# Foot dermatitis

> Foot dermatitis, or foot eczema, is a red, itchy rash that usually comes from the skin touching an irritant or allergen, often in footwear. Finding and avoiding the trigger and moisturising regularly are the main steps, with prescription treatment added for more severe cases.

Guide in [Skin and nails](https://footanklelowerlimb.com.au/learn/topics/skin-and-nails), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/dermatitis-of-the-foot
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 11 November 2026.
Next review by 11 November 2027.

- **It's a rash from contact.** Foot dermatitis is usually contact dermatitis, where the skin meets an irritant or allergen, often in footwear.
- **Finding the trigger matters most.** Avoiding it is the main treatment and the main way to keep the rash from coming back.
- **Moisturising helps.** Regular moisturiser protects the skin, and no single product has been shown to be better than another.
- **Infection can complicate it.** A wet, weeping, painful or crusted rash can be a sign of infection.
- **Other conditions can look similar,** including athlete's foot and pompholyx.

## What is foot dermatitis, and how common is it?

Foot dermatitis (foot eczema) is best understood as contact dermatitis of the foot: inflammation of the skin where it has touched something from outside the body, causing a red, itchy rash [1][2]. Contact dermatitis in general is common [2]. How often it affects the foot specifically isn't clear yet.

There are two main types. In irritant contact dermatitis the skin reacts badly to something it meets, and this is the more common type overall [3]. Allergic contact dermatitis is an immune reaction to substances that are usually harmless, and it often appears alongside the irritant type [4].

Shoe dermatitis is the form triggered by allergens or irritants in footwear. It can affect people of any age, sex or background [5].

## What causes it, and who gets it?

Most foot dermatitis comes from something your skin touches regularly, often in shoes [5]. Potassium dichromate, a chemical used in processing leather, is among the most common culprits, but it isn't the only one [5]. Metals such as nickel, chromium and cobalt are among the allergic triggers of contact dermatitis, and triggers vary from person to person [2]. Contact allergy in general is more common in women than in men [6].

Atopy (a tendency towards allergic conditions such as eczema) is a recognised risk factor for irritant dermatitis of the hands, and is linked with a poorer outlook [3]. Whether the same holds for the feet isn't clear yet.

Some other foot skin problems have different causes. Pompholyx is a blistering eczema of the hands and feet. Its cause isn't clear, but fungal infection, nickel, soaps, stress and sweating may set it off or make it worse [7]. Dry, cracked heels usually come from a lack of moisture in the skin, and can be worse in open-backed shoes such as sandals [8].

## What does it feel like, how is it diagnosed, and can it be serious?

In allergic contact dermatitis the skin feels very itchy before other symptoms appear [2]. In irritant contact dermatitis the skin may become very itchy, dry, thick and scaly, and the rash shows only where the skin touched the irritant [2]. An irritant rash starts at the site of contact and usually doesn't spread, and it tends to peak and then begin to heal. An allergic rash can keep getting worse even after the allergen is removed [3]. Long-lasting hand or foot eczema can also bring soreness, cracking, fissuring (splits in the skin) and bleeding [9].

Diagnosis starts with your history and an examination of the skin. For long-lasting foot eczema, that history covers when it began, how it has changed, and what your feet touch, including work and hobbies [9]. A full history matters because contact dermatitis can mimic other skin diseases, such as atopic dermatitis and lichen planus [10]. In adults with long-lasting hand or foot eczema, patch testing (putting small amounts of possible allergens on the skin to see whether it reacts) is treated as a standard part of the work-up, to rule out an allergic cause [9][11].

> [!tip] Try this
> Keep a short note of when the rash began, how it has changed, and which shoes, socks, creams, work and hobbies your feet have met. Noticing whether the rash lines up with one item can help point to the trigger.

Athlete's foot, a fungal infection, can look like eczema. It is more likely in people with diabetes, sweaty feet or a weakened immune system [8]. Pompholyx and dry, cracked heels can also look similar.

Some features mark the rash as more serious:

- **Infection.** Skin can become infected in both allergic and irritant contact dermatitis [2]. Signs include a wet rash that looks red or darker and 'angry' [12], painful blisters that ooze pus or become covered in a golden crust [7], and excessive weeping or tenderness [13]. Infection can spread.
- **A rash that isn't improving,** or one that comes with a fever or feeling unwell, can mean infection or that the diagnosis or treatment needs rethinking [2].
- **Eczema herpeticum,** a serious complication of eczema, can quickly become a medical emergency [12].
- **Steroid creams and infection.** Steroid creams can mask or spread infection, so they are generally avoided on infected skin unless given with an anti-infective or tablets for the infection [13][14][7].
- **After stopping a steroid cream,** intense redness and swelling of the skin is a warning sign [13][15].
- **In children,** a foot rash that looks unusual or lingers is described as needing further assessment [16].

## What can I do first?

The simplest and most important step for shoe dermatitis is avoiding the cause [5]. Once the trigger is identified and avoided, symptoms should improve and may clear up completely [15]. It can help to notice whether the rash follows a particular pair of shoes, a type of sock or a cream.

Regular moisturiser is the other mainstay: avoiding the irritant, protecting the skin and using moisturising creams is the main approach to irritant dermatitis [3]. In people with eczema generally, moisturisers lower disease severity and reduce flares, and no single moisturiser has been shown to be better than another [17]. Creams containing urea can irritate skin that is broken or strongly inflamed [17].

For long-lasting hand or foot eczema in adults, good skin care is an essential first step. It includes learning about skin care, changing habits, and using barrier products and soap substitutes, although support for those last two is weak [9]. Limiting contact with irritants and allergens matters too [9]. Care goes beyond creams and medicines to include avoiding causes, changing behaviours and social support [11]. Much of this advice comes from contact dermatitis in general, the hands, or eczema in general, rather than the foot alone.

## What helps if that isn't enough?

Treatment can be stepped up. The choice depends on how acute and severe the rash is, how it looks and where it is. Approaches can be combined and tailored to the person, and they don't all need to be used at once [1]. Avoiding the trigger remains as important as the eczema treatment itself [1].

When contact dermatitis is severe, prescription medicines may be used for a short time, such as corticosteroids, or tablets or creams that aren't steroids [2].

## Will it go away, and how do I stop it coming back?

Once you avoid the trigger, a contact dermatitis rash should slowly go away [2]. Symptoms often improve and may clear completely [15]. It can become long-term, though [2]. Pompholyx tends to relapse, and current treatments are limited at preventing relapses [18].

For adults with long-lasting hand and foot eczema, restoring everyday function is the main goal, and clearing the skin is secondary [11].

Prevention rests on recognising the trigger and then avoiding or minimising contact with it [1]. It helps to keep avoiding it even after the skin has settled. Regular moisturising may also lengthen the time between flares, as it does in eczema generally [17].

## Common questions

### Can my shoes cause a rash on my feet?

Yes. Shoe dermatitis is a rash set off by irritants or allergens in footwear, such as chemicals used in leather processing. The rash may line up with where a shoe touches your skin. Noticing which shoes, socks or creams the rash follows can help show what is triggering it.

### Is pompholyx the same as foot dermatitis?

No. Pompholyx is a blistering eczema of the hands and feet, and it tends to relapse. Its cause isn't clear. Fungal infection, nickel, soaps, stress and sweating may set it off. Shoe dermatitis is contact dermatitis, set off by something in footwear, though the two can look alike.

### Can children get foot dermatitis?

Yes. Shoe dermatitis can affect people of any age, sex or background, so children can get it. As with adults, working out which shoes, socks or products the rash follows is a useful starting point, and a rash that looks unusual or lingers deserves a closer look.

## Further reading

- [Foot dermatitis on Clindice](https://clindice.com/dermatitis-of-the-foot)
- [Athlete's foot](https://www.nhs.uk/conditions/athletes-foot/), NHS
- [Eczema](https://medlineplus.gov/eczema.html), MedlinePlus
- [Eczema of the Foot - Foot Health Facts](https://www.foothealthfacts.org/conditions/eczema-of-the-foot), FootHealthFacts (American College of Foot and Ankle Surgeons)
- [Eczema and its Management](https://primarycare.northeastlondon.icb.nhs.uk/wp-content/uploads/2024/02/Eczema-Creams.pdf), NHS
- [Dermatology - Hand and Foot PUVA Phototherapy :: Northern Care Alliance](https://www.northerncarealliance.nhs.uk/patient-information/patient-leaflets/dermatology-hand-and-foot-puva-phototherapy?q=%2Fpatient-information%2Fpatient-leaflets%2Fdermatology-hand-and-foot-puva-phototherapy), NHS

## Sources

1. German S1 guideline: Contact dermatitis · Dickel H, Bauer A, Brehler R et al. · Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology · 2022. https://doi.org/10.1111/ddg.14734
2. Contact dermatitis - treatments, symptoms and prevention · Healthdirect Australia. https://www.healthdirect.gov.au/conditions/skin-conditions/contact-dermatitis
3. Irritant Contact Dermatitis - a Review · Patel K, Nixon R · Current Dermatology Reports · 2022. https://doi.org/10.1007/s13671-021-00351-4
4. Allergic Contact Dermatitis · Kostner L, Anzengruber F, Guillod C et al. · Immunology and Allergy Clinics of North America · 2017. https://doi.org/10.1016/j.iac.2016.08.014
5. Shoe Dermatitis · Adeniran V, Cherian A, Cho JO et al. · Clinics in Podiatric Medicine and Surgery · 2021. https://doi.org/10.1016/j.cpm.2021.06.008
6. Prevalence of contact allergy in the general population: A systematic review and meta-analysis · Alinaghi F, Bennike NH, Egeberg A et al. · Contact Dermatitis · 2019. https://doi.org/10.1111/cod.13119
7. Pompholyx (dyshidrotic eczema) · nidirect · 2018. https://www.nidirect.gov.uk/conditions/pompholyx-dyshidrotic-eczema
8. Skin conditions · South Tees Hospitals NHS Foundation Trust · 2021. https://www.southtees.nhs.uk/services/community/podiatry/skin-conditions/
9. Management of chronic hand and foot eczema. An Australia/New Zealand Clinical narrative · University of Melbourne (Minerva Access). https://minerva-access.unimelb.edu.au/server/api/core/bitstreams/fe2c7775-e6c7-5145-8289-32538949a2a6/content
10. Contact Dermatitis: Classifications and Management · Li Y, Li L · Clinical Reviews in Allergy & Immunology · 2021. https://doi.org/10.1007/s12016-021-08875-0
11. Management of chronic hand and foot eczema. An Australia/New Zealand Clinical narrative · Rademaker M, Armour K, Baker C et al. · The Australasian Journal of Dermatology · 2021. https://doi.org/10.1111/ajd.13418
12. Information for adults with eczema · Bangholm Medical Centre. https://www.bangholmmedicalcentre.scot.nhs.uk/_common/getdocument?id=284203
13. Discoid eczema - Treatment · NHS. https://www.nhs.uk/conditions/discoid-eczema/treatment/
14. Topical corticosteroids · Newcastle Hospitals NHS Foundation Trust. https://www.newcastle-hospitals.nhs.uk/services/dermatology/patient-dermatology-information-leaflets/topical-corticosteroids/
15. Contact dermatitis - Treatment · NHS. https://www.nhs.uk/conditions/contact-dermatitis/treatment/
16. Common pediatric foot dermatoses · Guenst BJ · Journal of Pediatric Health Care · 1999. https://doi.org/10.1016/s0891-5245(99)90056-1
17. Emollients and moisturisers for eczema · van Zuuren EJ, Fedorowicz Z, Christensen R et al. · The Cochrane Database of Systematic Reviews · 2017. https://doi.org/10.1002/14651858.cd012119.pub2
18. Pompholyx: what's new? · Wollina U · Expert Opinion on Investigational Drugs · 2008. https://doi.org/10.1517/13543784.17.6.897

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This is general information, not advice about your own situation. To discuss your issues, book with one of our podiatrists. In an emergency, call 000.