Red Spots on Feet and Bottom of Feet: Causes and Treatments

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Red spots on the top or bottom of your feet can be indicative of local problems, such as athlete foot or bug bites, or a medical condition that involves other parts of the body, such as diabetes. Some cases are accompanied with no pain at all, but others may cause significant pain. Examination of the accompanying symptoms will help you, or your dermatologist, to determine the exact cause of red spots on feet.

Causes of Red Bumps and Red Spots on Feet

There are numerous possible causes of red patches on the feet. The spots may occur on the top, bottom, or side of the feet and may sometimes involve other parts of the body, such as the upper legs, hands, ankles, knees, and elbows. They may occur alongside other symptoms such as itching, pain, fatigue, and weight loss. Here is a breakdown of some common causes:

1. Petechiae (Blood Spots)

Red spots on feet may be petechiae. These are small, red, and sometimes purple, blood-filled dots that show under the skin as a result of localized bleeding into the skin (hemorrhage). Petechiae (or a petechia, if one only) are usually pin-sized and may show up following local trauma or viral infections. Newborns can also develop petechiae on certain parts of the skin, including the feet, during birth.

Allergic reactions, anticoagulants such as aspirin, antiplatelet medicines (clopidogrel), aging, and conditions such as leukemia can also cause bleeding into the skin. These, however, tend to leave behind more extensive areas of leaked blood known as purpura and ecchymoses.

You should suspect petechia if the red dots on the affected area of skin don’t become paler when you apply pressure to it.

Most petechiae will usually resolve on their own, but you should seek immediate medical attention if you experience sudden bleeding into the skin for no apparent reason. The same holds true for purple or red spots on feet – or any other part of your body – that come and go or don’t go away completely.

2. Athlete’s Foot

Athlete's foot

A fungal infection which is known as athlete’s foot, or Tinea pedis, could also be to blame for red spots on feet. The fungus responsible for athlete’s foot thrives in warm, moist conditions with an inadequate flow of air such as the one found on the feet, especially in the area between toes. Infection occurs when the fungus finds its way through the skin, usually through tiny cracks.

The fungus is easily transmitted from one person to another through direct contact, but it is more typically spread by touching contaminated objects and environment. Here we are talking about shoes, socks, towels, swimming pool decks, and changing rooms, among other transmission agents.

In addition to the red spots, you are likely to experience other symptoms of athlete’s foot ranging from itching to dryness, scaling, and flaking. In some cases, swelling, burning or stinging sensation, and blisters may occur.

Who Is At Risk of Athlete’s Foot?

Although anyone can get athlete’s foot, the fungal infection tends to occur more commonly in adolescents and adults. Individuals who sweat more profusely, such as those with hyperhidrosis, are especially susceptible to the condition. Wearing closed shoes for long periods of time also increases the risk of developing the infection. People with diabetes are also prone to athlete’s foot and other foot problems.

How Is Athlete’s Foot Treated?

Athlete’s foot is usually not a serious condition, but according to MedicineNet.com, it can result in more serious bacterial infections if left untreated. You should thus, seek treatment as soon as possible.

Treatment with over the counter antifungal creams, sprays, powders, or liquids will usually suffice. Observing proper foot hygiene will also help to prevent those red spots on feet, along with other associated symptoms, from reoccurring. You will, in particular, want to keep your feet dry and clean, especially in the area between the toes. Also, wear a fresh pair of socks every day, and alternate between at least two pairs of shoes. Wearing sandals and open shoes whenever possible will go a long way in getting rid of this skin problem too.

3. Contact Dermatitis

Contact dermatitis can also manifest itself in the form of a red rash on feet. As the name suggests, contact dermatitis is a skin irritation that occurs when you come into contact with an allergen or an irritant. There are two types of contact dermatitis that you could be dealing with:

Allergic Contact Dermatitis

Allergic contact dermatitis can cause red patches on the skin along with other symptoms associated with allergic reactions including:

  • Swelling
  • Itching
  • Blisters – in more severe cases
  • Raised welts, or hives.
  • Thick, leathery skin
  • Dry, scaly, and often cracking, skin

These symptoms tend to show up at the top of the foot, with the top part of the big toe being the area first affected. However, they can as well show up on the bottom of feet, the side of the feet (including the ankles), the heels, and lower legs.

Causes of Allergic Contact Dermatitis on Feet

Allergic contact dermatitis occurs when the feet get exposed to chemicals and other substances that trigger an allergic reaction. Such substances are known as allergens. They cause the body to release chemicals that make the skin irritated and itchy. For red spots on feet, here are some potential allergens:

  • Rubber accelerators. Rubber accelerators help to speed up the rubber manufacturing process. They are possible allergens. The compounds are commonly found in rubber box toe shoes and boots, but they can as well be found in some flip-flops, sneakers, tennis shoes, and slippers. If you recently started wearing footwear made of rubber – or with some rubber components – then you know the possible culprit for red spots on feet.
  • Chromates and formaldehyde. Potassium dichromate and formaldehyde are commonly used tanning agents in the leather industry. These chemicals can trigger an allergic reaction when your feet sweat, causing them to leach out of the shoes.
  • Dimethyl fumarate. You have probably seen a sachet with some chemical in it inside a new pair of shoes. While it helps to keep the shoes dry and keep mold at bay, it can permeate into the shoes and later leach out in sweat, thus causing red spots on feet and other symptoms of allergic contact dermatitis.
  • Metallic decorations and other components. Nickel and cobalt are known to be potential allergens. Shoe buckles and decorations that are made of these metals may be to blame for the allergic reaction on your feet.
  • Shoe dyes and glues.
  • Plants such as poison ivy. If you have been outdoors bare-footed, you could have come into contact with poison ivy.

Allergy to these substances can develop within a short period of exposing the skin on the feet to a specific allergen, or after an extended period of repeated contact. So, don’t be surprised if a red rash suddenly shows up on your feet after months, or even years, of wearing a particular kind of shoes or using a given substance.

Irritant Contact Dermatitis

This is the type of dermatitis most commonly seen. It occurs when the skin becomes exposed to substances it is sensitive to, leading to a direct irritation – damage to the outermost layer of the skin. Some toxic materials that may be responsible for red spots on feet include:

  • Dyes
  • Detergent, bleaches, and cleaning agents commonly found in homes.
  • Industrial chemicals.
  • Skin care products.
  • Water – spending too much time in water can cause irritant contact dermatitis on the feet, hands, or any other exposed part of the skin.

The red spots (rash) associated with irritant contact dermatitis is often non-itchy and may be accompanied by other symptoms such as:

  • Swelling
  • Blisters
  • Burning sensation
  • Cracking due to localized dryness
  • Tight-feeling skin
  • Open, crusty sores

Treatment for Contact Dermatitis

While red spots on feet are a concern on their own, itching is usually the most unbearable symptom of contact dermatitis. On a good note, though, these symptoms all go away once exposure to the causative factor is eliminated. Effective treatment of contact dermatitis, therefore, encompasses elimination of the potential allergen or irritant, coupled with symptoms alleviation. Here are some tips to help you relieve the symptoms:

  1. Identify and avoid further contact with the substance responsible for the irritation or allergic reaction. For the case of a shoe buckle made of nickel, for example, replace the buckle with another one made of another metal.
  2. Wash the affected area with warm, soapy water. This helps to flush out any irritants from the skin.
  3. Take over the counter antihistamine drugs, such as Benadryl (diphenhydramine) to relieve the itching and swelling.
  4. Apply calamine lotion or mild topical hydrocortisone cream to soothe the itching, redness, and swelling. These are available over the counter. Prescription topical steroids, along with antibiotic medication, are often prescribed for more severe cases, especially those involving infected blisters.
  5. Apply cold compress – a washcloth soaked in cool water – on the area of the feet affected by the red rash.

4. Insect Bites

Small, red spots on top of feet may be the result of insect bites and stings. Mosquitoes, fleas, bedbug, horsefly, tick, midge, mites, and ants are some of the common culprits. Bites and stings tend to leave behind one or multiple red raised bumps on the skin, which are in most cases itchy and are often painful. The spots may occur on one or both feet, and may – depending on the culpable insect – as well appear on the hands, but they are rarely seen on the bottom of feet. In some cases, small fluid-filled blisters develop.

Treating Insect Stings

It is often difficult to ascertain which insect has bitten or stung you unless of course, you saw it doing it. On a good note though, most bites will resolve in hours’ or days’ times. What is more, home treatment is usually adequate, regardless of the exact bite or sting you are dealing with. Here are home treatment measures you should try if you suspect that an insect bite is the underlying factor for those itchy, red marks on feet:

  1. Apply a hydrocortisone cream or ointment to the spots to relieve itching. Oral antihistamine pills can also help.
  2. Take over the counter analgesics such as ibuprofen or paracetamol to relieve any pain.
  3. Wash your feet with soapy water.
  4. Place a washcloth that has been soaked in cold water, or an ice pack (you could wrap some ice in a small towel) on the affected areas of the feet for about 10 minutes to soothe the itching and swelling.
  5. Keep the feet elevated on a pillow to cut down on swelling and reduce the appearance of the red bumps.
  6. Don’t fall into the temptation of popping off any blisters as this can cause an infection. In a case involving a child or baby, it may help to keep their nails short.

Red Spots on Bottom of Feet

Some conditions that tend to cause red spots on the top of feet, such as contact dermatitis, can in some cases be associated with red spots or patches that appear on the soles of feet. There are conditions, however, that are more likely to cause red spots on the bottom than on the top of feet. Here is a look at some of them:

1. Hand, Foot & Mouth Disease (HFM)

red spots on feet caused by hand, foot and mouth disease

Red spots on the bottom of the feet caused by Hands, Foot, and Mouth disease

Painful, raised, red spots on the bottom of feet, hands, and mouth of a child are often an indication of hand, foot and mouth disease. This is a common viral infection that affects children aged below 10 years, although it can as well affect adults and older kids. It is very contagious.

The disease is caused by coxsackievirus A16. The virus is passed to other people through coughing and sneezing, contact with feces from an infected person, or contact with the fluid from ruptured blisters. Transmission and infections tend to be more widespread during the warmer months.

Symptoms of Hand, Foot, and Mouth

The incubation period of HFM is 3-6 days, after which early symptoms appear. These usually are:

  • Fever
  • Loss of appetite
  • Coughing
  • Abdominal pain
  • Sore throat
  • General fatigue

These symptoms are then followed by red spots on the tongue and the inside of the mouth, 1-2 days down the line. The spots have a characteristic tiny bubble of fluid at the center, which makes them appears. These blister-like centers quickly peel, which makes then makes the spots to transform into larger ulcers (sores) with yellowish-green centers and reddish base. The ulcers are usually painful, and will therefore significantly interfere with your baby’s feeding routine.

A short moment after the appearance of mouth ulcers, small, red spots show up on the fingers, the palm and back of the hands, and the bottom of feet, and sometimes on the diaper area (buttocks and groin). The spots occurring on the bottom of feet and the palms of the hands often appear flat. In some cases, the spots associated with HFM will change to become small, grey-centered blisters.

HFM Treatment?

Although hand, foot, and mouth disease typically causes spots – and blisters – that are not itchy, patients have reported a few some cases of mild itching. Couple that with the pain and you have the making for a terrible experience for your child. Luckily, hand, foot, and mouth disease typically goes away on its own without treatment.

You may, however, want to use the following home remedies to treat and alleviate the symptoms as your child recovers from the viral infection:

  • Give your child plenty of water and other fluids.
  • Administer paracetamol or ibuprofen to your little angel to help relieve the pain associated with the red spots.
  • For older children who can manage, and adults, gargling with warm, salty water can help to relieve ulcers occurring on the tongue or the throat.
  • Avoid acidic, spicy, and hot foods and drinks. Instead, take, or give to your child soft servings such as soups, yogurt, and mashed potatoes.

Seek medical attention if your child develops cold hands and feet, doesn’t pass urine as usual (or at all), or appears unresponsive. These are all signs of dehydration. If symptoms have not improved 7 to 10 days down the line, you should as well see your GP or pediatrician.

2. Dyshidrotic Eczema

Red spots on feet soles and/or hands that comes after an eruption of small, itchy blisters may be an indication of dyshidrotic eczema or pompholyx. Dyshidrotic eczema is a form of eczema (inflammation of the skin) which can affect anyone, but it more commonly affects adults aged below 40 years. The cause is not yet apparent.

It begins as intense itching and burning sensation on the hands. An an eruption of small, deep-set blisters on the hands (usually the palms and edges of the fingers) and sometimes the bottom of feet soon follows. These blisters are typically very itchy and painful. The blisters clear in 2-3 weeks, leaving behind red, dry, cracked skin on the affected areas.

DE has no cure, and it is not uncommon for it to break out several times during a patient’s lifetime. Scientists have identified stress, high temperatures such as in summers (leading to sweating), fungal infections of the skin, allergic reactions, and contact with water over long periods of time as some of the potential triggers for the condition.

Soaking your hands and feet in cold water can help to relieve the itching and other symptoms. Frequently moisturizing your hands will also help to fasten the healing process. Running a humidifier is also a good idea. Your medical care provider may also prescribe a topical cortisone cream to control the itching and redness.

Other Causes of Red Spots on Feet

  • Psoriasis.
  • Syphilis – reddened areas of skin on the palms of the hands and the bottom of feet, coupled with small painless sores in your genital area (on the spot where the bacteria found its way into your body) may be suggestive of syphilis.

These are just some of the causes of red spots on feet. Your doctor will help you narrow down to the exact cause through physical examination and appropriate medical tests.

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