Many people with psoriasis find that the condition affects their hands. Hand psoriasis can lead to cracked, bleeding, and painful skin. This can prevent someone from comfortably using their hands.

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

However, various treatment options and lifestyle strategies can positively affect the 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.

Generally, palmoplantar psoriasis is the type of psoriasis that affects the hands and feet. According to the National Psoriasis Foundation, 12–16% of people with psoriasis have this type.

The following types could also affect the hands:

  • Guttate psoriasis: This causes inflammation that looks like small, round, red or discolored spots, and it affects about 8% of people with psoriasis.
  • Pustular psoriasis: This type causes inflammation that appears as pustules, which are white, pus-filled bumps that can be painful. It affects 3% of people with psoriasis.
  • Plaque psoriasis: This is the most common type of psoriasis, accounting for 80% of cases. It causes itchy, painful patches that may be red, white, or purple.
  • Erythrodermic psoriasis: This type of psoriasis can cause the skin to come off, which makes it life-threatening. However, it is rare, occurring in only 2% of cases.

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.

Various treatment options can help manage psoriasis on 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 moisture 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 calm the immune system and reduce swelling.
  • Topical retinoids: These prescription creams speed up the process of skin shedding and slow the growth of skin cells.
  • Other nonsteroidal topicals: Available options include Zoryve (roflumilast) and Vtama (tapinarof).

To improve absorption, people can use the following technique:

  1. Apply the treatment.
  2. Wrap the hands in plastic wrap or put on plastic gloves.
  3. Leave the treatment on 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 per week for a couple of months.

Systemic medication

If a person’s psoriasis does not respond to other treatments or if it is severe, a doctor may prescribe a systemic treatment, which will affect the whole body.

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

People can try some strategies that may prevent hand psoriasis from worsening or flaring up.

For example, when washing their hands, people can use moisturizing hand soap, avoid harsh scrubbing, and avoid using extremely hot water.

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

Learn more about at-home remedies for psoriasis.

Noting triggers

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

Learn more about potential psoriasis triggers.

Psoriasis is an inflammatory skin condition that can appear anywhere on the body. Psoriasis that appears on the hands or the soles of the feet is called palmoplantar psoriasis.

Like psoriasis elsewhere on the body, psoriasis of the hands can make skin appear flushed and cause scale-like plaques that can crack and cause pain and bleeding. The affected skin can also 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.

People with psoriasis may experience flare-ups, which are periods when the symptoms and appearance of psoriasis worsen.

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

Hands and fingers

Possible symptoms of hand psoriasis 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.

Fluid-filled bumps

A 2016 study noted a link between hand, foot, and nail psoriasis and a condition called palmoplantar pustulosis.

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.

Discover more pictures of psoriasis.

Hand psoriasis can potentially appear in the following places:

  • fingers
  • palms
  • knuckles
  • nails

In 40–50% of people with psoriasis, the condition 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 tasks 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.

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, which causes keratinocytes, or skin cells, to divide quickly.

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

Psoriasis may result from a mix of genetic and environmental factors, including:

  • general and skin infections
  • extremely cold or hot weather
  • skin injury
  • stress
  • medications such as antidepressants and antivirals
  • family history of the condition

If a person does not receive treatment, the condition may worsen. It could also affect the joints, causing psoriatic arthritis.

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. According to a 2016 analysis of research, 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, which 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 worsen psoriasis symptoms. In turn, the flare-ups may cause additional stress, which makes symptoms worse.

To manage stress, people may wish to try techniques such as:

  • breathing exercises
  • meditation
  • exercise
  • yoga
  • rest

Doctors do not diagnose psoriasis using traditional testing methods such as imaging or blood tests, as they do for other autoimmune diseases.

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

They may take a skin biopsy of the affected area.

A doctor can also identify whether 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, or they may have family members with psoriasis or other skin conditions.

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 other conditions with similar symptoms, such as eczema.

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

Hand psoriasis is a chronic disease that requires proper management to prevent symptoms from worsening.

People with hand psoriasis can manage their symptoms by trying lifestyle strategies and creating a treatment plan with help from a medical professional.

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