Psoriasis on the Hands and Feet: Palmoplantar Psoriasis and Treatment
The types of psoriasis that affect the palms and soles, how they're treated and how to protect your skin.
Part of our psoriasis guide.
Get urgent help first. Call 999 or go to A&E if your skin suddenly becomes red and inflamed over most of your body, or you have widespread pus-filled spots, especially with a fever, chills or feeling very unwell. These can be signs of erythrodermic or generalised pustular psoriasis, which are emergencies. See a GP soon if you have painful, swollen joints. Online treatment isn't suitable in these situations.
Key fact: psoriasis on the palms and soles is often thick and cracked, so it usually needs stronger treatment than elsewhere. Pustular psoriasis of the hands and feet is closely linked with smoking and usually needs a GP.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor's online psoriasis service is for adults aged 18 and over, and can't supply treatment if you're pregnant or breastfeeding: your GP or midwife can help. Children with psoriasis should see their GP.
Types of psoriasis on the hands and feet
| Type | What it looks like |
|---|---|
| Palmoplantar (plaque) psoriasis | Thick, well-defined, scaly patches on the palms and soles, often with painful cracks. |
| Palmoplantar pustulosis | Yellow or brown pus-filled spots on the palms and soles that dry to brown marks. Strongly linked with smoking. The spots aren't infected. |
| Psoriasis on the backs of the hands, knuckles and fingers | Plaques like those elsewhere on the body; can come with nail psoriasis. |
Hand and foot psoriasis can make everyday tasks such as walking, typing and washing up painful. Even though it covers a small area, doctors treat it seriously because of the effect on daily life.
Psoriasis or hand eczema?
They can look very alike. Psoriasis on the palms tends to form sharply edged, thick patches on both hands, while hand eczema is often very itchy, with tiny blisters, especially on the sides of the fingers. Contact with irritants such as detergents can make both worse. See our psoriasis vs eczema guide.
How hand and foot psoriasis is treated
1
Emollients, urea and salicylic acid
Thick emollients, and products with urea or salicylic acid, soften thick scale and help other treatments reach the skin.
2
A stronger steroid
The skin on the palms and soles is thick, so potent steroids are often used, and sometimes a very potent steroid for a short course, usually with specialist advice. Covering the area overnight (with cotton gloves or socks) can help the cream work, but only on a prescriber's advice.
3
Vitamin D or a combined product
Calcipotriol, or a combined steroid and vitamin D product, can also be used.
4
Specialist treatment
If it doesn't improve, a dermatologist may offer hand and foot light therapy, tablets such as acitretin, or other systemic treatments. See tablets, injections and light therapy.
Palmoplantar pustulosis and smoking
Palmoplantar pustulosis is closely linked with smoking: most people with it smoke or have smoked. Stopping smoking can help it settle and helps treatment work. It usually needs a GP or dermatologist, as it can be hard to treat with creams alone. Widespread pus spots elsewhere on the body with fever is an emergency.
Protecting your hands and feet
- Wear cotton-lined gloves for wet work and cleaning.
- Use a soap substitute and moisturise after every hand wash.
- Wear comfortable, well-fitting shoes and cotton socks.
- Don't pick at scale or cracks; cover painful cracks with a plaster or a liquid skin protector.
- Stop smoking, especially if you have pustules.
Psoriasis on your hands or feet?
Our GPhC-registered pharmacist independent prescribers can assess plaque psoriasis on the hands and feet online and, if suitable, prescribe treatment. Pustular psoriasis needs a GP. Adults 18 and over. Dispensed from our UK pharmacy. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose.
Start Psoriasis Consultation →How our online service supplies psoriasis treatment: adults 18 and over, not for the face, genitals or skin folds. Enstilar, Dovobet and other psoriasis-only treatments need psoriasis already diagnosed by a GP or dermatologist. Enstilar and Dovobet: one pack per order, supplied as a course of up to 4 weeks, on no more than 30% of the body. Betnovate and Elocon: up to 3 × 30g or 1 × 100g, for a 4-week course followed by a 4-week break. Dermovate only if you have been prescribed it before. Widespread psoriasis, joint pain or psoriasis that hasn't responded to treatment is referred to your GP.
UK safety and reporting side effects
Prescription psoriasis treatments are only supplied after a GPhC-registered pharmacist independent prescriber reviews your consultation, including where your psoriasis is, how much skin it covers and what you have used before. Always read the patient information leaflet. Since 2024, UK steroid packs show their strength on the front (mild, moderate, strong or very strong). The MHRA advises using topical steroids for the shortest time needed, and to tell a healthcare professional if your skin flares badly after you stop a steroid you have used for a long time, which can be a topical steroid withdrawal reaction.
If you think you've had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme.
Psoriasis treatments from Access Doctor
Following an online consultation, our prescribers can supply the treatments below where suitable, as part of our psoriasis treatment service.
Potent steroid · Rx
Betnovate Ointment
The greasier form, better for thick, dry or scaly plaques.
View product →Potent steroid · Rx
Elocon Ointment
Once-daily mometasone in an ointment base, for dry, thick plaques.
View product →Very potent steroid · Rx
Dermovate Ointment
Clobetasol in an ointment base, only if previously prescribed.
View product →Vitamin D + potent steroid · Rx
Enstilar Foam
Calcipotriol with betamethasone in a spray foam, once a day for up to 4 weeks. For diagnosed plaque psoriasis.
View product →Frequently Asked Questions
How do you treat psoriasis on your hands?
Thick emollients and urea or salicylic acid soften the scale, and a potent steroid, sometimes with vitamin D, treats the inflammation. If it doesn't improve, a dermatologist can offer light therapy or tablets.
Can hand psoriasis go away?
It can clear with treatment, but it often comes back, especially with wet work, irritants or smoking. Protecting your hands and treating flares early helps keep it under control.
What triggers psoriasis on the hands?
Friction, injury, wet work, detergents and cold weather are common triggers, as are stress and infections. Pustular psoriasis of the hands and feet is strongly linked with smoking.
Is it psoriasis or eczema on my hands?
They can look very similar. Psoriasis tends to form thick, sharply edged patches on both palms, while hand eczema is usually very itchy with tiny blisters on the sides of the fingers. A GP can help tell them apart.
What are the pus spots on my palms and soles?
Yellow or brown pus spots that dry to brown marks are usually palmoplantar pustulosis, a form of psoriasis strongly linked with smoking. They aren't infected, but they need a GP or dermatologist.
References
- NICE Clinical Knowledge Summaries. Psoriasis. cks.nice.org.uk
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
- British Association of Dermatologists. Psoriasis: an overview (patient information leaflet), August 2023. skinhealthinfo.org.uk
- Joint Formulary Committee. British National Formulary: psoriasis (treatment summary). bnf.nice.org.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Prescription psoriasis treatments need a clinical consultation before they can be supplied. If your skin is red all over, you have widespread pus spots, a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.