skin conditions & beauty center

What Medical Condition Causes Red Toes?

Reviewed on 9/15/2022
A foot with red toes
Red toes can be caused by a variety of conditions, including injury, skin infection (cellulitis), irritant contact dermatitis or allergic contact dermatitis, athlete’s foot (tinea pedis), nail infection (paronychia), peripheral vascular disease (PVD), frostbite or chilblains, and gout.

Red toes can be caused by a number of different conditions, and are usually accompanied by other symptoms that differ depending on the cause. 

8 red toe causes

Causes of red toes may include:

  • Injury
    • A direct blow to the foot such as kicking something hard or dropping a heavy object on the toes
    • Overuse and repetitive stress from high-impact sports such as running, football, or basketball
  • Skin infection (cellulitis)
    • A bacterial infection of the skin and soft tissues usually caused by staphylococci (“staph”) or streptococci (“strep”) bacteria 
    • Affects the deeper layers of the skin or the fat under the skin 
    • May develop due to a wound or other break in the skin that allows bacteria to enter the skin
  • Irritant contact dermatitis or allergic contact dermatitis
    • Can cause itchy, red, inflamed, scaly skin
    • The exact cause is not always known though genetics may play a role and people with a family history are at increased risk of developing the condition
    • Exposure to certain chemicals or cleaning solutions, including soaps and detergents, perfumes and cosmetics, wool or synthetic fibers, dust, sand, and cigarette smoke are common triggers for contact dermatitis symptoms
  • Athlete’s foot (tinea pedis) 
    • A contagious fungal infection caused by a ringworm
    • Ringworm is not actually a worm, but the condition is so-named because it can cause a ring-shaped, red, itchy rash on the skin
    • Most often caused by human dermatophytes, a type of fungus transmitted by direct contact with human ringworm sores
    • Ringworm may also be acquired from the soil or through exposure to animals (typically household pets)
  • Nail infection (paronychia)
    • An infection of the nail folds often caused by Staphylococcus aureus bacteria or a fungus
    • Can cause toe pain and swelling
    • Often starts as a hangnail that becomes infected when a person tries to bite or rip off the piece of nail at the corner 
    • Can also be caused by aggressively shoving back or trimming cuticles, leading to cuticle infection
  • Peripheral vascular disease (PVD), also called peripheral venous disease or peripheral artery disease (PAD)
  • Frostbite or chilblains
    • Toes can become red at first when exposed to cold temperatures
    • Repeated exposure to cold temperatures can cause chilblains
  • Gout
    • A type of inflammatory arthritis that causes pain and swelling in the joints
    • Usually caused by too much uric acid in the body (hyperuricemia), and foods that contain high levels of purines, compounds that can raise uric acid levels 

What Are Symptoms of Red Toes?

Depending on the cause, red toes may be accompanied by other symptoms such as: 

  • A sore on a leg or a foot that will not heal
  • Blisters or small pimples 
  • Bruising
  • Chills
  • Feeling a “pop” when the injury occurs
  • Fever 
  • Fluid leaking out of the wound
  • Hair loss on the legs
  • Impotence
  • Itching
  • Limited big toe movement
  • Numbness or tingling in the legs
  • One or both legs or feet feel cold or change color (pale, bluish, dark reddish)
  • Pain
    • Burning or aching pain in the feet or toes while resting
    • Buttock pain
    • Dull, cramping pain in one or both calves, thighs, or hips (called intermittent claudication) 
    • Sudden episodes of severe joint pain
  • Patches of inflamed skin/skin swelling
  • Pus under the skin and nail plate
  • Red, swollen, peeling, itchy skin between the toes 
  • Ring-shaped rash
  • Scaly, cracked, rough patches of skin
  • Sensitive skin
  • Skin discoloration (especially red or pink)
  • Skin dryness
  • Skin flaking 
  • The skin may appear pitted, like the peel of an orange
  • The skin on the feet may blister in severe cases
  • Skin redness
  • Stiffness in toe joint
  • Swelling
  • Tenderness 
  • Warmth
  • Weakness

How Are Red Toes Diagnosed?

The cause of red toes is diagnosed with a patient history and physical examination of the toes. Depending on the suspected cause, tests may include:  

What Is the Treatment for Red Toes?

Treatment for red toes depends on the cause. 

First aid treatment for red toes due to injury should be administered when the injury first occurs and includes RICE, which stands for:

  • Rest: avoid walking or putting weight on the injured toes
  • Ice: Ice the injured area 20 minutes at a time, several times a day (do not apply ice directly to the skin)
  • Compression: use an elastic compression bandage, such as an ACE wrap
  • Elevation: put the foot higher than the heart to reduce swelling

Treatment for skin infection (cellulitis) includes antibiotics and treatment of any underlying condition that led to the infection.

  • Home care for red toes due to cellulitis includes:
    • Rest and give the body time to heal 
    • Elevate the foot above the heart to help reduce swelling and facilitate healing
    • Keep the affected area clean and dry 
    • Only use antibiotic ointments or creams if prescribed
  • Medical treatment for red toes due to cellulitis includes:
    • Antibiotics
    • The choice of antibiotic depends the bacterial cause of the cellulitis 
    • In severe cases, hospitalization may be needed and intravenous (IV) antibiotics may be given

Home remedies to reduce or relieve symptoms of red toes due to contact dermatitis include: 

  • Identifying and eliminating triggers 
  • Keeping the skin hydrated
    • Emollients
    • Bathing
  • Wet dressings (wet wraps) may be used to help soothe and hydrate skin, reduce itching and redness, loosen crusted areas, and prevent skin injury due to scratching
  • Medications used to treat contact dermatitis include:
    • Over-the-counter (OTC) or prescription topical steroid creams or ointments 
    • Over-the-counter (OTC) or prescription oral antihistamines for itching 
    • Tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel)
    • Oral steroids (e.g., prednisone) used for short periods 
    • Injectable “biologics” 
    • Immunosuppressive drugs for patients with severe symptoms who do not improve with other treatments

Treatment for red toes due to athlete's foot (tinea pedis) includes:

  • Over-the-counter antifungal products to kill the athlete’s foot fungus
  • Chronic or extensive tinea pedis may require oral antifungals such as terbinafine, itraconazole, or fluconazole
  • Chronic tinea pedis may require adjunctive therapy such as foot powder or talcum powder to prevent skin softening

Treatment for red toes due to nail infection (paronychia) includes: 

  • Antibiotics
  • Proper wound care
    • May include incision and drainage of wound or even a partial removal of the nail

Treatment for red toes due to peripheral vascular disease involves treating the underlying condition, which includes: 

  • Angioplasty, enlarging an artery that is blocked or narrowed without surgery
  • Stenting, for arteries that are very severely blocked or begin to close up again after angioplasty
  • Atherectomy, removal of an atherosclerotic plaque
  • Medications such as antiplatelet agents, anticoagulants, and "clot-busters" (thrombolytics) and pentoxifylline (Trental) and cilostazol (Pletal) to help treat intermittent claudication 
  • Lifestyle changes include quitting smoking, getting regular exercise, eating a low-fat and healthy diet, maintaining a healthy weight, controlling high blood pressure and high cholesterol, and keeping blood sugar in check if you have diabetes

Treatment for frostbite or chilblains includes rewarming the toes and feet slowly:

  • Warm socks
  • Warm water baths
  • Warm air blown over the toes and feet

Treatment for red toes due to gout flares is usually short-term and limited to the duration of the flare and may include: 

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Reviewed on 9/15/2022
References
REFERENCES:

Image source: iStock Images

https://orthoinfo.aaos.org/en/diseases--conditions/turf-toe/

https://www.cdc.gov/groupastrep/diseases-public/Cellulitis.html

https://nationaleczema.org/eczema/

https://www.cdc.gov/fungal/diseases/ringworm/index.html

https://www.uptodate.com/contents/paronychia?source=search_result&search=paronychia&selectedTitle=1~59

https://emedicine.medscape.com/article/460178-overview

https://www.uptodate.com/contents/gout-beyond-the-basics?search=gout&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3