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Palmar Erythema: Causes and Treatments

Palmar Erythema causes the skin around the palms and fingers to become red and warm.

It happens whenever blood vessels in the hand become dilated. Although it sounds scary, this symptom is considered benign.

It’s not associated with itching, pain, or any other dangerous diseases. In this article, we’ll talk about the causes and treatments.

What is Palmar Erythema?

Palmar Erythema

The American Journal of Clinical Dermatology reports that palmar erythema is caused by blood vessel dilation in the hands.

Specifically, the capillaries near the surface become larger. This allows more blood to flow through, which can give the palms a redder appearance.

Also, due to the increased blood flow, the hand may feel warmer than normal. The fingers can also be affected by this condition.

In rarer cases, people may also experience it on the soles of their feet. Below, we’ll talk about common triggers and what can be done to control the symptoms.

Bottom Line: This condition is caused when the blood vessels near the surface of the hand dilate (become larger), resulting in increased blood flow.

Primary vs. Secondary Palmar Erythema

This condition can be one of two types:

  • Primary: Due to genetic factors and/or pregnancy.
  • Secondary: Due to an underlying medical condition.

In primary palmar erythema, the person is already born with the genes that make them susceptible to getting it.

They may develop it early or late in life. Additionally, about 1/3rd of pregnant women will develop red palms that can be itchy.

Researchers aren’t exactly sure why this happens. They believe that it’s caused by increased levels of estrogen associated with pregnancy.

Giving birth often makes the symptom go away. Finally, this type can be “idiopathic”, meaning there is no cause.

In secondary palmar erythema, there is an underlying medical condition present. One example is autoimmune diseases.

People with HIV or rheumatoid arthritis are more likely to develop it. Also, brain cancer can trigger red, warm palms and fingers.

Bottom Line: This condition can either be primary or secondary. Primary cases are benign and harmless while secondary cases are associated with underlying disease.

Additional Causes of Secondary Palmar Erythema

Here are some more causes for the secondary type:

  • Congenital Syphilis: “Congenital” means that the condition or disease is passed down to an unborn child.
  • Dermatological Conditions: Psoriasis and eczema are common skin conditions that can cause PE to develop.
  • Liver Disease: It’s estimated that about 20% of people who get liver disease will also present red palms as a symptom.
  • Diabetes: This disease results in high blood sugar, which can damage nerves. It can also make you more likely to get PE.
  • Medications: Certain medications have been known to cause palmar erythema. These include medications for epilepsy and bronchitis.
  • Smoking and Alcohol: People who are already prone to this condition can trigger an episode by drinking or smoking cigarettes.

Finally, the secondary type can happen in people with hepatitis B or C, as well as people who’ve been exposed to toxins.

As you can see, there’s a pattern: they’re all associated with an underlying disease. This is different than the primary type, which is genetic and benign.

Bottom Line: For people with secondary palmar erythema, common causes include medications, smoking and alcohol, liver disease, and diabetes.

Diagnosis

Palmar Erythema diagnosis

To determine why your palms are red and warm, your doctor may perform any one of the following diagnostic procedures:

  • Complete Blood Count (CBC): This type of blood test can tell your doctor a lot about what’s happening in your body.
  • Glucose Fasting Test: This test is used to determine if a patient has diabetes (a potential trigger for the secondary type).
  • Blood Urea Nitrogen/Creatinine Test: Nitrogen and creatinine are bodily waste products. This test will measure kidney and liver health.

Other diagnostic procedures include tests for hepatitis B and C, range of motion tests (for rheumatoid arthritis) and a liver function test.

Finally, a thyroid stimulation hormone test, as well as a chest X-ray, may be performed. Depending on the test, you may need to wait a week or two for the results to come back.

Bottom Line: There are a range of diagnostic tests- ranging from a CBC to a glucose fasting test- that can help a doctor determine why your palms are red.

Can it Be Treated?

Unfortunately, there aren’t any cures or treatment options for people with palmar erythema.

For women who are pregnant, giving birth will usually make the symptom go away.

However, if you’re born with it, there’s not much you can do. If you have the secondary type, and it’s being caused by an autoimmune disease, then you can try corticosteroids.

In short doses these might alleviate your symptoms. If a specific mediation is causing it then, with approval from your doctor, stop taking it and find a replacement.

Bottom Line: There’s not much in today’s medical arsenal to make your symptoms go away. The best thing you can do is avoid specific triggers (smoking, etc.).

Can Palmar Erythema Be Prevented?

Again, no. That’s because palmar erythema is a genetic disorder. The secondary type can be prevented, but only if you know the underlying cause.

For secondary palmar erythema, it’s recommended that you stop smoking and drinking. That should reduce your risk greatly.

Also, avoid medications that are known to cause your symptom. If you treat the underlying condition, whether it be cancer or liver disease, that should make your red palms go away.

Bottom Line: There’s no way to prevent primary palmar erythema (since it’s genetic). However, you can reduce your risk of the secondary type by making smart lifestyle choices.

Conclusion

To summarize, this condition happens because of blood dilation near the surface of the palms. For the primary type, it’s incurable and can’t be prevented.

For the secondary type, drinking and smoking less, as well as avoiding certain medications, can minimize your risk.

The good news is that this symptom rarely manifests itself in a painful manner. Few patients report having pain and/or itching with their redness and warmth.

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