Author: Chloe Wilson - BSc(Hons) Physiotherapy
A foot rash can develop for a multitude of reasons. It may only affect a small area, be short-lived and mild, or it may spread further up the leg, return frequently and be painful or itchy. Some cases of foot rashes are highly contagious.
With any type of foot or ankle rash, it is important to diagnose the cause so that treatment can be effectively targeted. It also helps to prevent it from returning and turning into a chronic (long lasting) condition where possible.
Here, we will be looking at some of the most common and then the rarer causes of a foot rash and how they present so you can identify your problem. We will also look at the best ways to treat them.
An allergic reaction that causes a foot rash is known as contact dermatitis and develops when the
skin is sensitive to certain substances. It can be split into two
categories of foot and ankle rash:
Causes: Damage to the protective outer layer of skin, usually due to contact
with chemicals such as household cleaning products, detergents, dyes,
cosmetics or industrial chemicals. This is the most common type of contact dermatitis.
Symptoms: Localised dry, cracked, scaly skin and a non-itchy foot and ankle rash. Symptoms vary according to the length of exposure, the amount and potency of the irritant.
Causes: Exposure to allergens trigger an immune reaction in the skin. Common allergens include latex rubber, plants e.g. poison ivy, metallic substances e.g. nickel and chromates e.g. in shoe leather.
Symptoms: This type of foot rash usually presents as pink or red skin with small bumps which may blister. It tends to be extremely itchy.
A foot or ankle rash from contact dermatitis may develop from a single exposure or after repeated episodes of contact. Symptoms usually appear within a few minutes to hours of exposure and can last for 2-4 weeks. A rash from contact dermatitis is not contagious.
Eczema is another cause of a foot or leg rash. It is a chronic condition that usually starts in early childhood. Many children grow out of eczema but it can persist into adulthood. It affects approximately 25% of children and 2-10% of adults and is becoming increasingly common.
Causes: The exact cause of eczema is unknown and it may be due to a number of factors including an inability for the skin to provide an effective barrier to allergens, bacteria on the skin and environmental conditions. There is a genetic link with eczema and it is often accompanied by allergies and hay fever. Stress and anxiety can cause flare ups.
Symptoms: Dry, red patches of inflamed skin. Often itchy, especially at night. Can progress to small, fluid filled bumps. A leg or foot rash from eczema often occurs in skin creases such as behind the knees or between the toes
Treatment: There is no cure for eczema but there are things you can do to reduce the symptoms of the leg or ankle rash including corticosteroid cream or ointment (ointment tends to be more effective), anti-histamines, UV light therapy. Regularly moisturise the skin (at least twice a day) to help reduce the chance of flare-ups. Reduce the frequency and length that you bathe or shower, use warm rather than hot water and use emollients such as Aveeno instead of soap in the water to prevent the skin drying out.
Eczema tends to flare up periodically and then subside for anything from a few days to years. It is not contagious.
Athlete’s foot, a type of ringworm, is a fungal infection that usually starts with a rash between the toes known as a ringworm rash. It affects approximately 15% of the population and is more common in men.
Causes: Sweaty feet, tight shoes, damp footwear – anything that makes the foot warm and wet for long periods
Symptoms: Scaly, flaky, itchy, red foot rash (aka a ringworm rash) accompanied by stinging and burning sensation. Blisters can develop
Treatment: Anti-fungal medication – usually cream or ointment or in severe cases oral medication. Good hygiene measures such as regularly changing socks and shoes, or wear sandals to prevent excessive moisture at the foot
Athlete’s foot is contagious and is spread by skin-to-skin contact or through contaminated surfaces e.g. floors, towels and clothing
Hand, foot and mouth disease is a mild viral infection which causes a mouth, hand and foot rash. It mainly affects children under the age of 10.
Causes: Infection from the coxsackievirus A16. Highly infectious, through nasopharyngeal secretions from coughing and sneezing. The incubation period (time from exposure to symptoms) is usually 3-6 days. Tends to occur during warmer weather.
Symptoms: Red, non-itchy hand and foot rash (on the soles of the feet). Blisters in the mouth, hands and feet. Fever, sore throat, loss of appetite and a general feeling of being unwell. Dehydration is a common side effect as it can be extremely painful to drink.
Treatment: Treatment is geared towards symptom relief. Oral anaesthetics can make swallowing more comfortable and over the counter medications such as paracetamol and ibuprofen can help relieve discomfort. Symptoms usually settle within a few days.
NB Not to be confused with foot and mouth disease in animals which is from a completely different virus. Hand, foot and mouth cannot be caught from or passed on to animals.
There are a number of other possible causes of a foot rash, but they tend to be less common or affect more of the body, rather than being confined to the foot or lower legs.
Psoriasis is a chronic skin disease causing red, scaly, itchy patches. It is caused by rapid overproduction of skin cells due to a problem with the immune system. Psoriasis skin lesions range from small, localised patches to major eruptions affecting the whole body.
A foot rash from psoriasis tends to occur on the soles of the feet. It affects 2-4% of the population. Symptoms usually go through recurrent cycles of flaring up for a few weeks or months then settling down.
Scabies is a contagious skin condition caused by a parasite burrowing under the skin affecting 1.5% of the population. It causes intense itching which is worse at night.
Superficial burrows from the mite through the skin appear in lines accompanied by small, red spots commonly in the webs of fingers and toes, producing a hand or foot rash.
A bite to the foot or ankle can produce a rash. It tends to be a small, localised spot or group of spots which are itchy and settle within a few days.
Other causes of a foot, ankle or leg rash include Lyme Disease, meningitis, lichen planus, chicken pox, shingles, and rheumatoid arthritis.
If you are suffering from a foot rash, it is always a good idea to get it checked out by your doctor. They will examine the foot, leg or ankle rash and ask questions such as when it began, if you’ve been taking any medications, eaten something disagreeable, used any new products e.g. soaps, if there is any associated itching or scaling, if you’ve spent lots of time outdoors and how your general health is.
If none of these is sounding quite like your problem, visit the foot pain diagnosis section for help working out what is wrong.