Dermatitis of the Foot

Skin and Nail Conditions· Also known as: foot eczema, eczema of the foot, foot dermatitisUpdated Nov 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, November 2026

At a Glance

Dermatitis of the foot is usually contact dermatitis: the skin becomes inflamed where it meets something that irritates it or sets off an allergy, such as a material in a shoe. It causes a red, itchy rash. It can affect anyone, and how common it is on the foot isn't yet clear. When the trigger is found and avoided, the rash usually improves and may clear completely. Left alone, it can become long-term, and the skin can become infected.

What is it?

Dermatitis of the foot is usually contact dermatitis of the foot. This means the skin is inflamed at the spot where it has touched something from outside the body, such as a material in a shoe. The result is a red, itchy rash.

There are two main types. In irritant contact dermatitis, the skin reacts badly to a substance it meets. In allergic contact dermatitis, the immune system reacts to something that is normally harmless. The two often happen together.

Shoe dermatitis is the form set off by substances in footwear. You may also hear foot dermatitis called foot eczema.

Who does it affect?

Anyone can get it. Shoe dermatitis can affect people of any age, sex or ethnic background. How common dermatitis of the foot is isn't yet clear.

Across all contact dermatitis, the irritant type occurs more often than the allergic type. That is a general finding, not one about feet.

Contact allergy (a sensitivity to a substance that touches the skin) is a different thing from dermatitis. About 20.1 per cent of people in the general population have at least one contact allergy. It was more common in women (27.9 per cent) than in men (13.2 per cent). These figures are not about the foot.

People with atopy (a tendency to eczema and similar allergic conditions) have a higher risk of irritant dermatitis of the hands. Whether this is also true for the feet isn't yet clear.

Signs and symptoms

The main sign is a red, itchy rash on the skin that touched the trigger. In allergic dermatitis, the skin often feels very itchy before anything else shows. In irritant dermatitis, the skin may become very itchy, dry, thick and scaly.

Irritant dermatitis starts where the skin touched the irritant and usually doesn't spread beyond it. Once contact stops, it usually peaks and then begins to heal. Allergic dermatitis can keep getting worse for a while even after the trigger is gone.

When it lasts a long time, you may notice soreness, cracking, splitting and bleeding of the skin, and feet that are sweatier or drier than usual.

Some signs point to a complication. A rash that is wet, red or darker, and looks 'angry', or that weeps a lot or is tender, can mean the skin has become infected. Painful blisters that ooze pus or are covered in a golden crust can also mean infection. An infection can get worse if it is left, and is usually treated with antibiotics to stop it spreading into a deeper skin infection (cellulitis).

A rash that isn't improving with treatment, or that comes with a fever or feeling unwell, can mean an infection, or that the diagnosis or treatment needs another look. Eczema herpeticum, an infection that can develop in eczema-affected skin, can quickly become a medical emergency. Intense redness and swelling after stopping a steroid cream is also a warning sign.

What causes it?

Foot dermatitis is usually caused by allergens or irritants in footwear. Potassium dichromate, a chemical used to process leather, is one of the most common culprits, but it isn't the only one. Many other substances can trigger contact dermatitis, and they differ from person to person.

Across the general population, the most common contact allergens are nickel, fragrance mix, cobalt and chromium. Metals such as nickel, chromium and cobalt are among the allergic triggers.

The main prevention step is working out what your feet touch regularly, such as shoe materials, socks and creams. It helps to note whether the rash follows a particular item.

How is it diagnosed?

Your podiatrist will usually start by asking questions. They may ask when the rash began, how it has changed, whether it comes and goes, and what your work and hobbies involve. They may also ask about your shoes, socks and any creams you use. They will look at your feet, and may check the skin on the rest of your body.

Before an appointment, it helps to jot down when the rash began, how it has changed, and which shoes, socks, creams and hobbies might be involved.

Irritant dermatitis can often be recognised from the skin examination and what the skin has been exposed to. For long-lasting hand or foot eczema, patch testing is widely treated as a standard test to check for an allergic cause. Telling the two types apart matters, because avoiding the trigger is as important as treating the skin.

Contact dermatitis is a great imitator, and several other conditions can look similar:

Athlete's foot (tinea pedis): a fungal infection that can look like eczema. It is more likely in people with diabetes, sweaty feet or a weakened immune system.
Pompholyx: a blistering eczema of the hands and feet. It isn't the same as shoe dermatitis.
Atopic dermatitis or lichen planus: other skin conditions that contact dermatitis can mimic.
Dry, cracked heels: usually from a lack of moisture in the skin, and often worse in open-backed shoes such as sandals. This is a separate problem from contact dermatitis.

Treatment

The most important step is to find and avoid whatever is causing the rash. Treatment also includes caring for the skin. How it is done depends on how severe the rash is, what it looks like and where it is.

Looking after it at home

Avoiding the cause is the simplest yet most important treatment for shoe dermatitis. Once the trigger is found, the rash should slowly go away as long as contact stops.

Regular moisturiser is also used. In eczema in general, moisturisers lowered severity and reduced flares, without more side effects. No one moisturiser has been shown to be better than another. Creams containing urea caused more side effects in one study and can irritate broken or very inflamed skin.

For long-lasting hand and foot eczema, good skin care is an essential first step. It includes learning about your skin, making lifestyle changes, and using barrier products and soap substitutes. The support for barriers and soap substitutes is weak. Reducing contact with allergens and irritants is also important. The main goal is to keep the skin working well, and clearing the rash completely comes second.

Other options

When the dermatitis is severe, prescription medicines may be used for a short time. These can include steroid creams or tablets, or other creams or tablets that aren't steroids. Steroid creams can hide or spread an infection, so they are generally avoided on infected skin unless given with a treatment for the infection.

Treatments can be combined and tailored to the person. They don't all need to be used together. Which second-step treatments work best for foot dermatitis, and in what order, isn't yet clear.

Recovery

If the substance causing the rash can be found and avoided, symptoms should improve and may clear completely. How long this takes for foot dermatitis isn't yet clear.

Contact dermatitis can become long-term, and the skin can become infected. If it comes with a fever, doesn't improve with treatment, or has the infection signs described above, the cause or the treatment may need rethinking.

Pompholyx tends to come back, and current treatments are limited at stopping repeat flares.

Preventing it

Prevention rests on recognising the trigger and then avoiding it or limiting contact with it. Avoiding an identified trigger even after the skin has settled helps to keep the rash from returning.

Regular moisturising may also help. In eczema in general, moisturisers lengthened the time between flares and reduced the number of flares.

Frequently asked questions

Is pompholyx the same as foot dermatitis?

No. Pompholyx is a blistering eczema of the hands and feet, and its cause is unclear. Possible triggers include a fungal infection, irritants or allergens such as nickel and soaps, stress and sweating. It tends to be long-lasting and to relapse.

Does it matter which moisturiser I use?

Regular moisturising helps, but no single moisturiser has been shown to be better than another. Creams containing urea caused more side effects in one study, so they may not suit very inflamed or broken skin.

Can children get foot dermatitis?

Yes. Shoe dermatitis can affect people of any age. In children and teenagers under 18, about 16.5 per cent have a contact allergy. A rash that is unusual or lingers on a child's foot can have causes other than dermatitis.