis Itch
Next up video playing in 10 seconds
5 Ways to Find Relief for Foot Psoriasis
Here are five ways manage foot psoriasis.
1. Topical Medications
The first line of defense against psoriasis symptoms is medication, according to Mark Lebwohl, MD, a professor and the chair of the department of dermatology at Mount Sinai Hospital in New York City.
For mild cases, topical steroids could be enough to reduce flare-ups, Dr. Lebwohl says. Besides topical steroids, there are topical vitamin D analogues and topical retinoids.
Over-the-counter and prescription lotions, ointments, creams, sprays, and foams reduce swelling and itching and can help make you more comfortable, Lebwohl notes.
Ask your doctor if over-the-counter treatments with salicylic acid, lactic acid, or coal tar are right for you.
2. Phototherapy
If topical medications don’t work, Lebwohl recommends moving to phototherapy treatment for your foot psoriasis. Phototherapy, or light therapy, involves treating affected areas of the skin, such as the bottoms of the feet, with ultraviolet (UV) light. These treatments can be done under medical supervision in your dermatologist’s office or at home with a personal phototherapy unit. Light therapy has been shown to slow the growth of skin cells on the feet that are affected by psoriasis, Lebwohl says.
3. Biologic Therapy
If your foot psoriasis symptoms persist, it may be time to consider systemic therapies, meaning medications that enter the bloodstream and work within your body rather than just on the surface.
Injectable biologics target specific parts of the immune system, blocking cells or proteins that play a role in the development of psoriasis.
Newer oral treatments, called small molecules, target molecules inside immune cells and help correct the overactive immune response that causes inflammation in those with psoriatic disease.
4. Lifestyle Measures
There’s no evidence that a particular food can exacerbate or benefit psoriasis, says Lebwohl. A generally healthy diet, combined with exercise, can have great benefits, he says, especially because there’s a correlation between obesity and psoriasis. Often, those with obesity experience more severe psoriasis symptoms. Conversely, weight loss can have a positive impact on people with psoriasis.
“Exercise and diet that specifically lead to weight loss can help,” Lebwohl notes.
In addition, psoriasis medications have been shown to be more effective for those who have lost weight, he says.
5. Foot Protection
Any kind of trauma to the feet can trigger psoriasis, notes Dr. Van Vorhees. Even a minor bump or bruise can cause psoriasis to flare up in a previously unaffected part of the skin, an effect known as the Koebner phenomenon. So protecting your feet from injury is critical for people with psoriasis.
Avoid tight shoes and high heels because of the pressure they place on the toes. The type of material the shoe is made of is less important than the fit, Van Vorhees says.
In general, the front of the shoe should be round, rather than triangular, and loose shoes that cause friction or rubbing on the heel should be avoided, says Van Vorhees. Flip-flops or other open-toe sandals should be worn with caution, since they can expose your toes to possible injury, she adds.
Above all, seeing your dermatologist is essential for managing symptoms that affect your feet. That’s because foot psoriasis can sometimes be mistaken for something else, such as a fungal infection.
The wrong treatment for the wrong condition can worsen symptoms and lengthen their duration, Lebwohl says.
The Takeaway
Palmoplantar psoriasis is psoriasis that affects the palms of the hands and the soles of the feet.
Symptoms of foot psoriasis can make it difficult to stand and walk.
Treatments for foot psoriasis include topical medications, light therapy, and injectible and oral medications.
Protecting your feet from injury is one way to prevent psoriasis lesions there.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Amy Spizuoco, DO, is a board-certified dermatologist and dermatopathologist. Dr. Spizuoco has been practicing medical, surgical, and cosmetic dermatology, as well as dermatopathology in New York City for 12 years.
She did her undergraduate training at Binghamton University, majoring in Italian and biology. She went to medical school at the New York Institute of Technology College of Osteopathic Medicine. After medical school, she completed her dermatology residency at Lake Erie College of Osteopathic Medicine–Alta Dermatology in Arizona. During that time she studied skin cancer surgery and pediatric dermatology at Phoenix Children’s Hospital and attended dermatology grand rounds at the Mayo Clinic in Scottsdale. After her residency, Spizuoco completed a dermatopathology fellowship at the Ackerman Academy of Dermatopathology.
She was previously an associate clinical instructor in the department of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. She is on the editorial boards of Practical Dermatology and Dermatology Times.
Nina Wasserman is a journalist with more than a decade of experience interviewing people and writing on a variety of topics, including health, medicine, business, and faith, as well as human interest stories. Wasserman also home-schools her two children in New Jersey and teaches writing to middle school students. Her passion is foraging for mushrooms and edible plants in the woods, a practice that contributes to her health and wellness.
