Palmar Erythema: Definition, Causes, Risk Factors, Symptoms, Diagnosis, Treatment and Overview

It is a rare condition that causes the palms of the hands to turn red.

There are a few different causes for the condition, such as pregnancy and liver cirrhosis.

Anyone experiencing the symptoms of palmar erythema should contact their doctor for diagnosis and treatment of any underlying condition.

Palmar erythema causes red palms, which may feel a little warm.

Palmar erythema, often called liver palms, is a condition where both palms become red.

The redness typically occurs on the underside of the palm but can sometimes extend up through the fingers.

Redness can also appear on the soles of the feet, but this is called plantar erythema.


The redness may resemble a rash, and the skin will turn pale when pressed.

The degree of redness can vary depending on several factors, such as body temperature, physical activity, and even your emotional state.

Palmar erythema is not a harmful condition. It can be a primary condition with no underlying cause but is usually caused by another medical condition.

These underlying conditions can be harmful if left untreated.

Causes and risk factors of palmar erythema

The redness of the palms is caused by the enlarged capillaries in hand, which draw more blood to the surface.

Many doctors think that palmar erythema is related to hormonal changes.

There are a variety of underlying causes and risk factors that can contribute to palmar erythema, and they vary depending on the type of erythema.

Primary palmar erythema

Primary palmar erythema is a physical symptom that is not caused by another condition. There are some risk factors for developing the disease.

Pregnancy is a prevalent cause of primary palmar erythema. The body of a pregnant woman undergoes hormonal changes during pregnancy, causing increased estrogen levels.

Higher levels of estrogen can increase the chance of developing palmar erythema.

This increase in estrogen is temporary, so the redness of the palms is likely to disappear after pregnancy.

In rare cases, genetics can contribute to primary palmar erythema.

People who have family members with palmar erythema may be more likely to have the condition.

Palmar erythema can also be idiopathic.

This means that there is no known cause and that doctors cannot find any underlying trigger for the symptom.

Secondary palmar erythema

As a secondary symptom, palmar erythema is linked to many different conditions and is often the first sign of a medical problem.

Palmar erythema is commonly associated with liver diseases, such as liver cirrhosis, hemochromatosis, and Wilson’s disease.

Some liver conditions are inherited, while others can be influenced by diet and lifestyle, such as alcohol consumption.

Depending on a person’s liver function, some medications can also cause palmar erythema.

During diagnosis, a doctor often asks about the medications a person takes to see if the condition is a side effect of any particular drug.

Other conditions that can cause redness of the palms include:

  • Thyrotoxicosis.
  • Autoimmune diseases, including rheumatoid arthritis and HIV.
  • States, including diabetes.
  • Hepatitis C.
  • Skin conditions, such as atopic dermatitis or eczema.
  • Viral or bacterial infections,
  • The habit of smoking.
  • Metastatic brain cancer.
  • Chronic obstructive pulmonary disease.

When palmar erythema appears in children, it can be linked to different conditions. The most common of these conditions include:

  • Congenital syphilis.
  • Wilson’s disease.
  • Poisoning.
  • Hepatopulmonary hypertension.
  • Kawasaki disease.

Children can also develop palmar erythema due to a genetic predisposition.


Palmar erythema is characterized by the redness of the palms of the hands. This redness appears on both hands and is not painful or itchy.

Some people may find that their hands feel warmer but are not irritated or swollen. The condition can spread to the fingers but will not apply to any other body part.

Other symptoms may appear on the body depending on the underlying condition, but palmar erythema usually does not cause additional symptoms.

Diagnosis of palmar erythema

Doctors can quickly diagnose palmar erythema by inspecting the palms. However, doctors will also conduct a thorough examination to determine if something else is causing the condition.

To help them with their diagnosis, a doctor will review the person’s medical history and may ask if the symptom has appeared in any blood relatives.

Doctors will usually order one or more tests to help confirm your diagnosis. This can include tests that measure:

Liver function

  • Fasting glucose levels.
  • Total blood cell count.
  • The presence of hepatitis B or C.

Thyroid function

  • Iron or copper levels.
  • Blood urea nitrogen.
  • Creatine levels in the blood.
  • Groups of various antibodies.

Depending on the suspected cause of palmar erythema, the doctor may also order imaging tests, such as a CT scan or an MRI scan. In some cases, they may request a bone marrow biopsy.

If initial tests do not verify a doctor’s diagnosis, the person may need additional tests.

This is important to help identify any underlying problems that may pose significant health risks.

Doctors will usually only conclude that palmar erythema is idiopathic if they have tried all other possibilities.

Treatment of palmar erythema

There is no specific treatment to cure red palms caused by palmar erythema.

Treatment involves finding and addressing the underlying cause of the condition. Once the underlying cause is treated, the redness of the palms may partially or wholly disappear.

If the redness is a side effect of a medication, doctors may recommend alternative medications.

Changing or stopping medications should always be done under the supervision of a healthcare professional.


Palmar erythema is redness on the palms that can also indicate an underlying condition.

Anyone with unexplained redness on the palms should contact their doctor for diagnosis and treatment to avoid complications.

An accurate diagnosis of the underlying cause of palmar erythema is crucial but may take some time.

Treating the underlying cause of palmar erythema will often reduce symptoms.

In cases where palmar erythema has no underlying cause, symptoms can be persistent but harmless.

It is always good to see a doctor regularly if palmar erythema is long-term.