Psoriasis on hands: what to know

Hand psoriasis may affect the palms, backs of the hands, fingers or skin beside the nails. Palms can develop thick, sharply defined areas that feel rough and split with bending or gripping. Other patches may be itchy, red or covered by scale. Repeated exposure to water, detergents, solvents or friction can aggravate already-irritated skin. Eczema, allergic contact dermatitis and fungal infection can produce similar findings, so location and appearance alone do not confirm psoriasis. Psoriasis is an inflammatory skin condition and is not contagious.

Wash with lukewarm water and a mild, fragrance-free cleanser, then pat dry rather than rubbing. Apply a thick moisturiser immediately afterwards and reapply when the skin feels tight. Use protective gloves for cleaning or prolonged wet work, and avoid wearing them for so long that sweat builds up. Keep cracks covered with a clean dressing when practical. Do not scratch, peel scale or use strong acids without medical advice. A clinician may choose a topical medicine based on whether the problem is on the palm, between fingers or near the nails.

Arrange a review when hand changes persist, spread, crack often or make work and sleep difficult. Get prompt care for pus, spreading redness, marked warmth, rapidly increasing pain or fever. Swollen fingers, morning stiffness or reduced grip should be assessed because psoriasis can accompany joint inflammation. If symptoms began after a new product or glove, mention that timing; contact irritation may need different care.

Which condition best explains the hand changes? What should I apply to thick palms or open cracks? How can I protect my hands at work? Do my finger stiffness or swelling need a joint assessment?