Itchy skin, also known as pruritus, is inflammatory reaction of the skin. A wide variety of mild to serious diseases, conditions and disorders can be the underlying causes of itchy soles of feet, such as dermatitis, athlete’s foot and systemic diseases. Such itch can also be associated with a rash and can cover a small area or the entire foot. Depending on the root cause, the proper treatment should differ in severity, duration and frequency.

Causes of Itchy Soles of Feet

1. Exogenous Causes

• Dry Skin is the most common and obvious cause of itchy soles of the feet. The most likely cause is a lack of moisture in the skin. This affects the elderly more than the younger members of the population and it is found more frequently during the colder winter months.
• Contact Dermatitis is a skin reaction, which results from the exposure to allergens or irritants, such as certain soaps, cosmetics, detergents or even some plants, such as poison ivy. It presents as a localized rash or irritation of the skin. It can take days to fade away, but this will only happen if the source, either the allergen or irritant, is longer coming in contact with the soles of the feet.
• Palmoplantar Psoriasis is a chronic skin condition that is characterized by scaling, itching and inflammation of the skin. There are several other symptoms of this type of psoriasis, such as recurring attacks of skin rash symptoms on the soles of the feet, small red patchy that grow and become scaly, pain, cracked skin, bleeding, emotional distress and difficulty walking or spending any excess time on feet.
• Ring Worm of the feet can appear on parts or all of the feet. It presents as a round, itchy scaly patches, which can be delicate or in some cases thick or hyperkeratotic, which is a thickening of the outer layer of the skin that produces a tough and often dry area of skin on the foot that can have some discoloration.
• Lichen Planus is an inflammatory skin condition, which is characterized by a small severely itchy, especially at night, non-infectious rash that can appear on one foot or both feet. This rash can appear suddenly and can last for several months. Once the symptoms subside there are sometimes dark brown or gray spots, which appear more visibly on dark skin.
• Candidal Intertrigo is an infection of the skin by candida albicans, which is a diploid fungus that grows both as yeast and filamentous cells that can affect the feet. It is usually located in the folds of the skin between the toes.
• Athlete’s Foot, which is also known as tinea pedis a fungal infection that affects the feet. People who have athlete’s foot experience cracks or fissures between the toes initially and skin then becomes red, moist-looking and itchy on the bottom of the feet and between the toes. The fissures will continue to become more painfully raw as blisters form. A foul odor can result if these blisters are not treated, because they will release pus. It is contagious and generally spread in damp or wet areas. It is often common in locker rooms, public showers, and pool areas and can also be passed through the sharing of towels as well.
• Scabies, which is also referred to as Norwegian scabies or the seven-year itch, is a contagious infection that can affect the feet. This type of infection is caused by mites, which are a tiny usually not visible parasite, that burrow deep under the skin. These mites cause an intense allergic itching, which increases in intensity at night. Symptoms also include tiny blisters, a red rash and in some cases burrow tracks are also visible.
• Pitted Keratolysis, also known as toxic shock syndrome, is a bacterial infection commonly seen in athletes. This infection presents on the soles of the feet and is usually caused from the feet being exposed to a hot moist environment, such as unventilated shoes or sweaty feet. Some symptoms of this infection are a foul odor, which smells like rotting fish, pain and itching on the bottom of the feet. Lesions will appear and are white in color and they are covered with small superficial pits that can in some cases attach to one another to create larger lesions.

2. Endogenous Causes

• Systemic Causes of itchy soles of the feet include leukemia, blood disorders including polycythemia vera, liver diseases, Hodgkin's lymphoma, chronic kidney failure, endocrine disturbances such as hyper or hypothyroidism, multiple myeloma, and cutaneous mastocytosis which can begin as generalized itching and then turn into localized itching in the soles of the feet.
• Idiopathic Causes for itchy soles of the feet are those that present without any obvious cause.
• Vitamin Deficiency is another cause of itchy soles of the feet. Vitamins that are included in this are Vitamins B6, B12 and B1.
• Palmoplantar Hyperhidrosis, which is increased or more than the normal amount of sweating on the soles of the feet, can lead to itchy eczematous dermatitis on the soles of the feet.
• Other Conditions can present with generalized itching that then becomes more localized to the soles of the feet, such as aquagenic pruritus, senile pruritus and atopic dermatitis. Crohn’s disease and HIV infections also have as a symptom, itching on the soles of the feet as well.

Treatments for Itchy Soles of Feet

1. Home Remedies

• Care for Dryness and Allergies. Using moisturizing creams on the soles of the feet with protective gloves for the application, can help to care for dry feet as well as feet that are sensitive to contact with certain soaps or detergents.
• Apply Antihistamines. In order to relieve the itching on the soles of the feet an antihistamine usually does the trick. Long acting antihistamines such as cetirizine or terfenadine, are effective in mild to moderate cases, whereas more severe cases in addition to the long acting antihistamine, a short acting one, such as hydroxyzine, can be useful with the itching as well as an aid for sleeping.
• Use Special Creams. Another helpful aid in relieving itchy soles of the feet is applying special creams, such as topical doxepin hydrochloride 5%. This cream, once absorbed can also help with sleeping, but this cannot be used by anyone who is using antidepressants that are in the MAO inhibitor class, people with narrow angle glaucoma or those who have a tendency for urinary retention.

2. Medical Choices

As with all other medications, whether over the counter or prescription, it is important to follow the usage instructions and make sure the physicians before any type of medications.

• Skin Condition Treatment. There are specific treatments available for patients with itchy feet caused by scabies, herpes simplex, palmoplantar psoriasis, pompholyx, foot eczema, lichen planus, contact dermatitis, dry skin, ring worm, etc.
• Underlying Disease Treatment. In order to relieve the itching of the soles of the feet that is due to an underlying disease, treated the underlying disease will allow the itching to subside.
• Palmoplantar Hyperhidrosis Treatment. To cure sweaty soles of the feet that are due to palmoplantar hyperhidrosis, a physician can inject the patient with botulinum toxin, use a topical aluminum chloride and use tap water iontophoresis.
• Medications. There are prescription medications that can be used to help to relieve the itchy soles of the feet, such as cholestyramine, for a patient with itchiness from cholestatic liver disease, antidepressant or anti-anxiety medications, for the patient suffering from psychogenic itchiness, and for patients with severe itchiness of the feet because of a variety of causes, naltrexone, naloxone or ondansetron can be effective.
• Phototherapy. Patients who are experiencing itchiness on the soles of their feet due to kidney, liver, aquagenic and polycythemia related to pruritus can get relief through phototherapy with narrowband UVB or PUVA. Another helpful treatment is using a solution of psoralen solution that is dilated with water to soak the feet in while exposing them to the UV radiation.
• Injection of Vitamins. When the cause of the itching to the soles of the feet is due to vitamin deficiency, a physician can inject the deficient vitamin (B6, B12 and B1) into the patient.

When to See a Doctor

It is extremely important that a physician or a specialist, such as a dermatologist is consulted if any of the following, regarding the itching, occurs:

• If after trying the home care remedies the itching continues for more than two weeks.
• If it prevents you from sleeping.
• If it distracts you from your usual daily routine, due to the severity and discomfort.
• If it spreads to your entire body or affects the entire body in some way.
• If the cause is unknown and it cannot easily be explained.
• If there are other symptoms present, such as fever, redness of the skin, change in bowel or urinary habits, lethargy and/or weight loss.