Do you have scaly, cracked skin on your palms that sometimes bleeds? Do you ever feel self-conscious shaking hands or find yourself hiding your hands at work?

If you have psoriasis symptoms on your hands or feet, the impact on daily life can be significant. Simple acts, like gripping a coffee cup or waving to a friend, can take a physical and emotional toll.

“My hands feel like they’ve been stung by 1,000 bees,” explained one member of MyPsoriasisTeam.

“When psoriasis breaks out, cracks, and bleeds on the hands, you can’t do much with them,” wrote another member.

“Mine started with an ungodly itch and later changed to small, red bumps and small dry spots. Now my hands look like I’ve been burned — red, peeling, painful, and itchy.”

— A MyPsoriasisTeam member

Psoriasis on the hands and feet is known as palmoplantar psoriasis, a form of plaque psoriasis. Some researchers consider palmoplantar pustulosis a distinct condition, but this is debated. It can be especially difficult to treat, especially since most people use their hands constantly. “My cracks are deep, and I cry when I wash,” said one member.

Here’s what it feels like to have hand psoriasis and what you can do to manage your symptoms.

Types of Psoriasis on the Hands

Psoriasis on the hands can appear as discolored, scaly patches on the palms or as pus-filled bumps called pustules — a symptom of a condition known as palmoplantar pustulosis. In some cases, both types can occur together.

Palmoplantar Psoriasis

Palmoplantar psoriasis can cause flaky, scaly skin on the hands. Skin may be discolored and feel itchy and dry. In more severe cases, fissures (deep cracks) can form, which may be painful and slow to heal.

Palmoplantar Pustulosis

This type of psoriasis causes small, pus-filled blisters on the palms. Over time, these can become painful and turn into thick, cracked plaques. The pus isn’t from an infection. Rather, it’s a result of inflammation.

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Psoriatic Nail Disease

Most people with psoriasis will have nail changes at some point. Nails may become thick, brittle, crumbled, or discolored, and they may show signs of pitting (tiny dents) or ridges. Nail changes alongside joint pain may signal psoriatic arthritis (PsA).

Because nail psoriasis can look like a fungal infection, it’s a good idea to ask your dermatologist to take a closer look.

Causes of Hand Psoriasis

Psoriasis on the hands develops when the immune system becomes overactive, causing inflammation and the rapid buildup of skin cells. This leads to the thick, scaly patches often seen in palmoplantar psoriasis.

There’s some evidence that certain genes may increase the risk of developing psoriasis. Environmental and lifestyle factors — such as smoking, stress, skin injuries, and some medications — can also play a role in triggering or worsening symptoms.

The exact cause of pustular psoriasis (including palmoplantar pustulosis) is unknown. The small, pus-filled blisters often occur in people who currently smoke or used to smoke. Other psoriasis triggers may include:

• Infections
• Pregnancy
• Certain medications
• Allergic reactions

Symptoms of Hand Psoriasis

Symptoms of hand psoriasis often include itchy, scaling, discolored skin patches that may appear on the palms and spread in a symmetrical pattern. Deep, painful fissures are also common. “Mine started with an ungodly itch and later changed to small, red bumps and small dry spots. Now my hands look like I’ve been burned — red, peeling, painful, and itchy,” explained one member of MyPsoriasisTeam.

Hand psoriasis can look similar to other skin conditions, including eczema. That’s why it’s important to see a dermatologist to get an accurate diagnosis.

To make a diagnosis, a dermatologist will typically:

• Examine your hands and check for psoriasis in other areas of your skin.
• Take a small skin scraping to rule out a fungal infection.
• Perform a biopsy (removing a small skin sample) to confirm whether it’s psoriasis.

How Hand Psoriasis Affects MyPsoriasisTeam Members’ Lives

Members of MyPsoriasisTeam have shared how psoriasis on their hands affects their everyday lives. Many talk about feeling isolated, self-conscious, or even depressed. The condition can make home, work, and social situations more difficult:

• “My hands are constantly cut open. They feel like they were caught in a fire.”
• “I’m so tired of hiding my hands.”
• “I can’t hold my hands out for change [from cashiers]. They give me strange looks and drop it in my hand.”
• “My hands and fingers feel like they have hot metal bands tightened around them.”
• “I’m a registered nurse and people are always looking at my nails and hands. It’s so frustrating.”

Treatment Options for Hand Psoriasis

Controlling hand psoriasis often requires a combination of general psoriasis treatments and targeted approaches for the skin on your hands.

Topical Treatments

Topical treatments — available over the counter (OTC) or by prescription — come as creams, ointments, or lotions. Common options include:

• Salicylic acid and coal tar — Found in many OTC products, these ingredients help reduce scaling and soften thick skin.
• Corticosteroids — These can help reduce inflammation and swelling and are typically used short term to avoid side effects.
• Vitamin A and vitamin D derivatives — Prescription creams can help slow down the overproduction of skin cells.
• Topical calcineurin inhibitors (TCIs) — TCIs offer a nonsteroid approach to calming the immune system to reduce inflammation.
• Other nonsteroidal creams or ointments — These may be prescribed if steroids or other treatments don’t work well for you.

A technique called occluding can make your topical treatment more effective. It involves covering your hands with cotton or plastic gloves after applying the product, helping the medicine absorb better. Talk with your doctor before trying this technique.

“Wearing white cotton gloves helps my hands but draws attention and Michael Jackson jokes. Maybe I’ll dye them flesh-colored,” said one MyPsoriasisTeam member.

Phototherapy

If hand psoriasis doesn’t improve with topical treatments, your doctor may recommend phototherapy (light therapy). One option is psoralen plus ultraviolet A (PUVA), a treatment that combines a light-sensitizing drug with UVA light. PUVA is sometimes preferred over narrowband UVB because it can penetrate deeper into the skin.

Your dermatologist can explain the potential risks of phototherapy, including a higher risk of skin cancer in areas exposed to repeated UVA treatments.

DMARDs and Biologics

If standard treatments for hand psoriasis don’t work well, your doctor may recommend disease-modifying antirheumatic drugs (DMARDs) or biologic medications. These prescription drugs are designed to target specific parts of the immune system involved in psoriasis.

DMARDs and biologics can help reduce inflammation, prevent flare-ups, and improve daily life for people living with psoriasis. These treatments may carry risks, such as infection or liver complications. Talk to your doctor about whether these options are right for you.

Hand Care Tips

Psoriasis can make the skin on your hands more vulnerable to irritation and injury. That’s why it’s important to care for your hands gently and consistently. Using moisturizers, washing carefully, and avoiding friction or harsh chemicals can help protect your skin and reduce flare-ups.

Moisturizers

Moisturizing is a key part of managing hand psoriasis. OTC creams, ointments, and lotions help soften rough patches, remove dead skin cells, and prevent your symptoms from getting worse. Apply moisturizers at least once a day, especially after a warm bath or shower.

Members of MyPsoriasisTeam often report good results with thick, hydrating creams and petroleum-based products like Vaseline, which form a protective barrier over the skin. Lightweight lotions may not be rich enough, so look for products that are thicker and more emollient (soothing and softening).

“I put emollient on my hands, then Vaseline on top, to seal in moisture so they don’t split and crack. It seems to be working,” shared one member of MyPsoriasisTeam.

Another said, “I use Gold Bond Psoriasis Relief. I no longer scratch myself bloody, and I’m not ashamed to shake hands or let people see my hands.”

Hand-Washing

Washing your hands regularly is important for overall health and those around you by preventing the spread of viruses or bacteria. But for people with hand psoriasis, alcohol-based hand sanitizers may dry out the skin and trigger flare-ups. Dermatologists recommend using gentle soap and water instead, as well as following up with moisturizer.

“I have pustular psoriasis on the palms of my hands and find that ‘normal’ alcohol hand sanitizers cause flare-ups,” said one member of My PsoriasisTeam.

“I used sanitizer on my hands, and I screamed and wanted to cry,” shared another.

Choose fragrance-free cleansers that don’t contain harsh chemicals, and rinse thoroughly. Leftover soap can dry out the skin and lead to chapping or cracking.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. Members come together to ask questions, give advice, and share their stories with others who understand what it’s like.

Do you have hand symptoms of psoriasis? If so, how do they impact your daily life? Share your tips and experiences in a comment below or on your Activities page.