From the Guidelines
The itching on the dorsum of your feet could be caused by several conditions, including dry skin, contact dermatitis, athlete's foot, or an allergic reaction, and the most effective approach to address this would be to try applying a moisturizing cream like CeraVe or Eucerin twice daily, especially after bathing when skin is still damp, as this can help alleviate dryness and reduce itching, as suggested by general dermatological principles 1. To further address the itching, consider the following:
- If the itching persists, an over-the-counter hydrocortisone cream (1%) applied thinly to affected areas twice daily for up to 7 days may help reduce inflammation.
- For potential fungal infections like athlete's foot, consider using an antifungal cream such as clotrimazole or terbinafine, applying it according to package directions, typically twice daily for 1-2 weeks, as these infections are common in warm, humid environments and can be prevalent among individuals who engage in sports, especially runners and swimmers 1.
- The top of feet are particularly prone to itching because the skin there is thin with fewer oil glands, making it susceptible to dryness, and this area is also exposed to friction from footwear and environmental irritants.
- It's essential to note that contact dermatitis, whether irritant or allergic, can also cause itching on the feet, and management involves removing the sensitizing agent and applying a topical steroid or other anti-inflammatory topical, as outlined in guidelines for managing dermatoses 1.
- If your symptoms don't improve within two weeks, are severe, or are accompanied by significant rash, swelling, or pain, consult a healthcare provider as you may need prescription-strength treatment or further evaluation, considering the potential for underlying conditions that may require specific management, such as onychomycosis, which has a high recurrence rate and requires thorough treatment and preventive measures 1.
From the Research
Causes of Pruritus on the Dorsum of the Feet
- Pruritus, or itch, can be caused by various factors, including dry skin, which reduces cutaneous barrier function 2
- Atopic dermatitis, a chronic relapsing and remitting inflammatory skin disease, can also cause pruritus due to a complex interaction of immune dysregulation, epidermal gene mutations, and environmental factors 3
- Damage to the stratum corneum, the outermost layer of the skin, can elicit a scratching response, which can lead to chronic itching 4
- Other factors that may contribute to pruritus include:
- Neurotransmitters such as substance P and neurokinin 1 receptor (NK1R) 2
- Nerve growth factor (NGF), muscarinic acetylcholine receptors, and opiates 4
- Serine proteases such as tryptase and their respective proteinase-activating receptor 2 (PAR2) 4
- Microbial imbalance of skin microbiota, immunoglobulin-E-induced sensitization, and neuro-inflammation 5
Pathophysiology of Pruritus
- The pathophysiology of pruritus involves a complex interplay between the skin, nervous system, and immune system 4, 5
- The itch-scratch cycle, which is characterized by repeated scratching and subsequent damage to the skin barrier, can lead to chronic itching 2, 3
- The epidermal barrier destruction, which can be caused by a lack of filaggrin protein, can induce inflammation and T-cell infiltration, leading to pruritus 5
Treatment of Pruritus
- Treatment of pruritus typically involves alleviation of itching and restoration of the skin barrier function 2, 3
- Topical moisturizers, corticosteroids, and anti-inflammatory agents such as calcineurin inhibitors can be effective in reducing pruritus 3, 5, 6
- Other treatments, such as phototherapy, systemic immunosuppressants, and antipruritic therapy, may also be used to manage pruritus 3, 5, 6