Palmar erythema is a rare condition that makes the palms of the hands 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 conditions.

What is palmar erythema?

Palmar erythema causing red palms.
Palmar erythema causes red palms, which may feel slightly warm.

Palmar erythema, often called liver palms, is reddening in both of the palms. Reddening typically occurs on the lower part of the palm (the heel), but sometimes it may extend all the way up through the fingers. Redness may also show up 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 may vary depending on several factors, such as a person’s body temperature, physical activity, and even their emotional state.

Palmar erythema is not a harmful condition. It can be a primary condition with no underlying cause, but it is usually caused by another medical condition. These underlying conditions may be harmful if they are left untreated.

Causes and risk factors

The redness in the palms is caused by dilated capillaries in the hand, which draw more blood to the surface. Many doctors think palmar erythema is linked to hormone changes.

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

Primary palmar erythema

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

Pregnancy is a very common cause of primary palmar erythema. A pregnant woman’s body goes through hormonal changes during pregnancy, causing estrogen levels to rise.

Higher estrogen levels may increase the likelihood of developing palmar erythema. This rise in estrogen is temporary, so redness in the palms will likely disappear after the pregnancy.

In rare cases, genetics may contribute to primary palmar erythema. People who have family members with palmar erythema may be more likely to get the condition themselves.

Palmar erythema may 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

doctor inspecting patients hand, palm, and wrist.
Palmer erythema may be the first obvious symptom of a medical condition.

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 disease.

Some liver conditions are hereditary, while others may be influenced by diet and lifestyle choices, such as drinking alcohol.

Depending on a person’s liver function, some medications may also cause palmar erythema. During diagnosis, a doctor will often ask about any medicines a person is taking to see if the condition is a side effect of any particular drug.

Other conditions may cause the redness in the palms. These include:

  • thyrotoxicosis
  • autoimmune conditions, including rheumatoid arthritis and HIV
  • endocrine conditions, including diabetes
  • hepatitis C
  • skin conditions, such as atopic dermatitis or eczema
  • viral or bacterial infections
  • smoking
  • metastatic brain cancer
  • chronic obstructive lung disease

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

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


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

Some people may notice that their hands feel slightly warmer but are not irritated or swollen. The condition may spread to the fingers but will not spread to anywhere else on the body.

Other symptoms may show up in the body depending on the underlying condition, but palmar erythema typically causes no additional symptoms.


Doctor looking at CT scans on tablet.
In some cases, MRI or CT scans may be required to diagnose an underlying condition.

Doctors can easily diagnose palmar erythema by inspecting the palms. However, doctors will also perform a thorough examination to determine if there is anything else 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 shown up in any blood relatives.

Doctors will typically order one or more tests to help confirm their 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
  • blood creatine levels
  • levels of various antibodies

Depending on the suspected cause of palmar erythema, a doctor may also order imaging tests, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI). In some cases, they may order a bone marrow biopsy.

If initial testing does not verify a doctor’s diagnosis, a person may have to return for additional testing. This is important to help identify any underlying issues that could pose significant health risks.

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


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 in the palms may go away partially or entirely.

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 guidance of a healthcare professional.


Palmar erythema is redness in the palms that may also be a sign of an underlying condition. Anyone with unexplained redness in the palms should contact their doctor for diagnosis and treatment to avoid any complications.

Accurately diagnosing 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 may be persistent but are harmless. It is always good to check in with a doctor periodically if palmar erythema is long-term.