Why are my toes red, swollen, itchy, and painful when scratched, and what should I do?

The toes are red, swollen, itchy, and painful when scratched—this may be caused by insect bites, friction irritation, athlete's foot (tinea pedis), contact dermatitis, or paronychia. Symptoms can be improved through local care, avoiding irritants, and medication. Seek medical attention promptly if symptoms worsen, pus develops, or the condition spreads.

1. Insect bites: Toes exposed to insects may get bitten, with insect venom triggering a localized inflammatory reaction, leading to redness, swelling, and itching. Scratching damages the skin and causes pain. It is recommended to clean the bite area with soapy water, apply soothing and anti-itch products, and avoid scratching to prevent skin damage and infection.

2. Friction irritation: Wearing tight, non-breathable shoes or prolonged walking can cause friction and pressure on the toes, resulting in local congestion, swelling, and sensitivity that triggers itching. Scratching further aggravates the injury and causes pain. It is advised to switch to loose, breathable footwear, reduce walking, and elevate the feet to promote blood circulation.

3. Athlete's foot (tinea pedis): A fungal infection affecting the skin of the toes damages the skin barrier and causes inflammation, resulting in redness, itching, peeling, and pain when scratched. Blisters may also appear. Under a doctor’s guidance, use antifungal medications such as clotrimazole cream, terbinafine hydrochloride spray, or itraconazole capsules to relieve discomfort.

4. Contact dermatitis: Allergic reactions occur when the toes come into contact with allergens such as certain shoe or sock materials or detergents, causing redness, swelling, and itching. Scratching leads to skin damage and pain. Patients may use medications such as dexamethasone cream, loratadine tablets, or calamine lotion under medical supervision to alleviate symptoms.

5. Paronychia: Minor injuries around the toenail allow bacteria to invade and trigger inflammation, characterized by redness, swelling, and itching around the nail. Pain is evident upon scratching or pressing, and pus may develop in severe cases. Follow a doctor's advice to use mupirocin ointment, cephalexin capsules, or iodophor disinfectant to manage symptoms.

Maintain clean and dry toes, wear breathable, sweat-absorbent cotton socks and shoes, avoid sharing footwear or foot basins with others, trim nails carefully without cutting too short or injuring surrounding skin, and follow a light diet avoiding spicy and irritating foods to minimize local irritation and support recovery.