What do Red Palms mean?

‘Red palms’ is a condition marked by abnormally reddish appearance of the palms of hand. It is medically termed as palmar erythema (PE).

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Red palms can occur due to a variety of factors, including severe underlying diseases. In case of the latter, the causative pre-existing disorders may be related to problems of the hormonal system, circulatory system, or the thyroid gland, etc. Hence, it is important for all patients to consult a doctor whenever they experience red palms. Doctors will diagnose the underlying cause and offer relevant treatment.


Some of the common signs and symptoms that occur along with red palms are listed below:

  • The palms elicit a reddish hue. The intensity of redness differs as per pressure on palm, elevation of hand, emotional condition of the patient, and palm/hand temperature.
  • There is no scaling or flaking of skin of palm
  • Red palms are not itchy or painful
  • The hypothenar eminence is the palm region that is commonly affected. But, palmar erythema can also affect the fingers and the thenar eminence area.
  • The skin of red palms is often warm to touch
  • The condition may occur along with plantar erythema, i.e., reddish soles of feet

Causes of red palms

Red palms or palmar erythema can be classified into two types as per the causes. Red palms which develops on its own without any other causative factors is categorized as primary PE, while red palms which occur as symptom of some underlying factor/disease is categorized as secondary PE.

Primary palmar erythema may have inherited or genetic causes. Idiopathic red palms, wherein the triggers or causes are unknown or unidentified are also categorized as primary PE. It may be noted that nearly 50 percent of the cases of red palms have no known causes.

Some of the causes of secondary PE or secondary red palms are mentioned below:

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  • One of the most common causes of red palms is pregnancy. Pregnant women undergo a lot of bodily changes such as alterations in the circulatory system and rise in the levels of estrogen and other hormones. This causes the palms to turn reddish. At least 30 percent of expecting mothers experience skin changes due to the associated hormonal changes in their body.
  • Hepatitis, cirrhosis, hereditary liver diseases like hereditary haemochromatosis and Wilson’s disease, and other kinds of liver problems. Oestradiol and estrogen levels are abnormal in people with chronic liver disease. Also, malfunction in the arteriovenous anastomoses is also observed in such cases.
  • In rare cases, red palms may be caused due to hereditary underlying conditions
  • People with hyperthyroidism, thyrotoxicosis, and other thyroid issues usually have elevated estradiol levels which can cause their palms to become reddish.
  • Dysfunction of the adrenal glands can cause reddish hue of palms
  • Growing tumors that occur along with different kinds of cancers like brain cancer, leukemia, ovarian cancer, and liver cancer, etc., cause the levels of estrogen to rise abnormally; this eventually results in red palms and other symptoms.
  • Rheumatoid arthritis, lupus, and other rheumatological diseases can also trigger secondary PE. Researchers have not been able to find the precise relationship between red palms and rheumatoid arthritis. However, PE affects nearly 60 percent of the patients.
  • Also referred to as reflex sympathetic dystrophy, shoulder-hand syndrome is a condition that adversely affects the body’s upper extremities and occurs along with red palms and inflexibility and pain in hand, shoulders, and fingers.
  • Polycythemia vera and other forms of circulatory disorders
  • Use of certain medicines like oral gemfibrozil (used for lipid level reduction), amiodarone (an antiarrhythmic agent), cholestyramine (sequestrant of bile acid), albuterol (anti-asthma drug suggested for bronchospasms), and topiramate (an anticonvulsant).
  • Diabetes mellitus patients often suffer from red palms that are warm or hot. Some diabetics may not experience complete redness of palms; instead they will have red spots on palms.
  • Alcohol abuse marked by increased intake of alcohol over a long period of time can affect the liver’s health and cause abnormal oestradiol and estrogen levels, which can then trigger red palms.
  • Circulatory issues, in the hands and other areas of the body, caused by smoking for a prolonged period.
  • Use of birth control pills can cause a spike in estrogen levels which can then result in red palms
  • Chronic mercury poisoning or intoxication is known to cause cutaneous and neurological side effects. ‘Red palms’ is one of the associated symptoms.
  • Gestational syphilis or syphilis virus infection in pregnant women can cause a variety of symptoms like red palms, etc.
  • Sarcoidosis is an inflammatory disease that affects many body systems. It causes a wide variety of signs and symptoms and red palms is one of them.
  • Myelopathy, a degenerative disease marked by circulatory issues and pinching of spinal cord, can also cause red palms as a symptom.

Treatment of red palms

Primary PE does not require any treatment.

Treatment of secondary PE is dependent on diagnosis of the underlying causative condition. It is then treated as per set medical procedures. For example, corticosteroids may be prescribed to manage symptoms of auto-immune related disorders.

Quitting smoking, limiting or quitting alcohol, lifestyle changes, eating a healthy diet, and exercising can help prevent red palms.

Palmar Erythema – Pictures

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