The Center for Podiatric Care and Sports Medicine

Eczema on the Feet: Recognize the Types and Know Your Treatment Options

Posted by on Friday, November 7th, 2014

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Most people assume a general practitioner or dermatologist would treat a skin condition like eczema, but podiatrists also treat eczema when it’s found on the feet. In fact, eczema is the most common skin reaction that podiatrists encounter. By definition, eczema is a form of dermatitis (inflammation) of the outermost skin layers. An acute “flare-up” can cause intense itching, redness, edema, discharge, dryness, flaking, blistering, cracking, bleeding, oozing, and crusting. It’s often confused with athlete’s foot, but athlete’s foot rashes come in a very specific pattern, in between the toes or along the sides of the feet. In today’s post, we’ll talk about different types and treatments for eczema of the feet. If you live near Manhattan or Westchester, be sure to visit us for an accurate diagnosis.

eczema feet
Winter is a common time for eczema flare-ups, say NY podiatrists. Image Source: GalleryHip.com

Types of Foot Eczema

There are many different types of pedal eczema:

– Atopic eczema: This type of inflammation tends to be hereditary among people who have hay fever, allergic rhinitis, asthma, and dermatitis. Itchy rashes appear on the face, scalp, neck, elbows, behind the knees and buttocks. Eczema appearing only on the feet is very rare. Secondary bacterial, viral, and fungal infections are common. Triggers may include extreme temperatures, over-washing, environmental allergens, oils, soaps, clothing material, illness, sweat, dry air, tight clothing, or dust mite allergens.

– Nummular eczema: These oval plaques begin as small papules on the arms, legs, hands, and feet, but enlarge and crust over. People report intense itching and often develop secondary dermatitis. Cold or dry climates, occupational hazards, and stress are contributing causes.

– Contact dermatitis: Irritant contact comprises roughly 80 percent of contact dermatitis cases. Sodium lauryl sulfate, commonly found in many shampoos and soaps, is a known irritant. Latex, rubber, dyes, topical creams, and steroids are other common culprits. We usually see irritation on the upper side of the feet. Similarly, allergen-related contact dermatitis results from contact with poison ivy or nickel. It may show up a few days after contact occurs, but the rashes are extremely itchy and often appear with linear streaking present.

– Hyperkeratotic plantar eczema: Mechanical trauma, typically among men, causes a dense, thick rash of interconnected cracks across the skin of the hands and feet. They may form as a result of allergy or irritant. Topical vitamin D has treated this form of eczema with some success.

– Venous eczema: People over 50 who suffer from venous insufficiency, impaired circulation, varicose veins, and edema often develop this form of eczema. This redness, scaling, and skin darkening predisposes a person to leg ulcers, so it’s very important that it be treated at once.

 – Discoid eczema: The round oozing spots or dry rash with clear boundaries is often seen on the lower legs in the winter. The cause is unknown, and the condition tends to come and go.

– Xerotic eczema: What starts as dry skin progresses to rough, flaky, scaly patches. This condition is worse in dry winter weather. The limbs and trunk are most commonly affected. On the feet, deep fissures may occur. We see this type of eczema frequently in the elderly.

– Dyshidrotic eczema: This condition is common among athletes especially. Painful blisters on the soles of the feet flare up with intense itching at night. At first, clear or pink vesicles that look like balls of tapioca form on the toes, with larger growths on the soles of the feet. Fissures develop after the condition has become chronic. Treatment involves decreasing stress, perspiration, and contact irritants. The etiology is unclear, but we know that these three factors tend to aggravate the condition.

– Infective eczema: Bacteria provokes existing eczema, which mimics the symptoms of athlete’s foot.

Treatments for Foot Eczema

The treatment for eczema is complex and depends upon your unique symptoms or type of eczema, as well as any secondary infections that may be present. One of the primary goals for treatment is to break the itch-scratch cycle that drives patients up a wall and makes it impossible for the lesions to heal. This may be done through cortisone tape, a topical cream, moisturizing ointments, and occlusive dressings at night. Oral steroids or antihistamines may be prescribed in some cases. Laser treatment is reserved for the worst cases. You want to keep your lesions moist by minimizing long, hot showers, applying Vaseline or ointment, using a humidifier at night, and switching your cleanser to something gentler.

Why Visit a NYC Podiatrist

For many people, itching of the feet is the worst symptom. We are particularly adept at treating foot itching and can counsel you in methods of alleviating excessive sweating or chronic dryness–two extremes that contribute to eczema flare-ups. We not only take care of your acute symptoms, but also try to figure out what may be triggering the flares and help you prevent eczema from becoming a chronic, recurring problem. Book your appointment with a NY podiatrist today.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.