Many people with psoriasis find the condition affects their hands. Hands help people to communicate and perform tasks. When psoriasis affects them, it can be particularly challenging.

Psoriasis on the hands can lead to cracked, bleeding, and painful skin. This can prevent someone from using their hands comfortably.

A person may also feel embarrassed about having this skin condition on their hands.

However, various treatment options and lifestyle changes can positively impact symptoms and the skin’s appearance.

This article explores the appearance and symptoms of psoriasis on the hands. It also looks at treatment options, including home care and prevention.

Psoriasis is an inflammatory skin condition that can appear anywhere on the body.

If psoriasis appears on the hands or soles of the feet, it is called palmoplantar psoriasis.

As with psoriasis elsewhere on the body, psoriasis of the hands can make skin appear flushed, with scale-like plaques that can crack open and cause pain and bleeding.

The affected skin can become raised and thickened.

Some people with hand psoriasis may not have flushed skin, but they may have scaling of the palms and generalized thickening of the skin.

Psoriasis can appear differently on the skin, depending on a person’s skin tone.

Learn more about what psoriasis can look like on black skin here.

People with psoriasis may experience flare-ups. This means they can experience changes to the symptoms and appearance of psoriasis.

Discover more pictures of psoriasis here.

Fluid-filled bumps

A 2016 study has linked a condition called palmoplantar pustulosis to hand, foot, and nail psoriasis.

If someone has this condition, they may see fluid-filled bumps on the psoriasis patches that later peel off, forming a crust.

Pustular psoriasis makes up about 3% of all psoriasis cases.

Symptoms can vary according to the location of psoriasis. Hand psoriasis can affect the hands, feet, and nails.

Around 12–16% of people with psoriasis have hand, foot, or nail psoriasis.

Hands and fingers

The other symptoms of hand psoriasis may include:

Nails

A person experiencing psoriasis of the nails may notice the following changes:

  • nail thickening
  • nails lifting away from the nail bed
  • pits and ridges in the nails

Learn about other possible causes of nail abnormalities here.

Hand psoriasis can potentially appear in the following places:

  • fingers
  • palms
  • knuckles
  • nails

In around 50% of people with psoriasis, it affects the nails.

The hands are particularly vulnerable to cracking and bleeding because of the joints and folds between the fingers.

In addition, routine daily tasks and personal care involving soap and cleaning products can lead to swelling or itchiness.

Palmoplantar psoriasis also affects the feet. So, a person may experience symptoms there, too.

Hand psoriasis can affect people of any age and sex. It is more common in females and people aged 20–60.

Of those with psoriasis, 3–4% will experience hand psoriasis. Psoriasis affects 2–5% of the population.

Household work and season changes can cause hand psoriasis. This means it can commonly affect the following groups:

  • farmers
  • manual laborers
  • homemakers

Psoriasis is a chronic inflammatory disorder that affects the skin. Some believe it is an autoimmune condition.

Doctors do not yet fully understand what triggers the immune system to attack the skin in this way.

A person with psoriasis will experience inflammation. The inflammation causes keratinocytes or skin cells to divide quickly.

The very quick division of the cells pushes immature skin cells to the skin surface faster than the skin can remove skin cells. This results in a thickening of the outermost layer of skin, which causes psoriatic plaques and lesions.

A mix of genetic and environmental factors may cause psoriasis, including:

  • general and skin infections
  • extremely cold or hot weather
  • skin injury
  • stress
  • medications, including antidepressants and antivirals
  • having a family member with the condition

If left untreated, the condition may worsen. It could also affect the joints, causing psoriatic arthritis.

Various treatment options can help manage psoriasis of the hands. Treatment can fall into three categories:

Topical treatments

Topical treatments can be the first line of therapy. A person can apply creams and lotions directly to the hands. Options include:

  • Moisturizing treatments: These treatments can help the hands retain water by forming a protective film.
  • Steroid creams: These creams reduce inflammation.
  • Vitamin D analog creams: These creams can work in combination with steroids.
  • Calcineurin inhibitors: These creams help to calm the immune system and reduce swelling.
  • Topical retinoids: These prescribed creams speed up the process of skin shedding and slow the growth of skin cells.

To improve absorption, people can use the following technique:

  1. Apply the treatment.
  2. Wrap the hands in Saran wrap or wear plastic gloves.
  3. Leave overnight.

Light therapy

Doctors can use artificial light to treat psoriasis, either by itself or in combination with other treatments.

The light may be UVA or UVB.

A person may need several sessions of light therapy weekly for a couple of months.

Systemic medication

If the psoriasis is not responding to other treatments, or if it is severe, a doctor may prescribe a systemic treatment. This treatment would impact the entire body.

Effective therapies include methotrexate, cyclosporine, apremilast, biologics, which modulate the immune system, and acitretin, which slows down skin cell production.

People can make habit adjustments that may prevent their hand psoriasis from worsening or flaring up.

For example, when washing the hands, people can use moisturizing hand soap.

A person with hand psoriasis can avoid harsh scrubbing and extremely hot water.

A person with hand psoriasis can apply a moisturizing lotion after washing the dishes to help reduce skin irritation.

Learn more about at-home remedies for psoriasis here.

Noting triggers

Recording factors that trigger psoriasis flare-ups can help a person to avoid them in the future.

Learn more about potential psoriasis triggers here.

Psoriasis can interfere with a person’s quality of life. However, people can manage their symptoms by remembering that the following factors can affect them:

Smoking

Many people who have hand psoriasis currently smoke or used to smoke.

Smoking may increase the risk of developing hand psoriasis, as it can interfere with immune and nervous system signaling.

Therefore, people who smoke should try to cut down or quit. A 2016 study shows that the amount someone smokes relates to the appearance of hand psoriasis symptoms.

Here are some tips on how to quit smoking.

Weather

People with hand psoriasis may experience flare-ups in cold weather because of the reduced humidity. This dries out the skin.

In hot weather, both sunburn and spending time in air-conditioned environments can trigger the condition.

People can protect their hands by wearing gloves and using moisturizing creams.

Stress

For people with hand psoriasis, stress plays a dual role.

Stress can exacerbate psoriasis symptoms. In turn, the flare-ups may cause additional stress, which makes symptoms worse.

There are some techniques people can use to manage stress, including:

  • breathing exercises
  • meditation
  • exercise
  • yoga
  • rest

If someone thinks they may have psoriasis, they should contact a doctor or dermatologist to discuss a treatment plan. Contacting a doctor can help rule out another condition with similar symptoms, such as eczema.

People with a psoriasis diagnosis should meet with their doctor if their symptoms worsen.

Unlike other autoimmune diseases, doctors do not diagnose psoriasis using traditional testing methods such as imaging or blood tests.

Instead, they perform a physical examination of the psoriasis symptoms and judge the severity.

They may also take a skin biopsy of the affected area.

A doctor can also identify if a person has an increased risk of developing hand psoriasis by looking at their medical history.

For example, the person may have other immune system disorders. They may have family members with psoriasis or other skin conditions.

Hand psoriasis is a chronic disease that requires proper management to avoid aggravation or worsening of symptoms.

People with hand psoriasis can manage their symptoms by making lifestyle changes and formulating a treatment plan alongside a medical professional.

Doctors will consider the severity of a person’s condition and prescribe an appropriate topical or systemic medication.