Why Are My Feet Peeling?

Overview

"Oh no! Why are my feet peeling?" If you've kicked off your shoes and socks, only to find the skin on your feet is peeling, you're probably looking for answers. Don't worry, this article is here to help you understand the causes and treatments for peeling foot conditions.

Peeling feet can stem from many factors; understanding the root cause is essential for getting the right treatment. Continue reading to learn about the symptoms, causes, and treatments available for peeling feet. By the end of this guide, you'll have the knowledge you need to tackle your skin issue and confidently step towards healthier, more comfortable feet.

What happens when foot skin peels?

Skin, our largest organ, is more than just a human wrapper.¹ It's an intricate, versatile, and dynamic shield that protects us from the outside world, expertly maintains hydration, regulates body temperature, and makes vitamin D from sunlight; all while helping us feel and interact with our surroundings.^1,3

The outer layer of your skin, called the epidermis, is always refreshing itself in a controlled way.⁴ In this process, called desquamation, new skin cells at the base of the epidermis multiply and replace dead skin cells that invisibly shed from your skin's surface.⁴ 

When this natural process speeds up, you might see visible peeling of your skin.⁵ This peeling is also known as scaling or flaking. These words are often used interchangeably to describe how the skin looks when it's shedding or loosening from the outer layer.^5,6

There are two main types of skin on your body:⁴ 

1. Thick, hairless skin (glabrous) — like on your soles and palms
2. Hair-bearing and oil-producing skin — found on most other parts of your body, including the tops of your feet and toes

Your glabrous skin is more resistant to wear and tear than hair-bearing skin, since it needs to withstand the pressures of physical activity.^4,7 The soles of our feet have more sweat glands than other parts of the body, but have no oil glands to keep them moisturised. What's more, feet are typically exposed to more pressure, irritants, and germs than other parts of the body.⁸ This combination makes your feet vulnerable to skin disorders, including peeling. Skin issues on your soles can significantly limit your physical activities, impacting your quality of life.^9,10

Symptoms of peeling feet

The symptoms of peeling feet can vary depending on the cause; some skin conditions cause your feet to peel evenly all over (diffuse), while other conditions cause feet to peel in patches with obvious edges.¹¹ Peeling skin on your feet may look flaky or scaly with large or small pieces shedding off.^5,11

Your feet might peel all over, just on your soles or between your toes. You might have two peeling feet or just one.¹²
Your doctor can get a good idea about the cause of your peeling foot skin from how and where it appears, so it's a good idea to see them for an examination.¹¹

Common accompanying symptoms of foot peeling

Depending on the cause, you might have other symptoms alongside peeling foot skin such as:

• Dry or cracked skin^7,11
• Itching^10,13,14 
• Sweating¹³
• Swelling¹⁵
• Pain or discomfort^10,14
• Blistering¹⁴
• Odour¹³
• Skin thickening or hard skin¹¹
• Peeling skin elsewhere on your body^11,16
• Visible nail changes¹¹
• Feeling generally unwell with fever and body aches¹⁴

Causes of feet peeling

Many different conditions can cause the skin on your feet to peel, including:

Dry skin:
If the top layer of your foot skin becomes overly dry, lacking water, it can flake and peel.^4,7,17,18

Factors like sun exposure, friction, dry environments, frequent hot showers/baths, and harsh soaps can up the risk of dry skin.^17,19

Infections:
Many infections can cause skin peeling.²⁰ For example:

• A common fungal infection, athlete's foot, causes peeling between your toes and on your soles
• Pitted keratolysis is a bacterial foot infection that affects athletes and people who wear closed shoes a lot. With this bug, you might also have very sweaty, smelly feet that itch or burn when you walk¹³
• In children, the bacterial infection scarlet fever can cause toe skin peeling²¹
• Less commonly, peeling feet can be a symptom of viral infections like hand-foot-and-mouth or even COVID-19^14,22,24

Keratolysis exfoliativa:
This common condition with no known cause can make your palms and soles peel.

Sweating (hyperhidrosis):
Your feel can peel due to 'sweaty sock syndrome' where excessive sweating or non-breathable shoes cause moisture to build up, affecting your skin.²⁵

Inflammation:
Skin inflammation (dermatitis), including eczema and contact allergy/irritation, can cause peeling feet. Dermatitis can happen as an allergy to your shoes and is more likely to affect the tops of your feet than your soles.²⁶

Kawasaki disease, a rare inflammatory condition, can cause foot peeling in children.

Autoimmune diseases:
If your immune system mistakenly attacks your skin as though it were a germ, you can get a peeling or blistering skin disease, such as psoriasis, that can affect your feet.¹⁰

Physical factors
Sunburn and thermal burns can damage foot skin, causing it to peel.²⁷ Similarly, friction from shoes that rub can cause blisters on your feet, which later peel. 

Rare genetic conditions:
Rarely, peeling feet can be genetic.

Acral (meaning hands and feet) Peeling Skin syndrome (APSS) causes painless peeling, itching, and redness on hands and feet, either from birth or later in life.

Oudtshoorn disease is a rare genetic condition, first seen in South Africa, that affects infants through to young adults, causing episodes of peeling and redness on palms and soles, mainly during cold, dry weather.

Erythrokeratoderma is a group of rare genetic skin disorders that cause thickened red skin. Most patients show symptoms in infancy, and in half the cases, palms and soles are affected, often with peeling.

Drug side effects:
Overuse of foot care treatments, for warts, corns, or calluses can cause excessive foot peeling. 

Certain medications like chemotherapy drugs, growth factor inhibitors, and immunosuppressants can cause foot peeling as a side effect.²¹

Extremely rare causes of foot peeling include life-threatening drug reactions, Stevens-Johnson syndrome, and toxic epidermal necrolysis (SJS/TEN). These cause intense blistering, peeling, and organ damage.¹⁶ Early signs of SJS/TEN are flu-like symptoms, sore throat, fever, and red, painful eyes. A painful, red, or purple, rash follows, affecting your mouth, lips, eyes and genitals. In some people, this rash spreads to include the feet.¹⁶

Treatment 

Peeling feet caused by dry skin, keratolysis exfolativa, infections, and physical factors tend to get better on their own with minimal treatment such as moisturising, good hygiene, and limiting shoe-wearing.^{11,19,22,23,25,26}

General care includes avoiding triggers like heat, sun, friction, irritants, and sweat.^11,25,27 

Home remedies

Using a moisturising foot cream, especially one containing ceramides, can help keep your foot skin hydrated and healthy.²⁸ Other helpful moisturiser ingredients to look out for are petroleum and glycerine.²⁹

You can also try:¹⁹

• Avoiding over-washing with hot water and harsh soaps¹⁹
• Wearing cotton socks¹⁹
• Using breathable footwear and going barefoot when possible²⁵
• Changing your footwear and socks regularly and airing out shoes^13,19
• Soothing calamine lotion and oatmeal baths²⁶

If you're confident that your peeling feet are due to Athlete's foot, many anti-fungal creams, powders, and sprays are available over the counter.

Medical treatment

Most of the time, you can manage mild foot peeling at home. But if you've tried this and your peeling hasn't improved, it's time to see your healthcare provider for treatment.

The type of medical treatment you need depends on what's causing your peeling. Your healthcare provider might advise some of the following.

Moisturisers:
Your doctor might recommend a cream for most types of foot peeling to moisturise, reduce inflammation and relieve any itching you feel.¹⁹

Urea:
Used topically (applied to your skin), urea helps hydrate, reduce itching and prevent peeling caused by dry skin, dermatitis, psoriasis and eczema.¹⁹

Infection fighters:
Fungus-fighting ointments treat foot peeling in mild cases of athlete's foot. If you have a more severe case, you may need an oral antifungal pill.¹¹

Topical antibiotics and antiseptics are good for tackling bacteria-related peeling, like pitted keratolysis.¹³

Oral antibiotics are used to treat full-body infections like scarlet fever. 

Sweat busters:
Foot antiperspirants, botox or iontophoresis can treat sweating associated with peeling feet.¹³

Dressings:
For eczema, your doctor might recommend dry or damp dressings to help heal your peeling feet.

Steroids:
Topical or oral steroids are helpful for dermatitis (including eczema), psoriasis²⁶, and sweaty sock syndrome.²⁵

Salicylic acid:
Used topically, this acid helps exfoliate peeling skin in eczema.

Immune-system suppressors:
These powerful medications can be helpful for certain types of psoriasis-related foot peeling.²⁶

Light therapy:
Phototherapy can help treat eczema, psoriasis, and occasionally, genetic peeling conditions.

Oral retinoids:

Potent vitamin A can help some types of foot psoriasis²⁶, and genetic peeling conditions.

Emergency medical attention:

In the unlikely event that you have widespread skin peeling related to a severe medication reaction, like in SLS or TEN, you'll need to stop the drug that's causing it and receive urgent hospital admission. 

Treatment for children with peeling feet due to Kawasaki disease also requires hospital admission for an infusion of immune proteins and possibly aspirin.

When to seek medical attention

If your skin peeling is severe, or you have any doubt about it, it's important to seek medical attention right away. 

Summary

In summary, peeling feet has many causes, including dry skin, infections, autoimmune diseases, and more. Identifying the root cause is crucial for effective treatment, and with the knowledge you've gained from this article, you're better equipped to address your foot issue.