Psoriasis on Hands and Feet

Written by Annie Stuart, Kristen Fischer
Medically Reviewed by Zilpah Sheikh, MD on June 25, 2025
7 min read

Psoriasis on your hands and feet, also known as palmoplantar psoriasis or hands and feet psoriasis (HFP), occurs when patches of scaly, flaky, discolored skin appear on these areas.

It’s a rare type of psoriasis, which is a chronic condition for which there’s no cure. Some estimates suggest that approximately 3%-4% of people with psoriasis experience it on their hands and feet, while other figures indicate that about 12%-16% of people living with psoriasis have this form of the condition. While it can spread and flare up from time to time, it’s not contagious.

HFP is one of the most disabling types of psoriasis, as it affects widely used parts of the body.

Palmoplantar psoriasis can occur beyond your palms and soles. It can also appear on the tops of your feet and hands, webbing between fingers and toes, backs of your hands, wrists, ankles, knuckles, and even the nails.

It can also cause your skin to:

  • Crack or split
  • Thicken
  • Redden
  • Scale
  • Swell
  • Blister or have pimple-like spots (pustules)

Your hands and feet make up about 4% of your body’s total surface area. Yet people with HFP are nearly two and a half times more likely to struggle with daily activities due to HFP. 

“Palmoplantar psoriasis presents distinct difficulties,” says Danilo C. Del Campo, MD, a dermatologist based in Chicago. “Even mild disease in these areas can interfere with daily activities. Patients may have trouble walking, using their hands, or performing basic tasks due to pain, thickened skin, and cracking.”

“When the hands are affected, it can also take a psychological toll because they are so visible,” Del Campo notes.

If it affects your ability to earn a living, that could cause financial burdens too.

HFP isn’t the only type of psoriasis to affect your hands and feet. Plaque psoriasis, guttate psoriasis, pustular psoriasis, and nail psoriasis can also appear on your hands and feet.

What is pustular psoriasis on the palms and soles?

Palmoplantar psoriasis and palmoplantar pustulosis both refer to skin issues on your hands and feet, but they have different symptoms and causes. Psoriasis causes scaly patches of discolored skin on your hands and/or your feet. Palmoplantar pustulosis is a subtype of psoriasis that looks like a scaly patch of discolored skin, along with pus-filled bumps or blisters on the patches.

Some people (mostly adults who smoke) get pustular psoriasis on their palms and soles. It may cause painful cracks, redness, and scales. Pustular psoriasis can be more stubborn to treat than other types of HFP, but the same methods are used.

Is palmoplantar psoriasis the same as eczema?

No. Psoriasis on your hands and feet can look similar to eczema and occur on your hands and feet, but they are different conditions. Scales and flakes on patches of discolored skin are common in psoriasis, while a dry, itchy, and discolored rash indicates eczema.

How does psoriasis affect your nails?

Psoriasis can damage your nails and cause:

  • Shallow or deep holes
  • Shape changes
  • Thickening
  • Separation of the nail from the nail bed, with debris under the nail
  • Discoloration

HFP can cause:

  • Scales or flakes
  • Discoloration
  • Itching
  • Dryness

“This form of psoriasis differs in more than just location. The skin on the hands and feet is thicker, and lesions are often more painful, prone to fissuring, and more resistant to treatment,” Del Campo says. “Symptoms like itching are less common, and many patients report burning or stinging instead.”

“It’s one of those times when location really does make a difference in both severity and treatment response,” Del Campo adds.

HFP, like other forms of psoriasis, occurs when the immune system attacks its own cells. Your skin cells multiply too quickly, leading to a buildup of excess cells on the surface of your skin. Scientists aren’t sure why this type of psoriasis is limited to hands and feet. They think genetic or environmental factors play a role.

These common triggers may cause psoriasis to flare up:

  • Stress
  • Smoking tobacco
  • Drinking alcohol
  • Diet
  • Some medications
  • Skin injuries
  • Illness, such as infections
  • Weather changes

Your health care provider will look at your skin to examine where patches occur and your symptoms. They may take a skin biopsy, which involves removing a small piece of skin and looking at it under a microscope.

Palms and soles tend to be much more difficult to treat than any other sites, says Johann E. Gudjonsson, MD, a professor of dermatology at the University of Michigan.

Treatments for HFP can include: 

  • Topical creams or ointments with ingredients such as urea, emollients, salicylic acid, or coal tar
  • Light therapy (phototherapy)
  • Topical medications such as corticosteroid or calcipotriene creams
  • Oral medications such as acitretin, cyclosporine, retinoids, and methotrexate 
  • Biologic medications such as etanercept (Enbrel) or infliximab (Remicade)

The go-to treatment for palmoplantar psoriasis is often topical corticosteroids. But topical agents may not work so well on hands and feet because the skin there is so thick. For many people with HFP, phototherapy helps. Systemic treatments such as cyclosporine and methotrexate can offer relief. Biologics are usually only considered if people don’t respond to the above-mentioned treatments.

Combinations of these often work better than one treatment alone. For instance, tazarotene combined with a topical corticosteroid is effective.

Your doctor might recommend a corticosteroid under a hydrocolloid occlusion dressing — a layer that keeps the skin moist and can stay on for several days. Wetting your skin, rubbing on a corticosteroid cream, and sealing it in with plastic wrap overnight may help, too.

Doctors often combine retinoids with light therapy for HFP. You might have UVB or psoralen-UVA (PUVA) phototherapy or targeted phototherapy (laser treatment). PUVA involves taking the drug psoralen, either by mouth or applied like paint, along with the phototherapy.

Nail psoriasis treatments

Corticosteroid creams or ointments, vitamin D analogs, and light therapy are used to treat nail psoriasis. Doctors can also inject a corticosteroid into your nail beds. Nail psoriasis can be complicated by fungal infections, for which your doctor may prescribe antifungal agents.

Cosmetic repair is also an option. This can involve:

  • Nail scraping and filing
  • Nail polish
  • Artificial nails
  • Surgical removal

To help prevent problems, trim your nails as short as possible and wear gloves when you work with your hands.

A few medications can slow the progression of psoriasis on a cellular level. If topical treatments don’t work, your doctor may suggest:

  • Cyclosporine to slow down your overactive immune system
  • Retinoids such as acitretin (Soriatane) to reduce cell multiplication
  • Methotrexate, which slows an enzyme that causes rapid skin cell growth

If those treatments don’t help, one of these biologics might:

  • Adalimumab (Humira)
  • Brodalumab (Siliq)
  • Certolizumab (Cimzia)
  • Deucravacitinib (Sotyktu)
  • Etanercept (Enbrel)
  • Guselkumab (Tremfya)
  • Infliximab (Remicade)
  • Ixekizumab (Taltz)
  • Risankizumab (Skyrizi)
  • Secukinumab (Cosentyx)
  • Tildrakizumab (Ilumya)
  • Ustekinumab (Stelara)

Effective home remedies can include:

  • Avoiding injury to your hands and feet
  • Washing skin gently in warm (not hot) water with moisturizing soap
  • Applying petroleum jelly to your feet and putting cotton socks over them
  • Wearing shoes with good cushioning and arch support
  • Going outside for vitamin D exposure, which may improve symptoms

You can’t prevent HFP, but you can try to lower your flare-up risk. These things may help:

  • Washing your hands and feet often with a gentle soap and water
  • Moisturizing your skin regularly
  • Identifying and avoiding triggers
  • Managing stress levels
  • Wearing sunscreen when outdoors
  • Eating a healthy diet and exercising regularly

Palmoplantar psoriasis, or HFP, is a rare type of psoriasis. It can be especially challenging because we use our hands and feet so much in daily life.

The appearance may make you feel self-conscious, as these parts of the body are often regularly visible.

Treatments are available, and lifestyle changes can give you relief.

What triggers palmoplantar psoriasis?

HFP is caused by changes in the immune system. Irritants, stress, and allergens are just a few things that can make it flare up. If you can identify and avoid triggers, you may be able to reduce flare-ups and ease symptoms. Scientists aren’t sure why HFP only affects hands and feet in some people and not other parts of the body.

What triggers psoriasis?

Scientists think that psoriasis is caused by genetic and environmental factors. These can cause your immune system to mistakenly attack your body, resulting in an overgrowth of skin cells that show up as flakes and scales.

How can I stop psoriasis from spreading?

Ask your doctor about a treatment plan to potentially stop the spread of your psoriasis. While psoriasis isn’t contagious, it can expand to other areas of your skin. Triggers such as cold weather, infections, stress, or smoking can lead to flare-ups, causing it to spread.