Why Do I Have a Rash on My Palms?

A variety of skin conditions can cause palm rashes. Treatments will vary depending on what's causing the rash. Dry skin, allergens, irritants, contact dermatitis, fungal infections, eczema, and other conditions can trigger a rash on palms.1

Some palm rashes cause physical discomfort marked by itchy palms; others, such as palmar erythema, don't itch but cause red or discolored palms.2 It's important to determine the exact cause of a rash on your palms, identify the best treatment based on its cause, and take steps to prevent future occurrences based on what triggers a flare-up.

What Does a Rash on the Palms Look Like?

Palmar rashes often present as reddish spots or darker-colored patches, depending on the person's skin tone and the rash's cause.

A palm rash typically looks red and scaly.3 Depending on its underlying cause, a palm rash might look swollen and blistery with leaking fluid or dry and flaky with peeling skin. Some palm rashes have distinctive borders; others look blotchy and don’t have clear borders. If a palm rash is infected, it may look raw and be oozing with pus.

Potential Causes of a Rash on Your Palms

Potential causes of a rash on your palms include dry skin, contact dermatitis, dyshidrotic eczema, allergic reactions, palmoplantar psoriasis, and ringworm (dermatophytosis). Read on to learn more about these and other causes of palm rash, along with treatment options.

Dry Skin

Dry skin, medically known as xeroderma or xerosis cutis, can cause a rash on your palms because a lack of oil on the skin limits the skin's ability to trap moisture. If dry skin is the underlying cause of a palmar rash, preventing or alleviating dryness is the best remedy. Try washing your hands with milder soap and lukewarm water or using a fragrance-free hand moisturizer to maintain a healthy skin barrier and prevent rash-inducing dryness.4

Contact Dermatitis

Contact dermatitis is an itchy, blistering skin rash caused by an irritant or allergen that touches the skin. Common irritants are cosmetic products, detergents, or chemicals in solvents. Allergens that cause palm rashes include poisonous plants containing urushiol oil (such as poison ivy, poison oak, or poison sumac) or metal objects such as coins containing nickel.5

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Dyshidrotic Eczema

Dyshidrotic eczema, also known as pompholyx or palmoplantar eczema, is a skin condition marked by intensely itchy skin and fluid-filled blisters that form on the palms of the hands, soles of the feet, or both. It can cause a prickling or burning sensation, dry peeling skin, or painful palm cracks.6 

The exact cause of dyshidrotic eczema on the palms is unknown. It often presents as sudden outbreaks triggered by stress, excessive sweating, prolonged exposure to dampness, or high humidity. Allergens or environmental irritants may also trigger flare-ups. 

Dyshidrotic eczema treatment typically involves over-the-counter (OTC) topical corticosteroids such as hydrocortisone or stronger prescription-strength steroid creams or a short course of oral steroids may be prescribed in more severe cases or acute flare-ups.7 

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Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is medically known as enteroviral vesicular stomatitis, a contagious illness that can cause an itchy, bumpy, or blistery palm rash. It is most commonly caused by a virus called coxsackievirus.8

HFMD can spread via saliva, nasal mucus, blister fluid, or exposure to droplets from coughing, sneezing, or talking. Home quarantine is recommended to avoid spreading hand, foot, and mouth disease until symptoms have completely subsided.9

There isn't a specific treatment for the palm rash caused by HFMD, but symptoms usually clear in about a week to 10 days.10

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Ringworm

Ringworm, also known as tinea or dermatophytosis, can cause a scaly and itchy palm rash. Although the rash may not always be shaped like a ring, it will likely have a slightly raised border that's clearly defined.

Ringworm is a broad term encompassing a wide range of fungal skin infections caused by over 40 different types of fungi. Tinea manuum is a condition caused by fungus that usually affects the hands and palms. Antifungal medications treat ringworm.11

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Hives

If hives (urticaria) cause a palm rash, it typically starts as a red patch of skin that develops into an itchy raised welt with clearly defined borders. Urticaria is usually an allergic reaction triggered by an allergen in food, medicine, or something in the environment that touches the skin. They may also be caused by infections. Cool compresses and antihistamines are first-line treatments.12

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Palmoplantar Psoriasis

Palmoplantar psoriasis is an autoimmune skin disorder that can affect the palms or soles of the feet.13 Someone with plaque psoriasis on other parts of their body or scalp could also have a palm rash marked by dry, raised psoriatic patches (plaques) with gray or silvery scales.

Like other autoimmune diseases, palmoplantar psoriasis is most likely caused by a combination of genetics and environmental factors. Potential triggers that cause flare-ups vary from person to person but may include emotional stress, extreme weather conditions, certain medications, or excessive alcohol use.14

Although there isn't a cure for palmoplantar psoriasis, it can be effectively treated with medications, self-care lifestyle choices, and ultraviolet (UV) light therapy.15

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Allergic Reaction

Allergic reactions can trigger a rash on your palms, similar to contact dermatitis caused by other irritants. Washing off the allergen with soap and water is the first step when treating contact dermatitis caused by an allergic reaction. Over-the-counter (OTC) anti-itch ointments that are topical (placed on the skin) or oral antihistamine pills can help with itchiness and inflammation caused by allergic reactions.

Identifying and avoiding the irritant or allergen that caused your palm rash is the best way to prevent future occurrences. Patch testing can be performed to find out what you're allergic to.16 Disposable gloves can also protect your hands from coming in contact with substances that trigger an allergic palm rash.3

Because latex allergies are relatively common, people prone to allergic reactions or hand eczema often wear latex-free safety gloves made of vinyl, nitrile, or polyethylene.17 For someone who's allergic to latex, wearing latex gloves could cause a palm rash.

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Impetigo

Impetigo is a highly contagious skin infection that usually affects infants and young children. It can appear as red or purple sores or blistering bumps on the palms. If a palm rash is caused by impetigo, a prescription-strength antibiotic ointment or cream is the gold standard treatment.18

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How Is a Palm Rash Diagnosed?

Getting a palm rash diagnosis will always include a clinical examination and medical history. Depending on what's observed during the physical exam or gained from your medical history, a healthcare provider or dermatologist (skin specialist) may order specific tests or perform other procedures to identify your palm rash's underlying cause.

Below are some common tests and procedures used for palm rash diagnosis:19

• Allergy testing20
• Complete blood count (CBC)
• Dermoscopy
• KOH prep test21
• Skin biopsy
• Tzanck smear22
• Wood's lamp exam

Treatment Options for a Palm Rash

OTC treatments do not require a prescription and include the following for a palm rash:

• Antifungal creams: Topical medications like clotrimazole or terbinafine can treat palm rashes caused by fungal infections like ringworm.23
• Antihistamines: Oral antihistamine tablets like Benadryl (diphenhydramine) alleviate itching caused by allergens.24
• Calamine lotion: This topical lotion relieves itching and redness or discoloration.
• Hydrocortisone cream: A mild topical corticosteroid like hydrocortisone 1% reduces inflammation and itching.25
  

Prescription options include:

• Oral antibiotics: Systemic antibiotic tablets may be prescribed for a moderate-to-severe palm rash that shows signs of infection.3
• Oral antihistamines: Prescription-strength antihistamines like hydroxyzine (sold under the brand names Atarax and Vistaril) are prescribed for persistent allergic skin reactions that don't respond to OTC tablets.
• Topical calcineurin inhibitors: Prescription medications like Protopic (tacrolimus) or Elidel (pimecrolimus) reduce immune responses and can help treat eczema and psoriasis.26
• Topical steroids: Prescription-strength topical steroid creams are prescribed when OTC-strength corticosteroids don't alleviate symptoms.27

If possible, consult a healthcare provider before starting any new OTC treatment to ensure it's appropriate for your specific palm rash condition. Prescription-strength treatments are only available from a prescribing healthcare professional after a diagnostic consultation.

Home Care

The following home care strategies can help with a palm rash:28

• Avoid scrubbing the skin.
• Use gentle cleaners to prevent irritation.
• Pat the hands dry and don't rub them together.
• Avoid cosmetics and scented lotions.
• Stop using any recently-introduced products on the hands (as these may have caused the rash if you're allergic to them).
  

When to Contact a Healthcare Provider

If you have a palm rash, it's important to get a timely and accurate diagnosis. Treating the underlying condition promptly and appropriately will help get rid of the rash faster. Because there are many different causes of a rash on the palms, self-diagnosis and self-treatment can sometimes worsens the rash since it's not addressing the underlying cause.

Severe pain, swelling, blistering, or oozing pus are all red flags and warning signs indicating an infection that requires immediate medical attention. Contact a healthcare provider immediately if your palm rash looks infected or is accompanied by a fever or pain that spreads up your arm.

Summary

Many different things, such as allergies, fungal infections, or skin conditions like eczema or psoriasis, can cause a palm rash. Treatments vary depending on the underlying cause.

If you’re not sure what’s triggering your palm rash or if it doesn’t respond to OTC treatments, speak to a healthcare provider. Diagnostic tests can help pinpoint its cause. Keeping your hands clean, wearing disposable safety gloves, and avoiding irritants or allergens can help prevent future palm rash flare-ups.