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Treating Psoriasis on the Hands or Feet

If you have an acute psoriasis flare-up on your hands or feet, see your doctor ASAP. He'll work with you until you find something that helps.

Psoriasis on these areas is most likely to show up on the palms and soles. This is called palmar-plantar psoriasis. But it can also appear on the tops of your feet, backs of your hands, and on knuckles and nails.

Small Area, Big Impact

Your hands and feet make up only 4% of your body's total surface area. But psoriasis here can still have a big effect on your quality of life. You might have pain, or you may just want to cover up the scales. If it affects your work, that could lead to a financial burden as well.

Hands and feet psoriasis (HFP) can also cause your skin to:

  • Crack or split
  • Thicken
  • Redden
  • Scale
  • Swell
  • Blister or have pimple-like spots (pustules)

Medications That Treat Your Skin

Here are some common ways to treat psoriasis on the hands and feet and relieve your symptoms.

In addition to moisturizers, mild soaps, and soap substitutes, your doctor may recommend:

  • Coal tar products, like creams, gels, or ointments, to slow skin growth and ease itchy, inflamed, or scaly skin
  • Salicylic acid, a peeling agent that softens or reduces thick scales
  • Corticosteroids, often creams and ointments

Combinations of these often work better than one treatment alone. Sometimes doctors suggest alternating or using topical corticosteroids with a type of vitamin D called calcipotriene. This medicine should not be used on the face, so be sure to wear gloves when applying to your hands and feet in order to avoid getting it on your face later. 

Your doctor might have you use a corticosteroid under a type of dressing called hydrocolloid occlusion. This filmy layer bonds to the cream, helps keep skin moist, and can be worn for several days.

Medications That Stop Disease Progress

Psoriasis is an immune system condition, so if skin treatments don’t work, your doctor may recommend drugs that affect the disease at a cellular level. These include:

  • Cyclosporine, to slow down your overactive immune system
  • Low-dose retinoids like acitretin (Soriatane), to reduce cell multiplication
  • Methotrexate, which slows an enzyme that causes the rapid growth of skin cells in psoriasis

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