From the Guidelines
For itchy feet, I recommend starting with simple self-care advice, such as keeping nails short, and using emollients, followed by a short trial of a nonsedating antihistamine if warranted, as generalized idiopathic pruritus may be the underlying cause 1. When evaluating itchy feet, it's essential to consider the potential for underlying systemic causes, as generalized pruritus may have a significant underlying cause in 20-30% of cases 1.
- Keep feet clean and dry, washing daily with mild soap and drying thoroughly, especially between toes.
- Wear breathable cotton socks and change them daily.
- For immediate relief, try soaking feet in cool water with colloidal oatmeal or applying hydrocortisone 1% cream for temporary itch relief. If symptoms persist beyond two weeks, worsen, or if you notice spreading redness, blisters, or cracks between toes, consult a healthcare provider as you may need further evaluation and management, including potential referral to secondary care if there is diagnostic doubt or significant distress despite primary care management 1. It's also important to note that fungal infections, such as athlete's foot, can cause itchy feet, especially in individuals who participate in sports that involve warm, humid environments, such as swimmers and runners 1.
From the FDA Drug Label
Uses • cures most athlete's foot (tinea pedis) • cures most jock itch (tinea cruris) and ringworm (tinea corporis) • relieves itching, burning, cracking and scaling which accompany these conditions For itchy feet, terbinafine (TOP) can be used as it relieves itching accompanying conditions such as athlete's foot (tinea pedis) 2.
- The treatment duration and application frequency may vary depending on the location and severity of the condition.
- It is essential to follow the directions for use and consult a doctor if necessary, especially for children under 12 years of age 2.
From the Research
Itchy Feet Workup
- Itchy feet can be caused by various factors, including fungal infections such as tinea pedis (athlete's foot) 3.
- Terbinafine is a synthetic antifungal that has been proven to be effective in the treatment of onychomycosis and tinea pedis 3.
- The drug is available in oral and topical forms, including a novel topical solution (film-forming solution--FFS) that is effective in the treatment of tinea pedis 3.
Treatment Options
- Oral antifungal drugs such as terbinafine, fluconazole, griseofulvin, and itraconazole have been used to treat fungal infections, but their effectiveness can vary 4.
- A study found that itraconazole was the most effective drug in treating chronic and chronic relapsing dermatophytosis in India, followed by fluconazole, terbinafine, and griseofulvin 4.
- Topical antifungal creams such as terbinafine, clotrimazole, ketoconazole, and miconazole can also be used to treat fungal infections, but may contain allergenic ingredients that can cause allergic contact dermatitis 5.
Considerations
- When choosing an antifungal treatment, it is essential to consider the potential for drug interactions, especially with oral antifungal agents such as fluconazole and itraconazole 6.
- Terbinafine may be a more rational choice for patients receiving concomitant medications that may interact with other antifungal agents 6.
- The frequency of allergenic ingredients in antifungal creams can vary, and healthcare providers should be aware of this when evaluating patients with allergic contact dermatitis 5.