What Makes Feet Psoriasis Treatment So Uniquely Challenging Feet psoriasis treatment demands a completely different strategy than managing psoriasis anywhere else on your body. Your feet endure constant pressure from walking, friction from shoes, moisture from sweat, and environmental assault that other body parts never experience. Every step you take creates micro-trauma to already inflamed skin, perpetuating the cycle of inflammation and scaling. This isn't just a cosmetic concern—feet psoriasis can make walking painful, limit your footwear choices, and severely restrict your mobility. The harsh reality? Feet psoriasis affects roughly 12-16% of psoriasis patients, but it causes disability far beyond what the numbers suggest. Unlike psoriasis on your back or chest that stays hidden, feet psoriasis impacts your ability to exercise, work on your feet, wear sandals, and even walk comfortably. The psychological burden of avoiding situations where others might see your feet compounds the physical symptoms. The Hard Truth About Feet Psoriasis Cure Possibilities Let's be absolutely clear from the start: there is no permanent feet psoriasis cure available today. Anyone claiming to cure your foot psoriasis completely is either uninformed or dishonest. Psoriasis originates from fundamental immune system dysfunction, where your body attacks healthy skin cells in a misguided defense response. Current medical science cannot reprogram your immune system to eliminate this tendency permanently. However—and this changes everything—you can achieve complete symptom clearance that lasts months or years with proper feet psoriasis treatment. Thousands of patients live with zero visible symptoms, maintaining clear feet through strategic management approaches. The goal shifts from impossible cure to achievable long-term remission and symptom control. Setting realistic expectations prevents the disappointment that leads many patients to abandon treatment prematurely. Understanding the Four Types of Feet Psoriasis (Each Needs Different Treatment) Plantar Psoriasis This variant affects the soles of your feet with thick, red plaques covered in silvery-white scales. The skin becomes so hardened and thickened that it resembles calluses, often leading to misdiagnosis. Plantar psoriasis typically appears on weight-bearing areas—heels, balls of feet, and along the arches. Feet psoriasis cream must penetrate these exceptionally thick plaques, making formulation selection critical for success. The constant pressure from standing and walking causes painful fissures that crack through all skin layers. Pustular Psoriasis of the Feet Small pustules (pus-filled bumps) erupt across your soles and toes in this severe presentation. These pustules contain white blood cells, not bacteria—they're sterile but look infected. The pustules can merge into larger formations, rupture, and leave behind brown discoloration and scaling. This type progresses rapidly and causes significant pain that can make walking nearly impossible. Feet psoriasis treatment for pustular variants requires aggressive intervention to prevent disability. Inverse Psoriasis Between Toes Smooth, red patches develop in the spaces between your toes where skin folds touch. Unlike typical scaly psoriasis, inverse psoriasis appears shiny and smooth due to moisture in these areas. The constant friction and moisture create ideal conditions for secondary fungal infections. This type causes intense itching, burning, and discomfort that intensifies when wearing closed-toe shoes. Toenail Psoriasis Your toenails become thickened, discolored (yellow-brown), pitted, and may separate from the nail bed. Toenail psoriasis accompanies foot involvement in up to 50% of cases and proves particularly stubborn to treat. The nail matrix inflammation distorts nail growth from the root, creating permanent changes until inflammation resolves. Thick, crumbly toenails make wearing shoes painful and increase risk of fungal nail infections. Treating toenail psoriasis requires extreme patience—toenails grow even slower than fingernails, taking 12-18 months to completely replace. Five Brutal Challenges That Make Feet Psoriasis So Difficult to Treat Challenge #1: Constant Mechanical Stress Your feet bear your entire body weight with every step—the average person takes 5,000-7,000 steps daily. Each step creates friction, pressure, and micro-trauma that disrupts healing and triggers new inflammation. Feet psoriasis treatment must somehow work while your feet continue their relentless daily punishment. The soles have the thickest skin on your body (up to 5mm thick), designed for durability but making medication penetration difficult. This mechanical stress explains why feet psoriasis often responds more slowly than psoriasis on protected body areas. Challenge #2: The Shoe and Sock Problem Shoes create an occlusive, warm, moist environment—perfect for fungal growth but terrible for psoriasis. The constant occlusion prevents your skin from breathing and can macerate (soften excessively) already fragile tissue. Friction from shoes and socks can trigger the Koebner phenomenon, where new psoriatic lesions form at sites of trauma. Feet psoriasis cream applied in the morning often absorbs into socks or rubs off from shoe friction before it can work. Many patients must choose between wearing professional footwear for work and maintaining their treatment regimen. Challenge #3: Sweat and Moisture Management Feet contain more sweat glands per square inch than most other body areas—approximately 250,000 sweat glands between both feet. Excessive moisture softens psoriatic plaques but also increases infection risk and prevents treatments from adhering properly. Conversely, excessive dryness causes painful cracks and fissures that bleed and become infected. Finding the perfect moisture balance becomes a daily tightrope walk that most patients struggle to master. Challenge #4: Diagnostic Confusion and Treatment Delays Feet psoriasis frequently gets misdiagnosed as athlete's foot, eczema, or simple calluses. This diagnostic confusion leads to months of ineffective antifungal treatment before proper feet psoriasis treatment begins. Even dermatologists sometimes need skin biopsies to distinguish plantar psoriasis from other foot conditions. The delay in correct diagnosis and treatment allows the condition to worsen and become more resistant to therapy. Challenge #5: Limited Accessibility for Treatment Application Reaching your feet to apply treatment multiple times daily proves physically challenging, especially for overweight, elderly, or less flexible patients. This accessibility issue leads to inconsistent application—the primary reason topical feet psoriasis treatment fails. The awkward positioning required to thoroughly treat between toes and on the soles means many areas get inadequate coverage. Patients often skip applications simply because the physical effort becomes exhausting. Evidence-Based Feet Psoriasis Treatment Options (From Most to Least Effective) Ultra-High Potency Topical Corticosteroids Corticosteroids remain the gold standard first-line feet psoriasis treatment for excellent reasons—they work rapidly and effectively. Clobetasol propionate 0.05% (the strongest available topical steroid) can achieve significant plaque reduction within 2-3 weeks. The thick skin on feet tolerates high-potency steroids better than thin-skinned areas, with lower risk of serious side effects. Apply this feet psoriasis cream twice daily to affected areas, massaging thoroughly to enhance penetration through thick plaques. Corticosteroids work through three mechanisms: reducing inflammation, suppressing excessive immune activity, and normalizing skin cell turnover rates. The thick stratum corneum (outer skin layer) on feet limits systemic absorption, making topical steroids safer for feet than elsewhere. Application technique matters enormously: Apply to slightly damp feet immediately after bathing when skin is most receptive. Cover with plastic wrap or occlusive dressings overnight to increase penetration up to 100-fold. Use in "pulse therapy" cycles—2 weeks on high-potency, then 2 weeks on lower potency to minimize side effects. The limitation? Long-term continuous use eventually causes skin atrophy, striae (stretch marks), and potential systemic effects. Your dermatologist will monitor usage and cycle you through different potencies and treatment-free periods. Combination Vitamin D Analogue and Steroid Products Calcipotriene combined with betamethasone (Taclonex, Enstilar) provides synergistic benefits for feet psoriasis treatment. The steroid component delivers rapid symptom relief while vitamin D analogue sustains improvement and reduces steroid requirements. This feet psoriasis cream combines quick steroid action with the long-term benefits of vitamin D without the full steroid exposure. Apply once daily—usually at night—to maximize the 24-hour coverage without requiring multiple applications. The combination formulation shows superior results compared to either ingredient used alone. Patients typically see initial improvement within one week, with maximum effect at 4-8 weeks. Vitamin D analogues work by slowing excessive skin cell production and modulating immune responses in psoriatic plaques. The soles of feet tolerate calcipotriene better than facial or flexural skin, which often experiences irritation. Keratolytic Agents for Plaque Reduction Salicylic acid (2-10%) and urea (20-40%) break down thick psoriatic scales, allowing other treatments to penetrate. These keratolytic agents are essential for plantar psoriasis where plaque thickness prevents medication absorption. Feet psoriasis treatment almost always requires a keratolytic component to succeed. Salicylic acid dissolves the intercellular "glue" holding dead skin cells together, promoting shedding. Apply salicylic acid preparations before your primary treatment medications for maximum penetration enhancement. Start with lower concentrations (2-5%) to assess tolerance, then increase if needed. Some patients experience stinging or irritation, especially on cracked skin—this usually indicates barrier compromise. High-concentration urea (30-40%) acts similarly to salicylic acid while also hydrating skin. Urea-based feet psoriasis cream reduces scaling and softens thick plaques remarkably effectively. The dual action—keratolytic and moisturizing—makes urea particularly valuable for feet psoriasis treatment. Apply once or twice daily, understanding that initial application may sting on damaged skin. Anthralin (Dithranol) for Stubborn Plaques Anthralin slows excessive skin cell production and reduces inflammation through mechanisms distinct from steroids. This older feet psoriasis treatment remains effective for thick plantar plaques resistant to other topicals. Short-contact therapy works best for feet—apply anthralin cream, leave for 10-30 minutes, then wash off thoroughly. The concentration starts low (0.1%) and gradually increases to 1-3% based on tolerance and response. Anthralin stains everything it touches purple-brown—skin, bathtubs, towels, floors—making it aesthetically challenging. The staining is temporary on skin but permanent on fabrics and surfaces, requiring careful application technique. Despite the inconvenience, anthralin provides genuine long-term benefit without steroid risks for patients who can tolerate the practical drawbacks. Coal Tar Preparations Coal tar has treated psoriasis for over a century and remains effective for feet psoriasis treatment today. It reduces inflammation, scaling, and itching through multiple poorly-understood mechanisms. Concentrations range from 1-10% in various cream, ointment, and solution bases. Apply coal tar preparations at bedtime, cover feet with plastic wrap or bags, then wear socks overnight. Wash off thoroughly in the morning to remove the characteristic odor and reduce daytime staining concerns. Modern formulations have improved tolerability but still smell medicinal and stain light-colored fabrics. Coal tar provides sustained benefit without the side effect profile of corticosteroids, making it valuable for long-term maintenance therapy. Many dermatologists use coal tar as "steroid-sparing" therapy to reduce overall corticosteroid exposure. Topical Retinoids Tazarotene gel (0.05% or 0.1%) normalizes skin cell growth and differentiation in psoriatic plaques. This feet psoriasis cream works slowly—expect 8-12 weeks for noticeable improvement—but provides sustained benefit. Retinoids are particularly effective for nail psoriasis affecting toenails when applied directly to nail folds. The primary side effect is local irritation, which occurs in about 30% of patients initially. Start with lower concentrations every other night, gradually increasing frequency as tolerance develops. Never use tazarotene if pregnant or planning pregnancy—it carries significant teratogenic risks. Combining tazarotene with corticosteroids reduces irritation and enhances effectiveness beyond either agent alone. Systemic Phototherapy (UVB and PUVA) Narrowband UVB phototherapy delivers specific ultraviolet wavelengths that suppress immune activity in psoriatic skin. For feet psoriasis, targeted phototherapy devices treat just your feet without unnecessary full-body exposure. Treatments occur 2-3 times weekly at a dermatology clinic for 12-20 weeks to achieve maximum benefit. Response rates reach 70-80% for plantar psoriasis, making phototherapy a legitimate feet psoriasis treatment option when topicals fail. The gradual improvement prevents the rapid relapse sometimes seen with steroid discontinuation. PUVA therapy (psoralen plus UVA light) penetrates deeper into thick plantar skin than UVB alone. You soak feet in psoralen solution or take it orally, then receive carefully dosed UVA exposure. PUVA shows superior effectiveness for thick plantar plaques but carries higher long-term skin cancer risk. The major drawback? Requiring clinic visits 2-3 times weekly for months makes phototherapy impractical for many patients. Systemic Medications for Severe Cases When feet psoriasis causes significant disability despite aggressive topical feet psoriasis treatment, systemic therapy becomes necessary. Biologic medications target specific immune pathways driving psoriasis: Adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade) block TNF-alpha Ustekinumab (Stelara) blocks IL-12 and IL-23 Secukinumab (Cosentyx), ixekizumab (Taltz) block IL-17 Risankizumab (Skyrizi), guselkumab (Tremfya) block IL-23 These medications achieve complete clearance in 40-70% of patients with palmoplantar psoriasis. The downsides? Extreme cost ($30,000-50,000 annually), injection requirements, and increased infection risk. Oral retinoids (acitretin) show particular effectiveness for pustular feet psoriasis. Acitretin normalizes skin cell growth and reduces inflammation systemically. Expect 8-16 weeks for maximum benefit, with gradual improvement throughout treatment. Side effects include dry skin/lips, hair thinning, and strict pregnancy prevention requirements. Traditional systemics like methotrexate and cyclosporine suppress overall immune function, helping feet psoriasis but requiring careful monitoring. These medications serve as "bridge therapy" while waiting for biologics to take full effect. Your dermatologist considers systemic therapy when feet psoriasis prevents walking, working, or significantly impairs quality of life. The Most Effective Feet Psoriasis Cream Ingredients (What Science Actually Supports) Salicylic Acid: The Essential Descaling Agent Salicylic acid breaks apart the bonds connecting dead skin cells, allowing thick scales to shed more easily. This keratolytic action thins psoriatic plaques from 5mm down to 1-2mm, enabling other feet psoriasis treatment ingredients to penetrate. Concentrations of 3-10% work best for feet—higher than concentrations used on thinner-skinned areas. The thick stratum corneum on feet tolerates higher salicylic acid concentrations without the irritation seen elsewhere. Apply salicylic acid products 30-60 minutes before applying corticosteroids or other active treatments. This pre-treatment dramatically improves the penetration and effectiveness of whatever medication follows. Some patients experience burning or stinging, especially when plaques are cracked—this typically indicates barrier compromise. Start with 3% formulations and increase gradually if tolerated without irritation. Urea: The Multi-Mechanism Workhorse Urea provides three distinct benefits in feet psoriasis cream formulations: hydration, keratolysis, and penetration enhancement. Low concentrations (10-20%) function primarily as humectants, attracting and retaining moisture in dry psoriatic skin. High concentrations (30-40%) break down thick scales similar to salicylic acid while simultaneously moisturizing. Urea-based feet psoriasis cream can reduce plaque thickness by 50% within 4 weeks of consistent use. The dual action makes urea particularly valuable—you get descaling and moisturization in one product. Apply liberally twice daily to all affected areas, including between toes where inverse psoriasis develops. Initial application stings on broken skin but this reaction typically resolves within 3-5 days as the barrier repairs. The stinging actually serves as a diagnostic indicator of how compromised your skin barrier has become. Lactic Acid: The Gentle Alternative Lactic acid (5-12%) exfoliates thick scales more gently than salicylic acid while also moisturizing. This alpha-hydroxy acid loosens dead skin cells and improves skin texture without the irritation potential of salicylic acid. Feet psoriasis cream containing lactic acid works well for maintenance after initial plaque clearance with stronger agents. Lactic acid also lowers skin pH, creating an environment less favorable for secondary bacterial and fungal infections. Apply once or twice daily, particularly to callused areas prone to painful cracking. Combine with occlusive moisturizers at night for maximum softening of thick plantar plaques. Ceramides: The Barrier Restoration Specialists Psoriatic skin shows significantly depleted ceramide levels, compromising the moisture barrier and increasing water loss. Feet psoriasis cream containing ceramides (particularly ceramides 1, 3, and 6-II) helps restore this essential barrier. Improved barrier function reduces inflammation, prevents infection, and enhances the effectiveness of active treatments. Ceramide-rich moisturizers should be applied 3-4 times daily as foundational therapy beneath active treatments. Think of ceramides as the "mortar" between skin cells—without adequate ceramides, your skin barrier resembles a brick wall with missing mortar. Regular ceramide application can reduce flare frequency by up to 40% by maintaining barrier integrity. Colloidal Oatmeal: The Anti-Inflammatory Soother Colloidal oatmeal contains avenanthramides and other compounds with anti-inflammatory and anti-itch properties. While not a primary feet psoriasis treatment, colloidal oatmeal significantly improves comfort during healing. Foot soaks with colloidal oatmeal reduce burning, itching, and irritation that make psoriasis unbearable. Use colloidal oatmeal as adjunctive therapy—it won't clear plaques but makes the journey more tolerable. Soak feet for 15-20 minutes in lukewarm water mixed with colloidal oatmeal, then immediately apply moisturizer while feet are damp. Tea Tree Oil: The Antimicrobial Addition Tea tree oil (melaleuca oil) has antimicrobial and anti-inflammatory properties that may benefit feet psoriasis. The antifungal action helps prevent secondary fungal infections common in feet psoriasis, particularly between toes. Some small studies show reduced scaling and redness with 5% tea tree oil cream applied twice daily. However, tea tree oil can irritate sensitive skin and should always be diluted—never apply pure tea tree oil to psoriatic plaques. The evidence remains limited compared to prescription treatments, but tea tree oil provides modest adjunctive benefit. Plant-Based Feet Psoriasis Cream Options for Daily Management Why Botanical Formulations Matter for Foot Care Plant-based feet psoriasis creams offer gentler alternatives for daily maintenance between prescription treatment cycles. Unlike synthetic medications with usage limitations, botanical formulations can be applied multiple times daily without side effect concerns. The key advantage? Consistent moisture and anti-inflammatory support throughout the day as you wear shoes and walk. Your feet need constant barrier support—plant-based options provide this foundation while prescription treatments deliver the heavy-hitting inflammation control. Swasti Botanicals: Plant-Based Approach to Feet Psoriasis Treatment Swasti Botanicals has developed plant-based psoriasis creams specifically addressing the unique challenges of foot psoriasis. These formulations combine traditional botanical ingredients with modern understanding of skin barrier function and inflammation. The feet psoriasis cream from Swasti Botanicals focuses on four principles: natural anti-inflammatory action, barrier restoration, intensive hydration, and antimicrobial protection. What makes botanical formulations different for feet: They provide sustained benefit throughout the day without washing off like water-based lotions. Plant-based feet psoriasis cream typically contains multiple botanical actives targeting different aspects of psoriasis simultaneously. The absence of synthetic steroids means unlimited application frequency—critical when you're washing feet, changing socks, or reapplying after workouts. Key Botanical Ingredients in Feet Formulations Neem extract has centuries of traditional use for inflammatory skin conditions and contains nimbidin and nimbin with proven anti-inflammatory effects. Research demonstrates neem reduces scaling, redness, and thickness in psoriatic plaques with consistent application. For feet psoriasis treatment, neem's antimicrobial properties protect against secondary infections in cracked, compromised skin. The antibacterial and antifungal actions prevent the athlete's foot infections that commonly complicate feet psoriasis. Turmeric (Curcumin) ranks among the most extensively researched anti-inflammatory botanicals with over 15,000 published studies. Topical curcumin formulations reduce pro-inflammatory cytokines in psoriatic skin through COX-2 inhibition and NF-kB pathway suppression. The feet psoriasis cream benefits from curcumin's ability to modulate inflammatory pathways similar to biologic medications but with gentler action. Curcumin also promotes wound healing in fissured, cracked skin common on psoriatic feet. Coconut oil provides deep emollient action and contains lauric acid with antimicrobial properties against bacteria and fungi. Virgin coconut oil improves skin barrier function and reduces trans-epidermal water loss by up to 50%. For dry, cracked feet, coconut oil's fatty acid profile creates a protective occlusive layer while still allowing skin to breathe. The medium-chain triglycerides in coconut oil penetrate more effectively than petroleum-based occlusives. Aloe vera gel contributes anti-inflammatory effects through inhibition of cyclooxygenase pathway and acceleration of wound healing. The polysaccharides in aloe stimulate fibroblast activity and collagen synthesis, promoting repair of fissured skin. Feet psoriasis patients report immediate cooling relief when aloe-containing creams are applied to hot, inflamed plaques. Aloe's high water content provides hydration without the greasy feeling many foot creams leave behind. Peppermint oil offers natural analgesic properties that reduce the burning and discomfort of feet psoriasis. The menthol component creates a cooling sensation that temporarily masks pain and itching. Antimicrobial effects help maintain skin hygiene in the warm, moist environment inside shoes. Use sparingly—essential oils can irritate if used in excessive concentrations. Integrating Swasti Botanicals Into Your Feet Psoriasis Treatment Routine Morning application: After your prescription medications absorb, apply Swasti Botanicals plant-based feet psoriasis cream as a protective layer. The botanical formula layers well over active treatments and provides moisture/protection throughout your day. Apply generously to clean, dry feet, massaging thoroughly into affected areas including between toes. Allow 5-10 minutes for absorption before putting on socks to prevent product transfer to fabric. Midday reapplication: Keep a tube of plant-based feet psoriasis cream at work for reapplication after lunch or during breaks. Unlike prescription steroids with frequency limits, botanical formulations are safe for unlimited applications. This midday boost maintains moisture and prevents the afternoon dryness that causes painful cracking. Post-exercise or foot washing: Reapply Swasti Botanicals cream immediately after any foot washing or sweating. Exercise, showering, or swimming strips away protective creams, leaving feet vulnerable. The quick reapplication after water exposure prevents the moisture-loss cycle that triggers flares. Intensive overnight therapy: Before bed, apply a thick layer of plant-based feet psoriasis cream and cover with cotton socks. This occlusive overnight treatment allows botanical ingredients to penetrate deeply during your 7-8 hours of sleep. The cotton socks enhance absorption without the maceration risk of plastic wrap. Morning feet will feel significantly softer and more comfortable. Between prescription treatment cycles: When taking breaks from high-potency prescription feet psoriasis cream, use botanical options to maintain improvements. Swasti Botanicals formulations bridge the gap during "steroid holidays" when you're resting from synthetic medications. This approach prevents regression while giving your skin recovery time from aggressive treatments. The Realistic Role of Plant-Based Creams in Feet Psoriasis Management Plant-based feet psoriasis creams like Swasti Botanicals work optimally as part of comprehensive, multi-modal treatment strategies. For mild feet psoriasis (less than 30% sole involvement), botanical formulations alone might provide adequate control with diligent use. For moderate to severe cases, plant-based creams serve as essential maintenance therapy supporting prescription treatments. They excel at: Providing multiple daily applications without side effect risks Gentle anti-inflammatory action suitable for unlimited frequency Supporting skin barrier repair with natural oils, ceramides, and botanicals Delivering antimicrobial protection against secondary infections Maintaining improvements achieved with prescription medications Offering safer long-term maintenance than continuous steroid use They're not optimal for: Rapidly clearing severe psoriatic plaques (prescription medications work faster) Active pustular feet psoriasis requiring immediate aggressive intervention Situations where you need dramatic improvement within days rather than weeks The feet psoriasis cure mentality doesn't apply to any product—prescription, botanical, or otherwise. However, Swasti Botanicals plant-based creams can substantially improve daily comfort and reduce severe flare frequency with consistent application. Patient Experiences With Botanical Feet Psoriasis Management Many patients report botanical formulations reduce their reliance on prescription steroids by 50-70% over time. The ability to apply feet psoriasis cream after every foot washing without side effect concerns addresses one of the biggest treatment challenges. Plant-based options also provide psychological benefits—taking multiple daily actions to care for your feet creates a sense of control. Patients appreciate the natural ingredient profiles, especially those concerned about long-term synthetic chemical exposure. Quality Standards for Plant-Based Feet Psoriasis Cream Not all botanical formulations deliver equivalent results—manufacturing quality and ingredient standardization determine effectiveness. Swasti Botanicals uses standardized botanical extracts ensuring consistent concentrations of active compounds in every batch. The feet psoriasis cream formulation excludes common irritants: synthetic fragrances, parabens, sulfates, and phthalates that trigger flares. Third-party testing for purity, potency, and contamination indicates a manufacturer's commitment to quality standards. Look for products listing including botanicals in named as ingredients. Combining Botanical and Prescription Approaches for Optimal Results The most successful feet psoriasis treatment plans strategically combine prescription medications with plant-based creams. Use high-potency prescription feet psoriasis cream to achieve initial clearance over 4-6 weeks. Gradually transition to alternating days of prescription treatment with daily botanical application for maintenance. Many patients eventually maintain clear feet primarily with botanical formulations, reserving prescriptions for occasional breakthrough flares. This layered approach minimizes long-term steroid exposure while maximizing sustained foot health and comfort. Feet Psoriasis Home Remedies With Scientific Support The Essential Moisturization Protocol Aggressive moisturization forms the absolute foundation of all feet psoriasis treatment—whether prescription or alternative. Apply thick, occlusive moisturizers (petroleum jelly, heavy ceramide creams) at least 3-4 times daily to affected areas. The "soak and seal" method maximizes hydration: Soak feet in lukewarm water for 10 minutes to hydrate the stratum corneum. Pat feet partially dry—leave them slightly damp. Immediately apply heavy moisturizer within 3 minutes while skin is receptive. Seal moisture in by covering feet with plastic wrap or bags for 20-30 minutes. Finish by applying cotton socks. This protocol can reduce scaling by 40-60% within three weeks through hydration alone. The timing is critical—skin loses absorbed water rapidly if you don't seal it in quickly. Epsom Salt Soaks for Inflammation Magnesium sulfate (Epsom salt) soaks reduce inflammation and soften thick psoriatic scales. Add 2-3 cups Epsom salt to warm water and soak feet for 15-20 minutes daily. The magnesium may absorb through skin, potentially reducing inflammatory markers systemically. Studies show mixed results, but patient-reported symptom improvement is consistent. Follow immediately with heavy moisturizer application while feet remain damp. Never soak in water hotter than lukewarm—heat triggers inflammation and worsens psoriasis. Dead Sea Salt Solutions Dead Sea salt contains unique mineral concentrations—magnesium, calcium, potassium, bromide—that may benefit psoriatic skin. Mix 1/2 cup Dead Sea salt per gallon of warm water and soak feet for 15 minutes 3-4 times weekly. Some research suggests Dead Sea minerals reduce scaling and inflammation in psoriatic plaques. This home remedy provides modest adjunctive benefit as part of comprehensive feet psoriasis treatment. The mineral content differs significantly from regular sea salt or Epsom salt, so substitutions won't provide equivalent effects. Apple Cider Vinegar Dilution (Extreme Caution Required) Diluted apple cider vinegar (1 part vinegar to 3 parts water) has antimicrobial and pH-balancing properties. Some patients report improvement using diluted vinegar as a brief foot soak or compress. Critical warnings: Never apply vinegar to cracked, bleeding, or severely inflamed skin—it will cause intense pain. Always dilute significantly—undiluted vinegar burns compromised skin. Stop immediately if you experience burning or increased inflammation. This remedy lacks robust scientific evidence and carries real risk of worsening symptoms. Many dermatologists advise against vinegar application due to unpredictable effects and irritation potential. Aloe Vera Gel Application Pure aloe vera gel (99% or higher) has anti-inflammatory properties and may reduce redness and scaling. Studies show modest improvement when pure aloe gel is applied three times daily for 4-8 weeks. Choose pure aloe gel without added alcohol, fragrance, or dyes—these additives irritate psoriatic skin. Aloe provides cooling relief for hot, inflamed feet and works best as supplementary therapy alongside conventional feet psoriasis cream. Keep aloe gel refrigerated for enhanced cooling sensation when applied. Oatmeal Foot Soaks and Masks Colloidal oatmeal reduces inflammation and soothes irritated psoriatic skin through multiple bioactive compounds. Mix colloidal oatmeal with water to form a paste and apply as a 20-minute foot mask. Alternatively, add 1-2 cups colloidal oatmeal to a foot bath and soak for 15 minutes. The anti-itch properties provide immediate symptomatic relief even though oatmeal doesn't clear plaques long-term. Follow with moisturizer application while skin remains damp from the soak. Omega-3 Fatty Acid Supplementation Oral omega-3 supplements (fish oil, krill oil, algae-based) may reduce systemic inflammation driving psoriasis. Meta-analyses show modest improvement in psoriasis severity with 3-4 grams daily of EPA/DHA. The anti-inflammatory effects take 12-16 weeks to manifest, so patience is essential. Omega-3s won't cure feet psoriasis but may reduce flare frequency and severity as part of overall management. Choose high-quality supplements with third-party testing for purity and concentration verification. Anti-Inflammatory Dietary Approach While not a direct topical remedy, dietary modifications may reduce the inflammatory processes driving psoriasis systemically. An anti-inflammatory diet emphasizes omega-3 fatty acids, colorful vegetables, fruits, whole grains, and lean proteins. Avoid processed foods, excessive sugar, red meat, and inflammatory omega-6 oils. Some patients report 20-30% symptom improvement with sustained dietary changes over 3-6 months. The Mediterranean diet specifically shows promise in observational psoriasis studies. Eliminate gluten if you have confirmed celiac disease or non-celiac gluten sensitivity—but gluten elimination helps only this specific subset of patients. Stress Management Techniques Stress consistently triggers psoriasis flares through elevation of cortisol and other pro-inflammatory stress hormones. Stress management qualifies as a legitimate home remedy for feet psoriasis treatment. Evidence-based stress reduction techniques: Meditation or mindfulness practice (20 minutes daily) Progressive muscle relaxation Regular aerobic exercise (within comfort limits given foot pain) Adequate sleep (7-9 hours nightly) Cognitive behavioral therapy for anxiety and depression Studies show 25-35% reduction in psoriasis severity with consistent stress management practices over 8-12 weeks. The benefits require sustained practice—occasional meditation won't significantly impact your feet psoriasis. What NOT to Do: Critical Mistakes That Worsen Feet Psoriasis Walking Barefoot on Hard Surfaces Walking barefoot on tile, concrete, or hardwood floors creates repetitive micro-trauma that triggers the Koebner phenomenon. Each impact sends shock waves through already-inflamed plantar tissue, perpetuating inflammation. Always wear supportive, cushioned shoes or slippers—even indoors—to minimize mechanical stress. The constant trauma from barefoot walking can prevent healing regardless of how good your feet psoriasis treatment is. Wearing the Wrong Footwear Tight, restrictive shoes create friction that damages psoriatic skin and triggers new lesions. Shoes made from synthetic materials trap moisture and heat, creating an environment for fungal overgrowth. High heels concentrate pressure on the balls of feet and toes, worsening plaques in these areas. Optimal footwear for feet psoriasis: Wide toe box allowing toes to spread naturally Breathable materials like leather or canvas Cushioned insoles distributing pressure evenly Proper arch support reducing stress on planar fascia Avoid shoes you can't easily remove for midday airing Using Harsh Soaps and Scrubbing Aggressively Antibacterial soaps, pumice stones, and aggressive scrubbing damage already-compromised skin barrier. The temptation to scrub away scales is understandable but counterproductive—you're causing trauma that worsens inflammation. Use gentle, fragrance-free cleansers specifically formulated for sensitive skin. Pat feet dry gently rather than rubbing, which causes additional mechanical trauma. Never use foot files, pumice stones, or abrasive scrubs on active psoriatic plaques—let chemical exfoliation (salicylic acid, urea) do the work gently. Ignoring Fungal Infections Athlete's foot commonly complicates feet psoriasis, and the two conditions can appear identical. The warm, moist environment inside shoes promotes fungal growth, especially between toes. Fungal infections trigger additional inflammation and can worsen psoriatic lesions. Watch for intense itching between toes, macerated (soft, white) skin, and spreading redness—these suggest fungal infection. Treat suspected fungal infections promptly with antifungal cream—sometimes feet psoriasis won't improve until you address concurrent fungal issues. Inconsistent Treatment Application Feet psoriasis treatment requires obsessive consistency—missing applications allows inflammation to resurge rapidly. Many patients apply feet psoriasis cream sporadically and incorrectly conclude "nothing works." The awkward positioning required to treat feet thoroughly leads to incomplete coverage and treatment failure. Set phone alarms for application times, keep products in multiple locations, and use a mirror to ensure complete coverage of difficult-to-see areas. Most topical treatments require 8-16 weeks of twice-daily application to show maximum benefit. Picking, Scratching, and Peeling Scales The irresistible urge to peel away thick scales causes trauma that triggers new psoriatic lesions. Every time you pick at your feet, you activate the Koebner response—new plaques form at trauma sites. Keep toenails trimmed short to minimize damage from unconscious scratching during sleep. Use anti-itch treatments aggressively rather than giving in to the scratch urge. Wear socks to bed if you scratch your feet while sleeping. Extreme Temperature Exposure Both very hot and very cold temperatures worsen feet psoriasis through different mechanisms. Hot water (showers, baths, hot tubs) strips protective oils and triggers inflammatory responses. Cold weather and low humidity cause excessive dryness and cracking. Keep water temperature lukewarm for foot washing and bathing. Protect feet from cold weather with warm, breathable socks—but avoid overheating which causes sweating. Creating Your Personalized Feet Psoriasis Treatment Plan Step 1: Accurately Assess Your Severity Level Mild feet psoriasis (less than 30% sole surface affected, minimal functional impact): Topical treatment alone usually sufficient Start with high-potency corticosteroid for 2-4 weeks Transition to maintenance with botanical creams Focus on aggressive moisturization and trigger avoidance Moderate feet psoriasis (30-70% involvement, moderate pain/limitation): Combination topical therapy required Consider phototherapy if topicals insufficient after 8-12 weeks May need prescription-strength keratolytics plus anti-inflammatory agents Occupational modifications may be necessary Severe feet psoriasis (greater than 70% involvement, significant disability): Systemic therapy likely necessary Cannot work or walk without significant pain High risk of secondary infections and complications Requires aggressive dermatologist-supervised treatment Take weekly photographs from consistent angles to track progress objectively—perceived improvement often differs dramatically from actual change. Step 2: Identify Your Personal Triggers Keep a detailed diary for 4-6 weeks tracking flares in relation to: Footwear choices (which shoes precede flares?) Activities (long walks, standing, running?) Seasonal changes (winter dryness, summer heat?) Stress levels (work deadlines, personal conflicts?) Dietary factors (alcohol, specific foods?) Illness or infections (even minor viral infections trigger flares) Common feet psoriasis triggers include: Prolonged standing or walking on hard surfaces Tight or restrictive footwear Excessive moisture or dryness Cold, dry winter weather Physical trauma (stubbing toes, dropping objects on feet) Stress and anxiety Strep throat and other infections Certain medications (beta-blockers, lithium, antimalarials) Step 3: Build Your Comprehensive Treatment Routine Morning routine (15 minutes): Wash feet with gentle, fragrance-free cleanser Pat partially dry, leaving feet slightly damp Apply keratolytic (salicylic acid or urea) if needed Wait 5 minutes for absorption Apply prescription feet psoriasis cream to affected areas Wait 5-10 minutes for absorption Layer plant-based botanical cream (Swasti Botanicals) over treated areas Apply to entire feet for moisture and protection Put on clean, breathable cotton or bamboo socks Throughout the day: Reapply botanical feet psoriasis cream after any foot washing Remove shoes for 5-10 minutes every 2-3 hours to air out feet Keep extra socks at work for midday changes if feet perspire Moisturize immediately after any water exposure Evening routine (20 minutes): Soak feet in lukewarm water with Epsom or Dead Sea salt (10-15 minutes) Pat partially dry Apply keratolytic agent if using Wait 5 minutes Apply prescription medication to active plaques Wait 10 minutes for full absorption Apply thick occlusive moisturizer or botanical cream over entire feet Cover with plastic wrap or bags for 20-30 minutes (optional intensive treatment) Put on clean cotton socks and keep them on overnight Weekly intensive treatment: Once weekly, do extended overnight occlusion therapy After evening routine, wrap feet in plastic wrap over thick cream layer Cover with cotton socks and sleep with feet elevated This "super-hydration" treatment can dramatically improve thick plaques Step 4: Set Realistic Expectations and Timelines Topical feet psoriasis treatment timeline: Weeks 1-2: Minimal visible change, possible initial irritation Weeks 3-4: Scaling reduction becomes noticeable Weeks 6-8: Significant thickness reduction, less redness Weeks 10-12: Maximum benefit from topical therapy achieved Systemic medication timeline: Weeks 1-4: Gradual improvement begins Weeks 8-12: Substantial improvement visible Weeks 16-24: Maximum effect achieved Toenail psoriasis timeline: Months 1-3: No visible change (nail takes time to grow) Months 4-6: New nail growth appears healthier at base Months 9-12: Significant nail improvement visible Months 12-18: Complete nail replacement with healthy nail Expect occasional setbacks—flares happen even with perfect treatment adherence. Stress, illness, and unknown triggers can cause temporary regression. Adjust your plan based on response rather than abandoning treatment entirely. Step 5: Partner With a Podiatrist and Dermatologist Self-treatment has clear limitations—severe or persistent feet psoriasis requires professional medical guidance. A dermatologist can prescribe stronger feet psoriasis cream, arrange phototherapy, or recommend systemic medications. A podiatrist can address mechanical issues (abnormal gait, pressure points) that perpetuate inflammation. Regular follow-ups every 4-8 weeks allow treatment adjustments based on your specific response patterns. Professional guidance prevents months of ineffective self-treatment when prescription options could provide rapid relief. The Feet Psoriasis-Mobility Connection: Protecting Your Independence How Feet Psoriasis Limits Daily Function Severe feet psoriasis can reduce walking distance by 70% and increase fall risk substantially. The pain forces altered gait patterns that create secondary problems: knee pain, hip pain, back pain. Avoiding physical activity due to foot pain leads to weight gain, cardiovascular deconditioning, and worsening overall health. The downstream effects of feet psoriasis extend far beyond your feet themselves. Adaptive Strategies for Maintaining Mobility Footwear modifications: Custom orthotics redistribute pressure away from psoriatic plaques Extra-depth shoes accommodate thickened, deformed toenails Rocker-bottom soles reduce pressure on ball of foot during walking Seamless socks prevent friction on sensitive areas Activity modifications: Swimming and water aerobics maintain fitness without weight-bearing stress Recumbent bikes keep you active while minimizing foot pressure Upper body strength training maintains overall fitness when walking is painful Yoga and stretching maintain flexibility without excessive foot impact Assistive devices: Walking sticks or trekking poles reduce foot pressure by 25% during walking Supportive sandals for home use (never walk barefoot) Cushioned floor mats in areas where you stand frequently Shower chairs reduce standing time during bathing Addressing the Pain Component Feet psoriasis pain significantly impacts quality of life and treatment adherence. Over-the-counter pain relievers (acetaminophen, NSAIDs) provide temporary relief but don't address inflammation. Topical lidocaine cream (4-5%) can numb painful areas temporarily for important activities. Prescription pain management may be necessary for severe cases—discuss options with your physician. Effective feet psoriasis treatment ultimately provides the best pain relief by eliminating the source of pain. Frequently Asked Questions About Feet Psoriasis Treatment Can feet psoriasis go away permanently? Feet psoriasis can enter complete remission with all symptoms disappearing for months or even years, but it's not a permanent feet psoriasis cure. The underlying immune dysfunction persists, and symptoms can recur with triggers like stress, illness, trauma, or medication changes. Many patients maintain long remission periods with consistent maintenance feet psoriasis treatment. The goal is managing symptoms so effectively that feet psoriasis doesn't impact your daily life, even though the tendency remains. How long does feet psoriasis treatment take to work? Topical feet psoriasis cream shows initial improvement within 2-4 weeks, with maximum effectiveness at 10-16 weeks. Systemic medications like biologics demonstrate results in 4-8 weeks, reaching peak effectiveness at 3-6 months. Phototherapy requires 12-20 weeks of consistent treatment sessions. Toenail psoriasis takes longest—typically 9-18 months—because toenails grow very slowly (1mm per month). Patience is absolutely essential—most treatment failures occur because patients discontinue therapy prematurely. Is feet psoriasis contagious? Absolutely not—feet psoriasis is an autoimmune condition, not an infection. You cannot transmit it to others through touch, shared surfaces, swimming pools, or any contact. The appearance sometimes resembles fungal infections (athlete's foot), leading to misconceptions about contagion. Educating family members, roommates, and partners about psoriasis reduces anxiety and social isolation. Can I go swimming with feet psoriasis? Yes, swimming is generally safe and beneficial—water exercise maintains fitness without weight-bearing stress on painful feet. Chlorinated pool water may temporarily irritate active plaques but won't worsen underlying psoriasis. Apply waterproof feet psoriasis cream before swimming for protection. Rinse feet thoroughly with fresh water after swimming and immediately apply moisturizer. Some patients report chlorine temporarily improves symptoms, while others experience irritation—individual response varies. What's the strongest feet psoriasis cream available? Ultra-high potency corticosteroids like clobetasol propionate 0.05% represent the strongest single-ingredient topical option. Combination products (calcipotriene/betamethasone) may be more effective than either ingredient alone despite lower steroid potency. "Strongest" doesn't always mean "best"—the optimal feet psoriasis cream depends on your specific psoriasis type, severity, and treatment goals. Work with a dermatologist to find the right balance between effectiveness and safety for your situation. Can I get a pedicure with feet psoriasis? Professional pedicures carry risks when you have active feet psoriasis. Nail manipulation, cuticle cutting, and callus removal can trigger the Koebner phenomenon and worsen symptoms. Tools may not be adequately sterilized, increasing infection risk in compromised skin. If you choose to get pedicures: Find a technician experienced with psoriasis Bring your own sterilized tools Avoid aggressive cuticle work and callus removal Skip pedicures entirely during active flares Consider at-home gentle foot care instead Will losing weight help my feet psoriasis? Weight loss may help feet psoriasis through multiple mechanisms. Excess weight increases pressure on feet, worsening mechanical trauma and inflammation. Obesity promotes systemic inflammation that can trigger or worsen psoriasis. Studies show 10-15% body weight reduction correlates with 25-35% improvement in psoriasis severity. Weight loss alone won't cure feet psoriasis, but it can significantly improve symptoms and treatment response. The reduced foot pressure alone provides meaningful relief for many patients. Can feet psoriasis lead to arthritis? About 30% of people with psoriasis eventually develop psoriatic arthritis—an inflammatory joint condition. Feet psoriasis doesn't directly cause arthritis, but both conditions share underlying immune dysfunction. Watch for joint pain, stiffness, swelling in toes or ankles—these may indicate developing arthritis. Early arthritis diagnosis and treatment prevent permanent joint damage and disability. Report any joint symptoms to your doctor immediately for evaluation. Does feet psoriasis mean I have psoriasis elsewhere? Not necessarily—some patients have psoriasis exclusively on hands and/or feet (palmoplantar psoriasis). However, about 40% of people with feet psoriasis also have plaques on other body areas. Feet psoriasis can be the first manifestation of psoriasis that later spreads, or it may remain localized permanently. Complete skin examination by a dermatologist identifies any additional affected areas requiring treatment. Are there foods that trigger feet psoriasis? Individual food triggers vary significantly—there's no universal "psoriasis diet" that works for everyone. Some patients report flares with alcohol, processed foods, nightshade vegetables, or dairy. An elimination diet can help identify your specific triggers over 6-8 weeks. Keep a detailed food and symptom diary to identify patterns. Common reported triggers include alcohol (especially beer), red meat, processed foods, and excessive sugar. Anti-inflammatory foods (omega-3 fatty acids, colorful vegetables, fruits) may help reduce flare frequency. Living Successfully With Feet Psoriasis: Long-Term Management Strategies The Maintenance Mindset Shift Once you achieve clearance or significant improvement, maintaining results requires ongoing vigilant effort. The biggest mistake patients make? Stopping all feet psoriasis treatment once symptoms resolve. Your psoriasis didn't disappear—you've just suppressed it successfully—and stopping treatment allows rapid return. Maintenance therapy principles: Continue applying botanical feet psoriasis cream daily even when clear Use low-potency corticosteroids 1-2 times weekly to prevent relapse Maintain aggressive moisturization regardless of symptom status Continue trigger avoidance indefinitely Stay connected with your dermatologist for periodic check-ins Think of feet psoriasis management like dental hygiene—daily prevention is infinitely easier than treating problems later. Seasonal Adjustment Strategies Winter typically worsens feet psoriasis due to cold, dry air and indoor heating systems. Prepare for winter by: Ramping up moisturization frequency starting in fall Using humidifiers in your home to maintain 40-50% humidity Switching to thicker, more occlusive feet psoriasis cream formulations Wearing warm, moisture-wicking socks to protect against cold Intensifying treatment before symptoms worsen rather than reacting to flares Some patients need prescription-strength treatments in winter but maintain clear feet with botanical creams alone during humid summer months. The Critical Role of Support Networks Connecting with other feet psoriasis patients reduces isolation and provides practical management tips. Online communities (Reddit r/Psoriasis, Facebook support groups, National Psoriasis Foundation forums) offer emotional support and treatment insights. Sharing experiences with others who understand normalizes your struggles and celebrates victories. The mental health benefits of knowing you're not alone facing this challenge cannot be overstated. Chronic visible skin conditions carry significant psychological burden—addressing mental health is part of comprehensive treatment. Tracking Progress and Adjusting Strategies Photograph your feet weekly from consistent angles and lighting to objectively track changes. Keep a detailed treatment diary noting: What products you applied and when Changes in symptoms (better, worse, stable) Potential triggers encountered Activities that worsened or improved symptoms Questions for your next dermatologist appointment This documentation helps identify what works specifically for you and what doesn't. Subjective memory of improvement is notoriously unreliable—objective tracking prevents false conclusions about treatment effectiveness. Share photos and diary with your dermatologist for data-driven treatment adjustments. The Future of Feet Psoriasis Treatment: Emerging Options Next-Generation Topical Treatments New topical medications targeting specific inflammatory pathways without steroid mechanisms are in development. Roflumilast cream (recently FDA-approved for plaque psoriasis) may offer effective inflammation control for feet without steroid side effects. Tapinarof (Vtama), a naturally-derived aryl hydrocarbon receptor modulator, shows promise for reducing inflammation without traditional medication concerns. These options may provide effective feet psoriasis treatment without the skin thinning and other issues that limit long-term corticosteroid use. As these medications gain approval for palmoplantar psoriasis specifically, they'll expand treatment options significantly. Advanced Biologic Medications Next-generation biologics targeting interleukin-17 (IL-17) and interleukin-23 (IL-23) pathways achieve impressive clearance rates. Medications like risankizumab (Skyrizi), bimekizumab (Bimzelx), and others achieve complete skin clearance in 60-80% of patients. As biosimilar versions of existing biologics become available, costs are decreasing and accessibility improving. Newer formulations include: Longer dosing intervals (every 12-16 weeks instead of monthly), Subcutaneous injection devices that are easier and less painful Oral small-molecule medications that avoid injection requirements entirely Personalized Medicine Approaches Genetic testing may soon identify which patients respond best to specific treatments based on their genetic profile. This precision medicine approach could eliminate the months-long trial-and-error process of finding effective feet psoriasis cream or systemic therapy. Biomarkers might predict who will develop severe disease, allowing early aggressive intervention before disability occurs. Artificial intelligence analysis of photos may track treatment response objectively and predict optimal treatment combinations. These advances are 5-10 years from widespread clinical availability but represent the future direction of psoriasis care. Microbiome-Based Therapies Research shows psoriasis patients have altered skin microbiomes compared to healthy individuals. Future treatments may include topical probiotics or prebiotics that restore healthy microbial balance on feet. These approaches could reduce inflammation and improve barrier function through natural microbial mechanisms. Early research is promising but clinical applications remain years away. Taking Action: Your Next Steps Starting Today Begin with the fundamentals: aggressive moisturization, proper footwear, and consistent application of any current treatments. If you haven't consulted a dermatologist, schedule an appointment—especially if feet psoriasis impacts your walking ability or daily activities. Immediate actions you can take: Take weekly photographs starting today to track progress objectively Choose one new strategy from this guide to implement this week Order quality botanical feet psoriasis cream (like Swasti Botanicals) for daily maintenance Invest in proper supportive footwear with cushioning and breathable materials Set phone alarms for consistent treatment application times This week: Start a treatment and trigger diary Purchase cotton socks for overnight therapy Begin the "soak and seal" moisturization protocol Schedule a dermatology appointment if needed This month: Establish consistent morning and evening treatment routines Identify and begin avoiding your personal triggers Consider dietary modifications to reduce inflammatory load Join an online support community Remember: feet psoriasis treatment is a marathon requiring sustained effort over months and years, not a sprint expecting rapid results. Success comes from consistent daily action, realistic expectations, and patience with the gradual improvement process. You may not achieve a complete feet psoriasis cure, but you can absolutely achieve clear, comfortable, functional feet. The impact of feet psoriasis on mobility and quality of life makes aggressive treatment absolutely essential. Don't settle for "manageable"—keep working with your healthcare team until you find the combination that restores your ability to walk, work, and live without constant foot pain and limitation. Your feet carry you through life—they deserve the investment of time and effort required for proper care. References National Psoriasis Foundation. Palmoplantar Psoriasis: Overview and Treatment. https://www.psoriasis.org/about-psoriasis/types/palmoplantar/ American Academy of Dermatology Association. Psoriasis: Signs and Symptoms. https://www.aad.org/public/diseases/psoriasis/what/symptoms Sevrain M, Richard MA, Barnetche T, et al. Treatment for palmoplantar pustular psoriasis: systematic literature review, evidence-based recommendations and expert opinion. Journal of the European Academy of Dermatology and Venereology. 2014;28(Suppl 5):13-16. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Psoriasis: Diagnosis, Treatment, and Steps to Take. https://www.niams.nih.gov/health-topics/psoriasis Bissonnette R, Pariser DM, Wasel NR, et al. Crisaborole topical ointment, 2% in adults with psoriasis: A phase 2a, randomized, vehicle-controlled study. Journal of the American Academy of Dermatology. 2016;75(6):1153-1158. Menter A, Strober BE, Kaplan DH, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. Journal of the American Academy of Dermatology. 2019;80(4):1029-1072. British Association of Dermatologists. Patient Information Leaflets: Palmoplantar Pustulosis. https://www.bad.org.uk/patient-information-leaflets/ Wolff K, Johnson RA, Saavedra AP. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 8th Edition. McGraw-Hill Education; 2017. World Health Organization. Global Report on Psoriasis. 2016. https://www.who.int/publications/i/item/global-report-on-psoriasis Mrowietz U, Kragballe K, Reich K, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Archives of Dermatological Research. 2011;303(1):1-10. European Academy of Dermatology and Venereology. Guidelines for the Treatment of Psoriasis. https://www.eadv.org/guidelines Lebwohl MG, van de Kerkhof PCM, Gelfand JM, et al. From the Medical Board of the National Psoriasis Foundation: The challenging landscape of palmoplantar psoriasis. Journal of the American Academy of Dermatology. 2018;78(3):580-586.