Caring for your hands and feet

Psoriais on the palms of your hands or the soles of your feet is often referred to as palmoplantar psoriasis, characterized by redness and scaling in these areas. You may develop pustules (white, pus-filled blisters) in addition to the redness and scaling, in which case your condition is called palmoplantar pustulosis. It’s unclear whether palmoplantar pustulosis is a form of psoriasis but sometimes those with palmoplantar pustulosis will also have psoriasis in other areas.

Either way, the presence of psoriasis on the hands and feet can create an impact beyond the outward physical effects. With this condition, some people may find they cannot pursue certain athletic activities, or some may find difficulty following their chosen career path (if your profession requires that your hands and feet be in the best condition possible). As with other chronic health problems, it's important to treat and manage psoriasis in all its forms as best you can to help minimize its effects on other areas of your life.

To treat psoriasis on your hands and feet, your doctor may recommend a topical (skin-applied) corticosteroid. If need be, a high-potency topical corticosteroid may be used if your skin does not respond to the initial treatment. Hands and feet can tolerate a higher strength medication than some other, more delicate areas of the body. Corticosteroids can come in both cream and ointment options. Creams are less greasy and useful in areas where there is a lot of movement or shifting, whereas ointments penetrate dry and scaly skin more effectively. Other skin-applied medications include coal tar or salicylic acid, vitamin D derivatives and calcineurin inhibitors, which can be used on its own or in combination with corticosteroids.

In more serious cases, other medications such as methotrexate or cyclosporine (called systemics, as they are absorbed into the bloodstream and carried throughout the body and its systems) may be taken by mouth. Acitretin (another systemic, also taken by mouth) may offer particular help for pustular psoriasis. There are also newer systemic options called biologics (injections or infusions given at certain intervals that target specific immune responses) that are effective and have fewer side effects. However, you should know that many systemic medications carry the risk of serious side effects, so make sure to ask your doctor any questions you may have about this type of treatment.

Light therapy is another option that may offer relief (sometimes in combination with other medications) for psoriasis scaling on your hands and feet.

For further information on treatment, or for resources to help manage the impact of this condition, talk to your doctor or pharmacist.

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