Thick peeling skin on feet: Causes and treatment

Thick, peeling skin on the feet may be a nuisance for many. Most complain that no matter what they do, their skin feels tight, dry, and flaky. They may also notice that the skin will slough off, but the process never stops. Peeling skin on the feet is quite common and can be caused by various health conditions, including poor blood flow, diabetes, kidney disease, liver disease, and thyroid problems. Certain skin infections, skin conditions or disorders, or environmental factors may also be responsible for thick, peeling skin on the feet. The good news is there are ways to prevent it, and many treatments can be found over the counter.

What causes thick peeling skin on feet?

There are many conditions associated with the cause of thick, peeling skin on the feet. We will review some causes and ways to treat the skin properly.

Athlete’s foot

The most common cause of peeling feet is athlete’s foot, also known as tinea pedis. Athlete’s foot is due to many different fungi found in moist environments. It can also infect the toenails. Fungus can occur anywhere on the foot, but the soles and in between the toes are the most common. 

Symptoms of athlete’s foot are a dry, flaky, scaly skin rash to the bottom of the feet. This condition is contagious and can spread from direct contact with surfaces touched by the infected skin.

Skin peeling from an athlete’s foot infection improves within two to four weeks after appropriate antifungal treatments. Treatment options include OTC medications such as antifungal foot sprays and powder products. Your primary healthcare provider or podiatrist can treat an athlete’s foot infection. They may recommend prescription antifungal creams such as terbinafine, tolnaftate, or Lotrimin (clotrimazole) for severe cases.

You can prevent the spread of athlete’s foot by avoiding bare feet in public places like locker rooms, public showers, or pools. You can also prevent it by wearing clean socks and shoes and wearing flip-flops versus closed shoes, which can cause your feet to sweat more and trap moisture. 

Dry skin 

Dry skin, also known as xeroderma, is another cause of peeling feet. It is more common on the bottoms of the feet but can occur anywhere on the body. Dry skin looks flakey and can be thick with small cracks. When skin is severely dry, it will also peel and cause pain. 

Dry skin can improve in a few days with appropriate treatment, such as:

• Using a pumice stone to remove dead skin
• Applying moisturizers such as aloe vera, Vaseline, Eucerin, and CeraVe.
• Soaking your feet in an oatmeal bath (colloidal oatmeal), 
• Using OTC skin peels, such as glycolic acid and lactic acid 
• Prescription medication, such as salicylic acid ER.

You should be able to treat dry, peeling skin at home and fairly quickly. If it does not improve with regular treatment in a few days, your primary healthcare provider or podiatrist should be able to develop an effective treatment plan.

Psoriasis

Psoriasis is an autoimmune disease that can cause the skin on the bottom of the feet to peel. It may affect small areas of the foot, but in severe cases, the entire sole of the foot will be affected. Symptoms include an itchy red rash with silvery scales on the soles of the feet. In severe cases, there may be pus-filled blisters on the soles of the feet.

You may be able to manage itchy feet from psoriasis at home by keeping the skin well-moisturized and using oatmeal baths or OTC hydrocortisone creams to soothe the skin. Phytotherapy, which involves exposing the skin to UV-B light, may also help, under the discretion of a healthcare provider. Topical steroid creams, such as betamethasone, desonide, and triamcinolone, may also help in mild cases. More aggressive choices may include retinoids, biologics, and calcineurin inhibitors. 

Once treatment is initiated, a psoriatic flare-up may last a few weeks to a few months. It can stay in remission for a few years once it calms down.

Eczema

Eczema is a type of dermatitis responsible for inflammation of the skin. There are seven different types: atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and stasis dermatitis. Three types specifically—atopic dermatitis, contact dermatitis, and dyshidrotic eczema—can present in the feet, and all types can occur simultaneously. People who suffer from allergies are prone to developing eczema. 

Symptoms of eczema on the feet include thick patches of flaky and scaly skin. If a particular irritant is causing the eczema, many of the minor symptoms can go away in a few days by avoiding symptoms. However, it usually requires several weeks of treatment before symptoms diminish completely. 

You can treat eczema on the feet by keeping them moisturized with coconut oil, aloe vera gel, or colloidal oatmeal. OTC antihistamine medications, such as Benadryl (diphenhydramine), may also help. For stubborn cases, your healthcare provider may prescribe topical corticosteroids such as hydrocortisone, betamethasone, and triamcinolone.

Hyperhidrosis

Excessive sweating is called hyperhidrosis, which can affect the feet. Unfortunately, hyperhidrosis places the feet at risk of developing red, irritated skin that peels. The skin may also look wet from the increased moisture, and odor may be present.

Hyperhidrosis can cause a skin condition called keratolysis exfoliativa, which causes chronic dryness to the soles of the feet and palms of the hands. In order to treat peeling skin on the feet due to hyperhidrosis, the excessive moisture must be under control. You can do this by:

• Keeping your feet dry, especially after baths and showers
• Wearing moisture-wicking socks
• Placing cotton between the toes
• Using OTC foot powders and antiperspirants

Your primary care doctor, dermatologist, or podiatrist can help with peeling from hyperhidrosis when other measures fail. They may prescribe prescription medication, such as Drysol (aluminum chloride) or anticholinergic oral drugs. They may also recommend Botox injections to prevent sweating. 

Acral peeling skin syndrome

Acral peeling skin syndrome is an inherited skin condition; however, it is quite rare. It’s associated with painless peeling of the skin’s outer layers, mostly on the hands and feet, but the legs and arms can also be affected. Signs of acral peeling skin syndrome include red, itchy skin and sometimes blisters.  

Treatment involves avoiding exposure to heat, friction, humidity, and other forms of moisture, which can exacerbate peeling from acral peeling skin syndrome. Although the underlying skin may be temporarily red and itchy, it typically heals without scarring.

Toxic epidermal necrolysis

Toxic epidermal necrolysis is a life-threatening skin disorder due to drug reactions. Symptoms include skin that peels and blisters to the point the area is raw and causes intense pain. Because this is such a rapidly progressing and very serious condition, it must be managed in a hospital setting.

Most importantly, peeling skin is treatable

Reasons for thick peeling skin on the feet vary but commonly include fungal infections like athlete’s foot, psoriasis, eczema, and skin that is either too dry or exposed to too much moisture. There are a variety of home remedies, OTC medications, and lotions to treat dry, peeling skin on the feet. However, if thick peeling skin on the feet continues, worsens, or is accompanied by open sores, redness that spreads, or swelling to the feet, it could be a sign of an underlying condition that requires close monitoring. Only your healthcare provider can rule out infection or other serious health conditions.