One of the most difficult types of psoriasis to live with is that which affects the hands and feet; this is known as palmoplantar psoriasis. This is mainly because it negatively impacts normal activities like writing, walking, carrying groceries, handshaking, washing the dishes, wearing shoes, and a lot more. This means that aside from the burdensome and taxing symptoms of psoriasis, palmoplantar psoriasis can be more upsetting and exhausting, especially during social interactions.
Luckily, there are a variety of remedies and treatments for psoriasis on the hands and feet that make it easier to accomplish everyday routine tasks. In this article, we're determined to get to the bottom of hand psoriasis, its cause, and symptoms, and present solutions on how to best cope with the situation.
What Does Psoriasis on the Hands Look Like?Read More
- Skin pain
- Peeling, cracking, bruising
- Red inflamed patches
- Thick silvery scales
- Flaking skin
- Burning sensation
In an interview, Dr. Kristina Callis Duffin, M.D., co-chair of the department of dermatology at the University of Utah in Salt Lake City, gave to the National Psoriasis Foundation, she explained the impact palmoplantar psoriasis has on its patients by saying "Having psoriasis or psoriatic arthritis on the hands and feet is life-altering," she says. "It raises the bar for how much it affects your quality of life."
In addition to these symptoms, hand psoriasis can also affect the fingers, knuckles, and nails. These can include the following symptoms:
- Discoloration of the nails where they can darken, turn yellowish-brown or yellowish-red as a result of crumbling and infections.
- Formation of small pits due to loss of keratin cells.
- Separation of the nail from the nail bed causing gaps.
- Thickening of the nail structure.
- Weakening of the nails.
What Causes Psoriasis on Hands?
Psoriasis is classified as an autoimmune disease that mistakenly attacks the immune system and causes rapid skin growth, producing inflamed patches known as psoriatic lesions. When these lesions appear on the hand or foot, it's called palmoplantar psoriasis.
The reason behind getting hand psoriasis is still unknown to this day. Similar to psoriasis, it's believed that palmoplantar psoriasis is caused by a combination of genetic and environmental risk factors.
Below is a list of the most common environmental triggers that can stimulate hand psoriasis to emerge:
- Continuous physical stress on the hands (like rough scrubbing, friction with hard tools, or wearing unfit gloves)
- Emotional stress
- Strong sun exposure
- Hand injury
- Cold and dry weather
- Some medications (like lithium and beta-blockers)
- Exposure to chemicals (like detergents)
- Allergens exposure
So, it's a good idea to keep away from these triggers to avoid instigating hand psoriasis symptoms. Also, there are many treatment options and home remedies for hand psoriasis, but you should consult your doctor first to know the right treatment for you.
Treatments for Psoriasis on Hands
The main goal of treating hand psoriasis is to reduce inflammation, alleviate psoriatic plaque symptoms, and attain remission as long as possible. Since there's no universal treatment for psoriasis, doctors have to first assess your condition according to the following criteria:
- Type of hand psoriasis you have
- The severity of your condition
- Any treatments taken
- Any underlying medical conditions
- Your overall health
"When I see a psoriasis patient, I first determine the extent of their condition. If it's fairly localized, I'm able to treat the patient with topical therapy by itself," Dr. Linda Stein Gold, Director of Clinical Research in the Department of Dermatology at Henry Ford Health in Detroit, said in a previous interview with SurvivorNet. "But if they have a more widespread condition, topicals alone are not practical."
Then, they will prescribe the best treatment for you, depending on the information they got. They may also recommend some lifestyle changes and daily habits you should avoid to reduce flareups.
Treatment for mild and moderate cases includes the following options:
Moisturizers. They act as emollients to treat dry, flaky, itching, and cracking skin.
Salicylic acid. This works on enhancing the shedding of skin and scales, which in turn reduces plaques.
Coal tar. This ingredient has anti-inflammatory properties, which reduce redness and inflammation of the skin.
Vitamin D derivatives. Analogs of vitamin D like calcipotriene play a role in reducing the inflammation and rapid growth of skin cells.
Topic corticosteroids. To soothe inflammation and reduce plaque sizes.
Treatment for moderate and severe cases requires stronger interventions; these include the following options:
Methotrexate. Which slows the enzyme responsible for rapid cell growth.
Oral retinoids. Which works on slowing down cell multiplication (ex. Acitretin/Soriatane).
Cyclosporines. Functions in slowing down the overactivity of the immune system.
Phototherapy. Works by adding a light sensitizing medication named psoralen, which helps with symptoms of psoriasis.
It's important to note that these systemic treatments don't just affect the skin, they also have an effect on the body through their immunomodulatory and immunosuppression functions
If none of the previous treatments work and the patient is still suffering from psoriasis symptoms, then biologics drugs are considered. There are many types of biologics for palmoplantar psoriasis, but the most frequently used are Humira (adalimumab) and Remicade (infliximab).
As for treatment for nail psoriasis, it will include the same options as hand psoriasis, but it can take more time to show noticeable improvements; Dr. Duffin says, "It can take months to learn whether a treatment is improving nail symptoms." She adds, "It takes three to six months for nails to regrow entirely, so patients need to be on a treatment continuously for that time for us to know whether it's working."
How You Can Care for Your Hands at Home
Here is a list of the most frequently used remedies for psoriasis on the hands that you can implement in your everyday life:
- Bathing and soaking at the right temperature can go a long way in relieving your hand psoriasis symptoms (the most important tips to follow are to avoid using products with irritating chemicals, dry yourself gently, and apply moisturizers).
- Using a humidifier to reduce dryness is especially important in dry and cold weather.
- Steering clear from hard manual labor and using hands consistently.
- Making a habit out of applying moisturizers to the hands and skin.
- Applying natural remedies with anti-inflammatory properties like aloe vera and essential oils can be very soothing (however, you should speak with your doctor first about which product is right for you).
- Taking supplements with anti-inflammatory and antimicrobial properties can be very helpful as well; these include tea tree oil, raw honey, turmeric, capsaicin, and dead sea salts (similar to applying natural remedies, you should consult with your doctor first before making any changes).
- Practicing mindfulness and meditation can be the best remedy to reduce tension and avoid flareups caused by stress.
- Implementing a healthy diet and light exercise can help with losing weight and avoiding obesity which puts stress on your body and can lead to psoriasis.
Questions to Ask Your Doctor
- What's the best treatment you recommend for me?
- What are the risks and benefits associated with my treatment?
- Is there anything I should do to improve my quality of life?
- How can I prolong my remission period?
- What are the triggers I should avoid?
- How many times should I come for a follow-up visit?
- How can I best manage my flareups?
- Are there any home remedies I can use that will help with my hand psoriasis?
- How can I cope with the stigma of my disease?
The Bottom Line
Hand psoriasis can arguably be one of the most irritating types of psoriasis, owing to the importance of the hands and feet in everyday life and activities. The impact it has on patients' quality of life is undeniable.
Nevertheless, it can be best managed by avoiding triggers and adhering to the treatment regimen prescribed to you by your doctor.