From the Guidelines
Diabetic foot itch should be managed by keeping the feet clean and dry, applying moisturizers, and using over-the-counter hydrocortisone or antifungal creams as needed, according to the most recent guidelines from 2024 1. To manage diabetic foot itch, several approaches can be taken.
- Keep your feet clean and dry, washing daily with mild soap and lukewarm water, then drying thoroughly, especially between toes.
- Apply a moisturizer containing urea or lactic acid like CeraVe Diabetic Skin Defense or Eucerin Diabetic Dry Skin Relief to prevent dryness, but avoid putting it between toes.
- For itching relief, try over-the-counter hydrocortisone 1% cream applied twice daily for up to 7 days.
- If fungal infection is suspected, use an antifungal cream like clotrimazole 1% or terbinafine 1% twice daily for 2-4 weeks.
- Wear clean, moisture-wicking cotton socks and properly fitting shoes. Diabetic foot itch often occurs due to dry skin from reduced sweat gland function, fungal infections like athlete's foot, or neuropathy causing abnormal sensations. It is essential to follow the guidelines for preventing foot ulcers in persons with diabetes, which include screening for signs or symptoms of peripheral neuropathy and peripheral artery disease, educating patients on foot self-care, and providing structured education on appropriate foot care 1. If itching persists beyond two weeks, worsens, or is accompanied by redness, swelling, or breaks in the skin, see a healthcare provider promptly as infections can progress rapidly in diabetic feet. The International Working Group on the Diabetic Foot (IWGDF) guidelines from 2024 provide the most up-to-date recommendations for managing diabetic foot itch and preventing foot ulcers 1.
From the Research
Diabetic Foot Itch
- Diabetic foot itch can be a symptom of various conditions, including dry skin, fungal infections, or nerve damage 2.
- Topical treatments, such as urea creams, can help improve skin quality and reduce itchiness in patients with diabetic foot syndrome 2.
- Hyaluronic acid (HA) has been shown to be effective in treating diabetic foot ulcers, including reducing itchiness and promoting wound healing 3, 4, 5.
- A study found that HA dressing increased the complete healing rate of diabetic foot ulcers compared to conventional dressing material 5.
- Another study found that a sodium hyaluronate and iodine complex dressing showed potential in treating diabetic foot ulcers, with clinical improvement observed in the majority of patients 4.
Treatment Options
- Topical antimicrobial agents, such as antimicrobial dressings, can be used to treat infected diabetic foot ulcers 6.
- Urea creams, including 10% urea creams, can be used to improve skin quality and reduce itchiness in patients with diabetic foot syndrome 2.
- Hyaluronic acid dressings, such as Healoderm, can be used to promote wound healing and reduce itchiness in patients with diabetic foot ulcers 5.
Study Findings
- A systematic review and meta-analysis found that HA increased the complete healing rate of diabetic foot ulcers compared to controls 3.
- A randomized controlled trial found that HA dressing increased the complete healing rate of diabetic foot ulcers compared to conventional dressing material 5.
- A case report found that a sodium hyaluronate and iodine complex dressing showed potential in treating diabetic foot ulcers, with clinical improvement observed in the majority of patients 4.