Why are my feet itchy at night?

Nocturnal pruritus, the medical term for itchiness at night, can occur anywhere on your body, including your feet. Although the itchiness may be present at any time of day, it can be more noticeable when trying to rest. The most common causes of itchy feet at night are related to fungal, bacterial, or viral infections, but we’ll explore some other potential causes to help you choose the best treatment and get a better night’s sleep. 

What causes itchy feet at night?

The cause of itchy skin at night is related to how our complicated peripheral nervous system works with our internal clock—better known as our circadian rhythm. When the body recognizes that it is time to go to bed, it increases blood flow and body temperature, which can cause itching. But when itching is excessive and interrupts your sleep, it could be the symptom of an underlying condition, an infection, or a reaction to an irritant.

1. Fungal infections

Athlete’s foot (tinea pedis) is the most common cause of itchy feet at night. Symptoms of athlete’s foot are dry, flaky, scaly skin on the bottoms of the feet and between the toes. Athlete’s foot symptoms should improve within two to four weeks with proper treatment.

Treatment options include over-the-counter (OTC) antifungal products. If those don’t work, your healthcare provider can provide stronger prescription antifungal creams, such as terbinafine, tolnaftate, and Lotrimin (clotrimazole). Occasionally, oral antifungal medications may also be required.

Typically, your general practitioner can diagnose and treat athlete’s foot. If their treatment does not work, they will recommend a second opinion from a podiatrist or dermatologist.

You can prevent athlete’s foot by avoiding walking barefoot in locker rooms and other public areas, wearing clean socks and shoes, avoiding extreme temperatures, and practicing good foot hygiene. 

2. Dermatitis

Dermatitis (a type of eczema) is another common cause of nocturnal pruritus. The most common types of dermatitis that impact the feet are dyshidrotic eczema, atopic dermatitis, and allergic contact dermatitis. 

Dermatitis symptoms include redness, scaling, and thickened skin on the bottoms of the feet. The skin patches may also itch or become painful. If the irritant causing the condition is avoided, many of the mild symptoms can go away in a few days. However, it usually requires several weeks of treatment before symptoms fully heal. 

Topical home remedies to treat dermatitis include coconut oil, aloe vera gel, colloidal oatmeal, honey, and apple cider vinegar. You can also use a humidifier to reduce dryness in your home. OTC medications such as Vaseline and Benadryl (diphenhydramine) can also relieve symptoms. For persistent dermatitis, your healthcare provider may prescribe prescription topical steroid creams such as hydrocortisone, betamethasone, and triamcinolone.

3. Psoriasis

Psoriasis is another skin condition that may cause foot itchiness at nighttime. It can affect a small area of the foot or become severe, affecting the entire sole. Common symptoms are inflamed patches of skin with silvery scales. Redness may occur along with pus-filled blisters in more severe cases. Skin may become thick where it cracks and cause discomfort.

A psoriatic flare-up may last a few weeks to a few months and then go into remission for a few years. Treatment options for psoriatic itchy feet include calming moisturizers and lotions, hydrocortisone creams, Coal Tar, and salicylic acid. Initially, your healthcare provider may prescribe steroid creams such as betamethasone, desonide, and triamcinolone. Other options include retinoids that help slow skin growth and reduce inflammation during a flare-up. Biologics and calcineurin inhibitors are also becoming popular for treatment and prevention of psoriatic flare-ups. 

4. Sunburn

Severe sunburn may also be responsible for itchy feet that are more noticeable at nighttime. Sunburn is usually more common on the tops of the feet but may be on the bottom as well from walking barefoot on hot pavement and sand.

Redness, blisters, and swelling of the skin are typical signs of sunburned skin on the foot. Minor sunburns will heal within three to five days, but more severe cases may require a few weeks of treatment. People who may have a weak immune system may take longer to heal. 

Sunburn treatment options include cold compresses, aloe vera gel, and colloidal oatmeal.

OTC medications for sunburn include Benadryl (diphenhydramine), Tylenol (acetaminophen), and Zyrtec (cetirizine). For severe cases of sunburn, your healthcare provider may provide prescription topical steroids such as hydrocortisone, betamethasone, and triamcinolone.

Itchy feet from sunburn should improve on their own. If not, you should contact your primary care physician or podiatrist for medical treatment.

5. Dry skin

Also called xeroderma, dry skin is another cause of nighttime itchiness of the feet. Dry skin is common on the soles and heels but can occur anywhere on the foot. Affected skin can look flaky or be thick with small cracks. It can also be very painful. 

Dry skin can improve in a few days with the appropriate treatment, such as Vaseline, OTC moisturizers such as Eucerin and CeraVe, oatmeal baths, and aloe vera. Dry skin that causes itchy feet at night should improve relatively quickly with treatment. If it does not improve, consult your primary care physician or podiatrist to determine the underlying cause and to rule out eczema and psoriasis. 

6. Medical conditions

There are many medical conditions for which itchy feet at night are a symptom. Examples include certain types of cancer, diabetic nerve pain (peripheral neuropathy), infections, kidney disease, liver disease, pregnancy, thyroid problems, and vitamin deficiencies.

Itchy feet caused by an underlying medical condition may last for as long as the medical condition is left untreated. For instance, people with itchy feet caused by diabetic nerve pain may notice less itching once they can control their blood sugar. 

If itchy feet at night are due to an underlying medical condition, make an appointment with your healthcare provider to ensure no other medical management is needed.

7. Environmental or pharmaceutical allergens 

Occasionally, allergic reactions, bug bites, and pest infestations like lice, mites, and scabies can cause nighttime itchiness of the feet. These types of infestations usually occur from skin-to-skin contact and cause intense itching, small pustules, redness, and blisters.

Itchy feet from allergens may last for as long as the feet are exposed to the allergen. For example, ceasing direct contact with any sheets, clothing, and towels causing the reaction may provide immediate relief.  In the case of lice, the infested person may also be prescribed pediculicide, a medicine that can kill lice. This typically isn’t necessary if hygiene is maintained and items are laundered appropriately at least once a week. 

You can also apply olive oil, vaseline, and apple cider vinegar to the affected area. OTC medications like Benadryl (diphenhydramine) can help relieve symptoms, depending on the cause.

Bottom line: How to relieve itchy feet at night

Itchy feet at night have several possible causes, with skin conditions such as eczema, athlete’s foot, and psoriasis among the most common. Health conditions like diabetes, liver disease, and cancer may cause itchy feet at night as well. Additionally, allergic reactions to the environment and medications should not be ignored when trying to determine the cause of your nighttime itchiness. 

Itchy feet at night may resolve independently, but typically, the underlying cause must be treated before the symptoms go away. You can manage symptoms with home remedies or OTC medications in minor cases, but if itchy feet at night continue, worsen, or are accompanied by open sores, fever, or chills, it could be a sign of a secondary bacterial infection, which may be a medical emergency. Only your healthcare provider can rule out infection or other serious health conditions. They will perform a physical exam and rule out other common conditions to determine the best treatment for itchy feet at night.