What Is Palmar Erythema?
Have you ever noticed your palms turning red and wondered what it could be? Yes, it is a skin condition called palmar erythema, where the palms of your hands turn red and sometimes feel warm.
If you notice redness in your palms, it is always best to consult a physician to determine the exact cause and treat it appropriately.
Palmar erythema is sometimes referred to as liver palms, red palms, or Lane's disease.
What Does Palmar Erythema Look Like?
If you’re trying to figure out whether you have developed palmar erythema, here is what you might notice:
- Redness on both palms (usually symmetrical).
- More intense redness over the fleshy areas at the base of your thumb and little finger.
- Sometimes redness extends to your fingers.
- The center of your palm may appear slightly less red.
What Are the Causes of Palmar Erythema?
The redness that you notice in your palms occurs because the tiny blood vessels (capillaries) near the surface of your skin become dilated, meaning they widen. When these vessels dilate more than usual, extra blood flows through them, giving your palms a noticeable red appearance.
In some cases, the intensity of the redness can reflect how active or severe an underlying condition is, if one exists. There are several reasons and underlying risk factors that might contribute to palmar erythema, and they differ depending on the type of erythema.
Primary Palmar Erythema:
Primary palmar erythema means the redness in your palms is not caused by another medical condition. It is simply a physical finding, and in many cases, it is completely harmless.
Let us look at why it can happen.
1. Pregnancy:
If you’re pregnant and notice redness in your palms, this is actually quite common. Research has shown that around 30 % of pregnant individuals experience palmar erythema. During pregnancy, your body undergoes significant hormonal changes. One of the key hormones that increases is estrogen. Higher estrogen levels can cause your little capillaries to widen, increasing blood flow to your hands, which is why they appear red. The comforting aspect? This hormonal increase is only brief. When your pregnancy ends, and hormone levels return to normal, the redness normally goes away on its own.
2. Hereditary:
In some cases, palmar erythema can run in families. If you have close relatives with red palms and no underlying illness, you may be more likely to develop it as well. Hereditary palmar erythema is rare, but when it occurs, the redness may:
- Be present from birth.
- Develop later in life.
- Persist long-term.
Importantly, this type is not linked to inflammation, allergic reaction, or other diseases.
3. Idiopathic (No Known Cause):
Sometimes, you might develop palmar erythema without pregnancy, family history, or any detectable health issue. When doctors cannot identify a cause, it is called idiopathic palmar erythema. Idiopathic simply means:
- There’s no known trigger.
- No associated medical condition.
- You are otherwise healthy.
Secondary Palmar Erythema:
Secondary palmar erythema means the redness in your palms is linked to an underlying condition, medication, or environmental factor. In other words, your red palms may be a clue that something else is going on in your body.
Let’s go through the most common causes in a simple way.
1. Liver Disease:
One of the most well-known causes is liver disease. About 23% of people with cirrhosis develop palmar erythema. Cirrhosis happens when your liver becomes heavily scarred and healthy tissue is replaced with scar tissue. Other liver conditions linked to palmar erythema include:
-
Wilson's Disease:
A rare inherited condition where copper builds up in the body.
-
Hereditary Hemochromatosis:
A condition where your body absorbs too much iron.
Interestingly, babies and young children with liver disease are less likely to show palmar erythema compared to teenagers and adults.
2. Autoimmune Diseases:
Autoimmune conditions can also cause red palms. For example, rheumatoid arthritis (an inflammatory condition that causes swollen, painful joints) is strongly associated with palmar erythema. Other autoimmune or inflammatory conditions may also contribute.
3. Diabetes:
If you have diabetes (increased blood sugar levels), your skin may be more prone to infections and slower wound healing. Around four percent of people with type 1 or type 2 diabetes have palmar erythema. While it is not extremely common, it can happen.
4. Thyroid Disease:
Too much thyroid hormone in your blood (a condition called thyrotoxicosis) can also cause red palms. Up to 18% of people with thyrotoxicosis (an increase in circulating thyroid hormone levels) experience palmar erythema.
5. Brain Tumors:
In a study of people with brain tumors, about 25% had palmar erythema. The severity of redness appeared to depend on the tumor type and how fast it was growing.
6. HIV:
There has been at least one reported case linking palmar erythema with HIV (human immunodeficiency virus). However, this appears to be very rare.
7. Medications:
Some medications can trigger palmar erythema as a side effect, including Topiramate, Albuterol (in rare pregnancy-related cases), Amiodarone, Gemfibrozil, and Cholestyramine.
8. Environmental Causes:
Sometimes lifestyle or environmental factors play a role. Possible triggers include smoking, heavy alcohol use, and mercury poisoning. These factors may affect your blood vessels or liver function, leading to redness in the palms.
What Are the Symptoms of Palmar Erythema?
If you have palmar erythema, you may have the following symptoms:
- Redness in both palms.
- Mild warmth.
- Usually, there is no pain.
- No itching.
- No swelling.
In palmar erythema, the “symptoms” are often minimal because it is mostly a visible change rather than an uncomfortable one.
How Is Palmar Erythema Diagnosed?
If you’ve noticed redness in your palms, the first step is actually very simple. Your doctor will look at your hands. In many cases, palmar erythema can be recognized just by examining your palms.
But while identifying it is straightforward, figuring out why it’s happening may take a little more work.
It includes:
- Liver function tests.
- Hepatitis B.
- Thyroid-stimulating hormone.
- Complete blood count.
- Blood urea nitrogen or creatinine.
- Fasting glucose levels.
- Iron levels.
- Hepatitis C
- Copper levels.
Your doctor may also suggest imaging tests such as a CT (computed tomography) scan, an MRI (magnetic resonance imaging), a bone marrow biopsy, or additional antibody tests. These are usually recommended only if initial results point toward something specific.
And what if all your tests come back normal? Then your palmar erythema is considered idiopathic, which simply means there’s no identifiable cause, and that’s often reassuring.
How Is Palmar Erythema Treated?
There is no specific treatment for the redness itself. Management depends on the cause:
- If it’s related to pregnancy, it often resolves after delivery.
- If it is caused by medication, your doctor may adjust your prescription.
- If linked to liver or thyroid disease, treating that condition may improve the redness.
- If it’s hereditary or idiopathic, treatment is usually not necessary.
The good news is that palmar erythema itself is generally harmless.
Conclusion
Palmar erythema is a condition where you will notice redness in the palms of your hands. The condition can arise for various reasons or without any cause at all, which we call idiopathic palmar erythema. Treating palmar erythema involves treating the underlying condition or changing the medication that may be causing it. In case of pregnancy, it will resolve on its own after your pregnancy period. If you experience any symptoms related to this condition, you can consult a skin doctor to identify what exactly causes it and begin the treatment.
Key Takeaways
- Palmar erythema is a skin condition in which the palms of the hands turn red due to increased blood flow.
- Symptoms include redness in the palms (both hands), and they may feel warm.
- Diagnosis includes physical examination and various tests to determine the underlying cause.
- Treatment depends on what exactly is causing the condition.
